Living Donor Protection Act of 2021

TriCare Issue with Express Scripts Rural Emergency Hospital REH Model Sequestration ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

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

H.R. 8594/S. 4750, the Restore Protections for Dialysis Patients Act H.R. 7845/ the NIH Clinical Trial Diversity Act H.R. 1255/S. 377, the Living Donor Protection Act H.R. 1676, the Jack Reynold Medigap Expansion Act H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021 Health disparities S. 1002, the Junk Plan Accountability and Disclosure Act of 2021 H.R. 4065/S. 1971, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2021. H.R. 3893, the CARE for All Kidneys Act FY 2023, Labor-HHS-Education Appropriations Act H.R. 7585, the Health Equity and Accountability Act of 2022 (HEAA) H.R. 5801, the Help Ensure Lower Patient (HELP) Copays Act H.R. 7667, the Food and Drug Amendments of 2022 H.R. 7506, the New Era for Preventing End-Stage Kidney Disease Act of 2022 Medicare Program; Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and Other Revisions to Medicare Enrollment and Eligibility Rules Diversity Plans To Improve Enrollment of Participants From Underrepresented Racial and Ethnic Populations in Clinical Trials; Draft Guidance for Industry Request for Information on ways to strengthen and improve the Organ Procurement and Transplantation Network

Client expense: $160,000 · Firm income: Not reported

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

Covid-19 recovery and response efforts for ESRD patients. HR 1676 - The Jack Reynolds Memorial Medigap Expansion Act HR 1255 - Living Donor Protection Act of 2021 S. 377 - Living Donor Protection Act of 2021 HR 3893 - CARE for All Kidneys Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Living Donor Protection Act (H.R. 1255/S. 377); Issues related to health care working staffing shortages; Dental coverage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Home dialysis/home therapies issues; H.R. 5426 - Improving Access to Dialysis Act; H.R. 4065 and S. 1971 - Chronic Kidney Disease Improvement Act; H.R. 2903 and S. 1512 - CONNECT Act; H.R. 1255 and S. 377 - Living Donor Protection Act; H.R. 2568 and S. 1220 - US Cadet Nurse Corps Service Recognition Act.

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

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

Issues and legislation relating to kidney disease. Policies that impact kidney care providers and patients. 2022 Labor, HHS, Education and Related Agencies Appropriations bill (KidneyX Program) S.1971 and H.R.4065 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 S.377 and H.R.1255 - Living Donor Protection Act of 2021 S. 4750 and H.R. 8594 Restore Protections for Dialysis Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 1255/S. 377, The Living Donor Protection Act of 2021 H.R. 2617, Consolidated Appropriations Act, 2023, issues related to health care H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 5376, Build Back Better Act, provisions relating to health care H.R. 5585, Advanced Research Project Agency Health Act H.R. 6000, Cures 2.0 Act S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 Implementation of Executive Order 13879, Advancing American Kidney Health.

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

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

Issues relating to End Stage Renal Disease (ESRD) and Chronic Kidney Disease (CKD); S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021; H.R. 4065, To improve the understanding of, and promote access to treatment for, chronic kidney disease, and for other purposes; End-Stage Renal Disease (ESRD) payment reform and quality metrics; S. 377/H.R. 1255, Living Donor Protection Act; H.R. 1676, Jack Reynolds Memorial Medigap Expansion Act H.R. 3893, Coordination, Accountability, Research and Equity for All Kidneys Act of 2021 (CARE for All Kidneys Act); H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act; End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and utilization of calcimimetic drugs; Medicare Secondary Payer; H.R. 7878/S. 4307 Kidney Health Connect Act of 2022; Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Final Rule (CMS-1768-F); H.R. 8594/S. 4750, Restore Protections for Dialysis Patients Act

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

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

Charitable premium assistance and end-stage renal disease issues; H.R. 1255/S. 377 Living Donor Protection Act; CARE for All Kidneys Act (H.R. 3893)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Living Donor Protection Act (H.R. 1255/S. 377); Issues related to health care working staffing shortages; Dental coverage.

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

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

Initiatives to increase, improve and facilitate organ donation and transplantation. S. 377 and H.R. 1255, the "Living Donor Protection Act," to prohibit discrimination in the issuing, pricing, and benefits level of life, disability or long-term care insurance for living organ donors. H.R. 7506, "The New Era of Preventing End Stage Renal Disease Act." Activities to address COVID-19 impact and needs of kidney patients and caregivers, including supply change disruptions; prioritization for access to vaccination for dialysis patients and kidney transplant recipients; and, priority access to specific COVID-19 prescriptions. Letter to HHS Advisory Committee of Blood and Tissue Safety re: HIV Organ Policy Equity (HOPE) Act of 2013. Letter to FDA in support of the Kidney Health Initiative and Kidney Innovation Accelerator (KidneyX). Healthy People 2030. Activities regarding the HHS Advancing American Kidney Health Initiative. Initiatives to address ethnic, racial and social disparities in health care and in chronic kidney disease detection, prevention, management and care. Activities included H.R. 7585, the Health Equity and Accountability Act (HEAA). H.R. 5030/S.2706, DIVERSE Trials Act to address clinical trails participation barriers by underrepresented patient populations. H.R. 7667, PDUFA reauthorization (support for clinical trial diversity provisions). Expand access to telemedicine. Support for limits on insulin prices for consumers. Prescription drug pricing and access. Affordable Care Act access and utilization, including comments on the ACA Nondiscrimination Proposed Rule.

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

Government targets: Centers For Disease Control & Prevention (CDC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Assist the Administration during Covid-19 epidemic on how to help and protect dialysis patients; Urge Congress to provide access to Medigap for all ESRD patients under 65 years of age - (H.R. 1676) - The Jack Reynolds Memorial Medigap Expansion Bill; Protect organ donors by urging passage of the Living Donor Protection Act of 2021 (H.R. 1255/S. 377); Protect dialysis patient access to charitable premium assistance; Ensure ESRD patients retain access to private insurance; Support ESRD care coordination - The BETTER Kidney Care Bill (H.R. 4942/S. 2649); Encourage support for improved kidney research and treatment; Support increased oversight of Organ Procurement Organizations; Support the Chronic Kidney Disease Improvement in Research and Treatment Act (H.R. 4065/S. 1971); Assist the Administration about Prioritizing Prevention, Home Dialysis; and Urge Congress to protect access to private insurance H.R. 8594/S. 4750 - The Restore Protections for Dialysis Patients Act.

Client expense: $450,000 · Firm income: Not reported

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

ISSUEDiversity, Equity, and Inclusion Initiatives ISSUEPaid Medical and Family Leave ISSUENational Data Privacy Standard ISSUESystemic Risk/Capital Standards PL 111-203, Dodd-Frank Wall Street Reform and Consumer Protection Act - provide financial regulatory reform, to protect consumers and investors, to enhance federal understanding of insurance issues, and other purposes. ISSUEAutonomous Vehicles ISSUE Federal Pandemic Risk Programs ISSUE Insurance Underwriting HR 842/S 420, Protecting the Right to Organize (PRO) Act - amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959, and for other purposes. HR 528, Financial Stability Oversight Council (FSOC) Reform Act - place FSOC and the Office of Financial Research under the regular appropriations process and to provide for certain quarterly reporting and public notice and comment requirements for the Office of Financial Research. HR 1523/S 526, Modern Worker Empowerment Act - to amend the Fair Labor Standards Act of 1938 to harmonize the definition of employee with the common law. HR 5, Equality Act - prohibits discrimination based on sex, sexual orientation, and gender identity in areas including public accommodations and facilities, education, federal funding, employment, housing, credit, and the jury system. HR 1277/S 374, Improving Corporate Governance Through Diversity Act - prohibits an automobile insurer from considering specified factors when determining a consumer's insurance rates or eligibility. HR 1270, PAID Act - prohibits an automobile insurer from considering specified factors when determining a consumer's insurance rates or eligibility. HR 1255/S 377, Living Donor Protection Act - promote and protect from discrimination living organ do HR 1816, Information Transparency & Personal Data Control Act - require the Federal Trade Commission to promulgate regulations related to sensitive personal information, and for other purposes. HR 1512, CLEAN Future Act - build a clean future by addressing the climate crisis, protecting the health, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050. S 524, Federal Insurance Abolishment Act - to eliminate the Federal Insurance Office. HR 1549/S 588, Addressing Climate Financial Risk Act - establish the Advisory Committee on Climate Risk on the Financial Stability Oversight Council. HR 1641/S 638, Promoting Infrastructure by Protecting Our Subcontractors and Taxpayers Act - to include a payment and performance security requirement for certain infrastructure financing. HR 1187, ESG Disclosure Simplification Act of 2021 - requires an issuer of securities to annually disclose to shareholders certain environmental, social, and governance metrics. S 653, Coordination of Medicare Payments and Workers Compensation (COMP) Act - provide for the application of MSP rules to certain workers' compensation settlement agreements and qualified Medicare set-aside provisions. HR 2068/S 862, CLAIM Act - safe harbor for insurers engaging in the business of insurance in connection with a cannabis-related legitimate business. HR 1996/S 910, SAFE Banking Act - create protections for financial institutions that provide financial services to cannabis-related legitimate businesses S 574, PROTECT Asbestos Victims Act - improve asbestos trust claim transparency. S 840, Litigation Funding Transparency Act - increase transparency and oversight of third-party litigation funding. HR 358, FRESH Trucking Act - modifies service hour requirements for drivers transporting perishable agricultural, horticultural, or floricultural commodities. HR 1799, PPP Extension Act of 2021 - extend deadlines for the Paycheck Protection Program. HR 2467 PFAS Action Act of 2021 -- require EPA to designate per- and polyfluoroalkyl substances as hazardous substances HR 2570/S 1217 Climate Risk Disclosure Act of 2021 -- directs SEC to require issuers to disclose information regarding climate change-related risks. HR 2001 Diversity Data Accountability Act - requires regulated entities to report to the Offices of Women and Minority Inclusion within specified financial agencies. HR 1087 Shareholder Political Transparency Act -- requires disclosure of information related to expenditures for political activities HR 3099 Primary Regulators of Insurance Vote Act -- To include the State insurance commissioner as a voting member of the FSOC. HR 3962/S 1625 SECURE Notarization Act -- To authorize notaries public to perform, and to establish minimum standards for, electronic notarizations and remote notarizations S 1805SHELTER Act -- allows a tax credit to individuals and businesses for disaster mitigation expenditures. S 1896Algorithmic Justice and Online Platform Transparency Act -- To prohibit the discriminatory use of personal information by online platforms in any algorithmic process HR 3571/S 1876 Climate Change Financial Risk Act of 2021 -- To require the Fed to develop and conduct financial risk analyses relating to climate change, and for other purposes. HR 3664 SMART Act -- to provide for an exception from patent infringement for certain component parts of motor vehicles. HR 3676 To amend title 23, United States Code, to establish national standards relating to sanctions for individuals who drive a motor vehicle, with a child passenger in the vehicle, while intoxicated or impaired, and for other purposes. HR 3711 SELF DRIVE Act -- to provide safety measures for over highly automated vehicles HR 1187 Corporate Governance Improvement and Investor Protection Act - to require annual disclosure of certain ESG metrics. HR 3675 Drug-Impaired Driving Education Act -- To establish a grant program to educate the public on the dangers of drug-impaired driving, and for other purposes. HR 3757/S 1999 Multiple Substance Impaired Driving Prevention Act -- To authorize the use of certain Federal funds for multiple substance impaired driving countermeasures HR 3899 Financial Stability Oversight Council Improvement Act of 2021 -- To amend the Financial Stability Act of 2010 to require the Financial Stability Oversight Council to consider alternative approaches before determining that a U.S. nonbank financial company shall be supervised by the Board of Governors of the Federal Reserve System, and for other purposes. DRAFT Consumer Information Notification Requirement Act -- to provide a national standard for financial institution data security and breach notification. S 919 Data Care Act of 2021 -- imposes various duties on online service providers with respect to their handling of individual-identifying data 4614 Resilient Federal Forests Act of 2021 - improve forest management activities on National Forest System lands HR 4866 Federal Insurance Office Elimination Act - to abolish FIO HR 5823, Pandemic Risk Insurance Act (PRIA) 2022 - establish a Pandemic Risk Reinsurance Program HR 5736, Booster Seat Safety Act - direct the Secretary of Transportation to revise regulations relating to child restraint systems HR 5807/S 3065, DATA Privacy Act - establishes information security requirements for businesses that collect, process, store, or disclose information HR 963, Forced Arbitration Injustice Repeal Act - prohibits a pre-dispute arbitration agreement from being valid or enforceable if it requires arbitration of an employment, consumer, antitrust, or civil rights dispute HR 5734, Catastrophic Risk Transfer (CART) Act - to establish a system for the taxation of catastrophic risk transfer companies to ensure sufficient capital to cover catastrophic insurance losses HR 5689, Resilient AMERICA Act - improve the provision of Federal resources to help build capacity and fund risk-reducing, cost-effective mitigation projects HR 4006 Fair Repair Act -- requires an original equipment manufacturer (OEM) to make diagnostic, maintenance, and repair equipment available to independent repair providers HR 6580/S 3572 Algorithmic Accountability Act of 2022 -- direct the Federal Trade Commission to require impact assessments of automated decision systems and augmented critical decision processes HR 6570 REPAIR Act -- ensure consumers have access to data relating to their motor vehicles, critical repair information, and tools, and to provide them choices for the maintenance, service, and repair of their motor vehicles HR 4521 America COMPETES Act -- bill addresses U.S. technology and communications, foreign relations and national security, domestic manufacturing, education, trade, and other matters HR 4777/S 2497 Nondebtor Release Prohibition Act -- addresses the release by bankruptcy courts of creditor or other third-party claims against non-debtors S 3844Economic Continuity and Stability Act -- establish a clear and uniform process, on a nationwide basis, for replacing the London interbank offered rate in existing contracts S 3715E-SIGN Modernization Act -- repeals certain requirements regarding the use of electronic records in commerce S 3755Arbitration Fairness for Consumers Act -- amend the Consumer Financial Protection Act of 2010 with respect to arbitration HR 6027 Online Privacy Act -- establishes certain online privacy rights for personal information (including contents of communications) and certain requirements for data processors, service providers, and third parties S 3875, Community Disaster Resilience Zones Act -- require the President to develop and maintain products that show the risk of natural hazards across the United States DRAFT, Jumpstart our Business Startups Act of 2022 -- help accelerate economic growth and spur new business formation S 4110, Primary Regulators of Insurance Vote Act of 2022 -- establishes a state insurance commissioner as a voting member of the Financial Stability Oversight Council S 4299, Rebuilding Small Businesses After Disasters Act -- to repeal the sunset for collateral requirements for Small Business Administration disaster loans S 4274, National Wildland Fire Risk Reduction Program Act -- improve the Federal effort to reduce wildland fire risks ISSUE, SEC 144A/Rule 15c2-11 No Action Letter ISSUE, ESG, DEI, Climate-Related Financial Risk HR 8152, American Data Privacy and Protection Act - to create a federal privacy standard DRAFT, Rep. McHenry/Financial Services Privacy Draft - to amend GLBA HR 8063, RAMP Act - to improve MSP statute by eliminating the private right of action HR 8254 Financial Services and General Government Appropriations Act, 2023 - FY2023 appropriations for several federal departments and agencies HR 7900 National Defense Authorization Act for Fiscal Year 2023 - authorizes Department of Defense (DOD) activities for FY2023 HR 4346 CHIPS and Science Act of 2022 - funds to support the domestic production of semiconductors and authorizes various programs and activities of the federal science agencies. S 4619 Fair Access to Financial Services Act - provide that all persons shall be entitled to the full and equal enjoyment of the goods, services, facilities, privileges, and accommodations of financial institutions HR 8589 To prohibit the Securities and Exchange Commission from finalizing the proposed rule titled "The Enhancement and Standardization of Climate-Related Disclosures for Investors", and for other purposes - prevent finalization of SEC climate-risk disclosure rule HR 2123 D&I DATA Act - requires certain regulated entities to report to the Offices of Women and Minority Inclusion within specified financial agencies ISSUE SEC Rule 144A/15c2-11 HR 8483 Wildfire Insurance Coverage Study Act of 2022 - require studies regarding insurance coverage for damages from wildfires DRAFT Diverse Investment Advisers Act - require companies to consider diverse individual-owned and controlled firms when seeking the services of investment advisers DRAFT Minority and Women Inclusion in Insurance Act - require FIO to conduct an annual survey of insurers to determine the extent of diversity in the insurance industry DRAFT Diversify Insurers Workforce Study Act - require FIO to conduct a study regarding recruitment, retention, and attrition of employees in the insurance industry S 4826 Community Wildfire Protection Act- amend the Heathy Forests Restoration Act of 2003 to modify the definition of the term at-risk community HR 9570 Improving Disclosure for Investors Act of 2022 - direct the Securities and Exchange Commission to promulgate rules with respect to the electronic delivery of certain required disclosures HR 7776 James M. Inhofe National Defense Authorization Act for Fiscal year 2023 - National defense authorization for FY 23 HR 9588 Consumer Information Notification Requirement Act (CINRA) - amend the Gramm-Leach-Bliley Act to provide a national standard for financial institution data security and breach notification on behalf of all consumers

Client expense: $810,000 · Firm income: Not reported

Government targets: Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Postal Service (USPS)

Appropriations for the KidneyX initiative; Advocate for passage of the Living Donor Protection Act S.377 and HR 1255

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Assist the Administration during Covid-19 epidemic on how to help and protect dialysis patients; Urge Congress to provide access to Medigap for all ESRD patients under 65 years of age - (H.R. 1676) - The Jack Reynolds Memorial Medigap Expansion Bill; Protect organ donors by urging passage of the Living Donor Protection Act of 2021 (H.R. 1255/S. 377); Protect dialysis patient access to charitable premium assistance; Ensure ESRD patients retain access to private insurance; Support ESRD care coordination - The BETTER Kidney Care Bill (H.R. 4942/S. 2649); Encourage support for improved kidney research and treatment; Support increased oversight of Organ Procurement Organizations; Support the Chronic Kidney Disease Improvement in Research and Treatment Act (H.R. 4065/S. 1971); Assist the Administration about Prioritizing Prevention, Home Dialysis; and Urge Congress to protect access to private insurance H.R. 8594/S. 4750 - The Restore Protections for Dialysis Patients Act.

Client expense: $400,000 · Firm income: Not reported

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

FY23 Congressional appropriations: -Increase NIH funds, including $632 million increase for NIDDK to support kidney research and prioritizing research to improve the diagnosis of kidney diseases and health equity interventions -Provide $25 million to KidneyX to continue development of an artificial kidney and other innovations innovative kidney therapeutics and technologies -Support CDC Chronic Kidney Disease Initiative at $15 million Other: -Enact the Living Donor Protection Act (HR1255 S377) -Enact the Restore Protections for Dialysis Patients Act (HR8594/S4750) -Enact the Jack Reyonlds Medigap Expansion Act (HR1676) -Enact the Improving Access to Home Dialysis Act of (HR5426) -Enact the Medical Nutrition Therapy Act (HR3108 S1536) -Enact the Health Equity and Accountability Act (HR7585) -Increase transparency and accountability in the US transplant system -Address Clinical Labor Cuts impacting vascular access in FY 23 Medicare Physician Fee Schedule

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

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

Covid-19 recovery and response efforts for ESRD patients. HR 1676 - The Jack Reynolds Memorial Medigap Expansion Act HR 1255 - Living Donor Protection Act of 2021 S. 377 - Living Donor Protection Act of 2021 HR 3893 - CARE for All Kidneys Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 1255/S. 377, The Living Donor Protection Act of 2021 H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 5376, Build Back Better Act, provisions relating to health care H.R. 5585, Advanced Research Project Agency Health Act H.R. 6000, Cures 2.0 Act S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 Implementation of Executive Order 13879, Advancing American Kidney Health.

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

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

H.R. 8594/S. 4750, the Restore Protections for Dialysis Patients Act H.R. 7845/ the NIH Clinical Trial Diversity Act H.R. 1255/S. 377, the Living Donor Protection Act H.R. 1676, the Jack Reynold Medigap Expansion Act H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021 Health disparities S. 1002, the Junk Plan Accountability and Disclosure Act of 2021 H.R. 4065/S. 1971, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2021. H.R. 3893, the CARE for All Kidneys Act FY 2023, Labor-HHS-Education Appropriations Act H.R. 7585, the Health Equity and Accountability Act of 2022 (HEAA) H.R. 5801, the Help Ensure Lower Patient (HELP) Copays Act H.R. 7667, the Food and Drug Amendments of 2022 H.R. 7506, the New Era for Preventing End-Stage Kidney Disease Act of 2022 Medicare Program; Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and Other Revisions to Medicare Enrollment and Eligibility Rules Diversity Plans To Improve Enrollment of Participants From Underrepresented Racial and Ethnic Populations in Clinical Trials; Draft Guidance for Industry Request for Information on ways to strengthen and improve the Organ Procurement and Transplantation Network

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

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

Appropriations for the KidneyX initiative; Advocate for passage of the Living Donor Protection Act S.377 and HR 1255

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Initiatives to increase, improve and facilitate organ donation and transplantation. S. 377 and H.R. 1255, the "Living Donor Protection Act," to prohibit discrimination in the issuing, pricing, and benefits level of life, disability or long-term care insurance for living organ donors. H.R. 7506, "The New Era of Preventing End Stage Renal Disease Act." Activities to address COVID-19 impact and needs of kidney patients and caregivers, including supply change disruptions; prioritization for access to vaccination for dialysis patients and kidney transplant recipients; and, priority access to specific COVID-19 prescriptions. Issued Position Statement on White House Conference on Hunger, Nutrition, and Health. Healthy People 2030. Activities regarding the HHS Advancing American Kidney Health Initiative. Initiatives to address ethnic, racial and social disparities in health care and in chronic kidney disease detection, prevention, management and care. Activities included H.R. 7585, the Health Equity and Accountability Act (HEAA). H.R. 5030/S.2706, DIVERSE Trials Act to address clinical trails participation barriers by underrepresented patient populations. H.R. 7667, PDUFA reauthorization (support for clinical trial diversity provisions). Expand access to telemedicine. Support for limits on insulin prices for consumers. Prescription drug pricing and access. Affordable Care Act access and utilization.

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

Government targets: Centers For Disease Control & Prevention (CDC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Issues and legislation relating to kidney disease. Policies that impact kidney care providers and patients. 2022 Labor, HHS, Education and Related Agencies Appropriations bill (KidneyX Program) S.1971 and H.R.4065 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 S.377 and H.R.1255 - Living Donor Protection Act of 2021 S. 4750 and H.R. 8594 Restore Protections for Dialysis Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Living Donor Protection Act (H.R. 1255/S. 377); Issues related to health care working staffing shortages; Dental coverage.

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

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

Living Donor Protection Act (H.R. 1255/S. 377); Issues related to health care working staffing shortages; Dental coverage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to End Stage Renal Disease (ESRD) and Chronic Kidney Disease (CKD); S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021; H.R. 4065, To improve the understanding of, and promote access to treatment for, chronic kidney disease, and for other purposes; End-Stage Renal Disease (ESRD) payment reform and quality metrics; S. 377/H.R. 1255, Living Donor Protection Act; H.R. 1676, Jack Reynolds Memorial Medigap Expansion Act H.R. 3893, Coordination, Accountability, Research and Equity for All Kidneys Act of 2021 (CARE for All Kidneys Act); H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act; End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and utilization of calcimimetic drugs; Medicare Secondary Payer; H.R. 7878/S. 4307 Kidney Health Connect Act of 2022; Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule, issued 6/21/22; H.R. 8594/S. 4750, Restore Protections for Dialysis Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Charitable premium assistance and end-stage renal disease issues; H.R. 1255/S. 377 Living Donor Protection Act; CARE for All Kidneys Act (H.R. 3893)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Home dialysis/home therapies issues; H.R. 5426 - Improving Access to Dialysis Act; H.R. 4065 and S. 1971 - Chronic Kidney Disease Improvement Act; H.R. 2903 and S. 1512 - CONNECT Act; H.R. 1255 and S. 377 - Living Donor Protection Act; H.R. 2568 and S. 1220 - US Cadet Nurse Corps Service Recognition Act.

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

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

ISSUEDiversity, Equity, and Inclusion Initiatives ISSUEPaid Medical and Family Leave ISSUENational Data Privacy Standard ISSUESystemic Risk/Capital Standards PL 111-203, Dodd-Frank Wall Street Reform and Consumer Protection Act - provide financial regulatory reform, to protect consumers and investors, to enhance federal understanding of insurance issues, and other purposes. ISSUEAutonomous Vehicles ISSUE Federal Pandemic Risk Programs ISSUE Insurance Underwriting HR 842/S 420, Protecting the Right to Organize (PRO) Act - amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959, and for other purposes. HR 528, Financial Stability Oversight Council (FSOC) Reform Act - place FSOC and the Office of Financial Research under the regular appropriations process and to provide for certain quarterly reporting and public notice and comment requirements for the Office of Financial Research. HR 1523/S 526, Modern Worker Empowerment Act - to amend the Fair Labor Standards Act of 1938 to harmonize the definition of employee with the common law. HR 5, Equality Act - prohibits discrimination based on sex, sexual orientation, and gender identity in areas including public accommodations and facilities, education, federal funding, employment, housing, credit, and the jury system. HR 1277/S 374, Improving Corporate Governance Through Diversity Act - prohibits an automobile insurer from considering specified factors when determining a consumer's insurance rates or eligibility. HR 1270, PAID Act - prohibits an automobile insurer from considering specified factors when determining a consumer's insurance rates or eligibility. HR 1255/S 377, Living Donor Protection Act - promote and protect from discrimination living organ do HR 1816, Information Transparency & Personal Data Control Act - require the Federal Trade Commission to promulgate regulations related to sensitive personal information, and for other purposes. HR 1512, CLEAN Future Act - build a clean future by addressing the climate crisis, protecting the health, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050. S 524, Federal Insurance Abolishment Act - to eliminate the Federal Insurance Office. HR 1549/S 588, Addressing Climate Financial Risk Act - establish the Advisory Committee on Climate Risk on the Financial Stability Oversight Council. HR 1641/S 638, Promoting Infrastructure by Protecting Our Subcontractors and Taxpayers Act - to include a payment and performance security requirement for certain infrastructure financing. HR 1187, ESG Disclosure Simplification Act of 2021 - requires an issuer of securities to annually disclose to shareholders certain environmental, social, and governance metrics. S 653, Coordination of Medicare Payments and Workers Compensation (COMP) Act - provide for the application of MSP rules to certain workers' compensation settlement agreements and qualified Medicare set-aside provisions. HR 2068/S 862, CLAIM Act - safe harbor for insurers engaging in the business of insurance in connection with a cannabis-related legitimate business. HR 1996/S 910, SAFE Banking Act - create protections for financial institutions that provide financial services to cannabis-related legitimate businesses S 574, PROTECT Asbestos Victims Act - improve asbestos trust claim transparency. S 840, Litigation Funding Transparency Act - increase transparency and oversight of third-party litigation funding. HR 358, FRESH Trucking Act - modifies service hour requirements for drivers transporting perishable agricultural, horticultural, or floricultural commodities. HR 1799, PPP Extension Act of 2021 - extend deadlines for the Paycheck Protection Program. HR 2467 PFAS Action Act of 2021 -- require EPA to designate per- and polyfluoroalkyl substances as hazardous substances HR 2570/S 1217 Climate Risk Disclosure Act of 2021 -- directs SEC to require issuers to disclose information regarding climate change-related risks. HR 2001 Diversity Data Accountability Act - requires regulated entities to report to the Offices of Women and Minority Inclusion within specified financial agencies. HR 1087 Shareholder Political Transparency Act -- requires disclosure of information related to expenditures for political activities HR 3099 Primary Regulators of Insurance Vote Act -- To include the State insurance commissioner as a voting member of the FSOC. HR 3962/S 1625 SECURE Notarization Act -- To authorize notaries public to perform, and to establish minimum standards for, electronic notarizations and remote notarizations S 1805SHELTER Act -- allows a tax credit to individuals and businesses for disaster mitigation expenditures. S 1896Algorithmic Justice and Online Platform Transparency Act -- To prohibit the discriminatory use of personal information by online platforms in any algorithmic process HR 3571/S 1876 Climate Change Financial Risk Act of 2021 -- To require the Fed to develop and conduct financial risk analyses relating to climate change, and for other purposes. HR 3664 SMART Act -- to provide for an exception from patent infringement for certain component parts of motor vehicles. HR 3676 To amend title 23, United States Code, to establish national standards relating to sanctions for individuals who drive a motor vehicle, with a child passenger in the vehicle, while intoxicated or impaired, and for other purposes. HR 3711 SELF DRIVE Act -- to provide safety measures for over highly automated vehicles HR 1187 Corporate Governance Improvement and Investor Protection Act - to require annual disclosure of certain ESG metrics. HR 3675 Drug-Impaired Driving Education Act -- To establish a grant program to educate the public on the dangers of drug-impaired driving, and for other purposes. HR 3757/S 1999 Multiple Substance Impaired Driving Prevention Act -- To authorize the use of certain Federal funds for multiple substance impaired driving countermeasures HR 3899 Financial Stability Oversight Council Improvement Act of 2021 -- To amend the Financial Stability Act of 2010 to require the Financial Stability Oversight Council to consider alternative approaches before determining that a U.S. nonbank financial company shall be supervised by the Board of Governors of the Federal Reserve System, and for other purposes. DRAFT Consumer Information Notification Requirement Act -- to provide a national standard for financial institution data security and breach notification. S 919 Data Care Act of 2021 -- imposes various duties on online service providers with respect to their handling of individual-identifying data 4614 Resilient Federal Forests Act of 2021 - improve forest management activities on National Forest System lands HR 4675/S 2432 Catastrophe Loss Mitigation Incentive and Tax Parity Act of 2021 - excludes from gross income qualified catastrophe mitigation payment made under a state-based catastrophe loss mitigation program. HR 4866 Federal Insurance Office Elimination Act - to abolish FIO HR 5823, Pandemic Risk Insurance Act (PRIA) 2022 - establish a Pandemic Risk Reinsurance Program HR 5736, Booster Seat Safety Act - direct the Secretary of Transportation to revise regulations relating to child restraint systems HR 5807/S 3065, DATA Privacy Act - establishes information security requirements for businesses that collect, process, store, or disclose information HR 963, Forced Arbitration Injustice Repeal Act - prohibits a pre-dispute arbitration agreement from being valid or enforceable if it requires arbitration of an employment, consumer, antitrust, or civil rights dispute HR 5734, Catastrophic Risk Transfer (CART) Act - to establish a system for the taxation of catastrophic risk transfer companies to ensure sufficient capital to cover catastrophic insurance losses HR 5689, Resilient AMERICA Act - improve the provision of Federal resources to help build capacity and fund risk-reducing, cost-effective mitigation projects HR 4006 Fair Repair Act -- requires an original equipment manufacturer (OEM) to make diagnostic, maintenance, and repair equipment available to independent repair providers HR 6580/S 3572 Algorithmic Accountability Act of 2022 -- direct the Federal Trade Commission to require impact assessments of automated decision systems and augmented critical decision processes HR 6570 REPAIR Act -- ensure consumers have access to data relating to their motor vehicles, critical repair information, and tools, and to provide them choices for the maintenance, service, and repair of their motor vehicles HR 4521 America COMPETES Act -- bill addresses U.S. technology and communications, foreign relations and national security, domestic manufacturing, education, trade, and other matters HR 4777/S 2497 Nondebtor Release Prohibition Act -- addresses the release by bankruptcy courts of creditor or other third-party claims against non-debtors S 3844Economic Continuity and Stability Act -- establish a clear and uniform process, on a nationwide basis, for replacing the London interbank offered rate in existing contracts S 3715E-SIGN Modernization Act -- repeals certain requirements regarding the use of electronic records in commerce S 3755Arbitration Fairness for Consumers Act -- amend the Consumer Financial Protection Act of 2010 with respect to arbitration HR 6027 Online Privacy Act -- establishes certain online privacy rights for personal information (including contents of communications) and certain requirements for data processors, service providers, and third parties S 3875, Community Disaster Resilience Zones Act -- require the President to develop and maintain products that show the risk of natural hazards across the United States DRAFT, Jumpstart our Business Startups Act of 2022 -- help accelerate economic growth and spur new business formation S 4110, Primary Regulators of Insurance Vote Act of 2022 -- establishes a state insurance commissioner as a voting member of the Financial Stability Oversight Council S 4299, Rebuilding Small Businesses After Disasters Act -- to repeal the sunset for collateral requirements for Small Business Administration disaster loans S 4274, National Wildland Fire Risk Reduction Program Act -- improve the Federal effort to reduce wildland fire risks ISSUE, SEC 144A/Rule 15c2-11 No Action Letter ISSUE, ESG, DEI, Climate-Related Financial Risk HR 8152, American Data Privacy and Protection Act - to create a federal privacy standard DRAFT, Data Breach and Security Notification Act of 2021- to establish data breach and security standards. DRAFT, Rep. McHenry/Financial Services Privacy Draft - to amend GLBA HR 8063, RAMP Act - to improve MSP statute by eliminating the private right of action HR 8254 Financial Services and General Government Appropriations Act, 2023 - FY2023 appropriations for several federal departments and agencies HR 7900 National Defense Authorization Act for Fiscal Year 2023 - authorizes Department of Defense (DOD) activities for FY2023 HR 4346 CHIPS and Science Act of 2022 - funds to support the domestic production of semiconductors and authorizes various programs and activities of the federal science agencies. S 4619 Fair Access to Financial Services Act - provide that all persons shall be entitled to the full and equal enjoyment of the goods, services, facilities, privileges, and accommodations of financial institutions HR 8589 To prohibit the Securities and Exchange Commission from finalizing the proposed rule titled "The Enhancement and Standardization of Climate-Related Disclosures for Investors", and for other purposes - prevent finalization of SEC climate-risk disclosure rule HR 2123 D&I DATA Act - requires certain regulated entities to report to the Offices of Women and Minority Inclusion within specified financial agencies ISSUE SEC Rule 144A/15c2-11 HR 8483 Wildfire Insurance Coverage Study Act of 2022 - require studies regarding insurance coverage for damages from wildfires DRAFT Diverse Investment Advisers Act - require companies to consider diverse individual-owned and controlled firms when seeking the services of investment advisers DRAFT Minority and Women Inclusion in Insurance Act - require FIO to conduct an annual survey of insurers to determine the extent of diversity in the insurance industry DRAFT Diversify Insurers Workforce Study Act - require FIO to conduct a study regarding recruitment, retention, and attrition of employees in the insurance industry

Client expense: $900,000 · Firm income: Not reported

Government targets: Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Postal Service (USPS)

TriCare Issue with Express Scripts Rural Emergency Hospital REH Model Sequestration ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

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

Appropriations for the KidneyX initiative; Advocate for passage of the Living Donor Protection Act S.377 and HR 1255

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Covid-19 recovery and response efforts for ESRD patients. HR 1676 - The Jack Reynolds Memorial Medigap Expansion Act HR 1255 - Living Donor Protection Act of 2021 S. 377 - Living Donor Protection Act of 2021 HR 3893 - CARE for All Kidneys Act

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

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

Charitable premium assistance and end-stage renal disease issues; H.R. 1255/S. 377 Living Donor Protection Act; CARE for All Kidneys Act (H.R. 3893)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1255/S. 377, the Living Donor Protection Act H.R. 1676, the Jack Reynold Medigap Expansion Act H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021 Health disparities S. 1002, the Junk Plan Accountability and Disclosure Act of 2021 H.R. 4065/S. 1971, the Chronic Kidney Disease Improvement in Research and Treatment Act of 2021. H.R. 3893, the CARE for All Kidneys Act FY 2023, Labor-HHS-Education Appropriations Act H.R. 7585, the Health Equity and Accountability Act of 2022 (HEAA) H.R. 5801, the Help Ensure Lower Patient (HELP) Copays Act H.R. 7845, NIH Clinical Trial Diversity Act of 2022 H.R. 7667, the Food and Drug Amendments of 2022 H.R. 7506, the New Era for Preventing End-Stage Kidney Disease Act of 2022 Medicare Program; Implementing Certain Provisions of the Consolidated Appropriations Act, 2021 and Other Revisions to Medicare Enrollment and Eligibility Rules Diversity Plans To Improve Enrollment of Participants From Underrepresented Racial and Ethnic Populations in Clinical Trials; Draft Guidance for Industry Request for Information on ways to strengthen and improve the Organ Procurement and Transplantation Network

Client expense: $130,000 · Firm income: Not reported

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

FY23 Congressional appropriations: -Increase NIH funds, including $632 million increase for NIDDK to support kidney research and prioritizing research to improve the diagnosis of kidney diseases and health equity interventions -Provide $25 million to KidneyX to continue development of an artificial kidney and other innovations innovative kidney therapeutics and technologies -Support CDC Chronic Kidney Disease Initiative at $15 million Other: -Enact the Living Donor Protection Act (HR1255 S377) -Enact the Jack Reyonlds Medigap Expansion Act (HR1676) -Enact the Improving Access to Home Dialysis Act of (HR5426) -Enact the Medical Nutrition Therapy Act (HR3108 S1536) -Enact the Health Equity and Accountability Act (HR7585) -Address Clinical Labor Cuts impacting vascular access in FY 23 Medicare Physician Fee Schedule

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

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

Issues and legislation relating to kidney disease. Policies that impact kidney care providers and patients. 2022 Labor, HHS, Education and Related Agencies Appropriations bill (KidneyX Program) S.1971 and H.R.4065 - Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 S.377 and H.R.1255 - Living Donor Protection Act of 2021

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY22 Congressional appropriations: -Increase NIH funds, supporting $6.5 billion for NIH in general including $2.2 billion for kidney research at NIDDK -Provide $25 million to KidneyX to continue development of an artificial kidney and other innovative kidney therapeutics and technologies -Support CDC Chronic Kidney Disease Initiative at $5 million FY23 Congressional appropriations: -Increase NIH funds, including $632 million increase for NIDDK to support kidney research -Provide $25 million to KidneyX to continue development of an artificial kidney and other innovations innovative kidney therapeutics and technologies -Support CDC Chronic Kidney Disease Initiative at $15 million Other: -Enact the Living Donor Protection Act (HR1255 S377) -Enact the Jack Reyonlds Medigap Expansion Act (HR1676) -Enact the Improving Access to Home Dialysis Act of (HR5426)

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

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

Issues relating to End Stage Renal Disease (ESRD) and Chronic Kidney Disease (CKD); S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021; H.R. 4065, To improve the understanding of, and promote access to treatment for, chronic kidney disease, and for other purposes; End-Stage Renal Disease (ESRD) payment reform and quality metrics; S.377/H.R. 1255, Living Donor Protection Act; H.R. 1676, Jack Reynolds Memorial Medigap Expansion Act H.R. 3893, Coordination, Accountability, Research and Equity for All Kidneys Act of 2021 (CARE for All Kidneys Act); H.R. 2934, Renal Anemia Innovation Support and Expansion (RAISE) Act; End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and utilization of calcimimetic drugs; Medicare Secondary Payer; H.R. 7878/S. 4307 Kidney Health Connect Act of 2022; Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule, issued 6/21/22

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

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Assist the Administration during Covid-19 epidemic on how to help and protect dialysis patients; Urge Congress to provide access to Medigap for all ESRD patients under 65 years of age - (H.R. 1676) - The Jack Reynolds Memorial Medigap Expansion Bill; Protect organ donors by urging passage of the Living Donor Protection Act of 2021 (H.R. 1255/S. 377); Protect dialysis patient access to charitable premium assistance; Ensure ESRD patients retain access to private insurance; Support ESRD care coordination - The BETTER Kidney Care Bill (H.R. 4942/S. 2649); Encourage support for improved kidney research and treatment; Support increased oversight of Organ Procurement Organizations; Support the Chronic Kidney Disease Improvement in Research and Treatment Act (H.R. 4065/S. 1971); and Assist the Administration about Prioritizing Prevention, Home Dialysis.

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

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

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act H.R. 1676, Jack Reynolds Memorial Medigap Extension Act H.R. 1255/S. 377, The Living Donor Protection Act of 2021 H.R. 4065, The Chronic Kidney Disease Improvement in Research and Treatment Act H.R. 5376, Build Back Better Act, provisions relating to health care H.R. 5585, Advanced Research Project Agency Health Act H.R. 6000, Cures 2.0 Act S. 1971, Chronic Kidney Disease Improvement in Research and Treatment Act of 2021 Implementation of Executive Order 13879, Advancing American Kidney Health.

Client expense: $320,000 · Firm income: Not reported

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

Home dialysis/home therapies issues; H.R. 5426 - Improving Access to Dialysis Act; H.R. 4065 and S. 1971 - Chronic Kidney Disease Improvement Act; H.R. 2903 and S. 1512 - CONNECT Act; H.R. 1255 and S. 377 - Living Donor Protection Act; H.R. 2568 and S. 1220 - US Cadet Nurse Corps Service Recognition Act.

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

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

Living Donor Protection Act (H.R. 1255/S. 377); Issues related to health care working staffing shortages; Dental coverage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Living Donor Protection Act (H.R. 1255/S. 377); Issues related to health care working staffing shortages; Dental coverage.

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

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

ISSUEDiversity, Equity, and Inclusion Initiatives ISSUEPaid Medical and Family Leave ISSUENational Data Privacy Standard ISSUESystemic Risk/Capital Standards PL 111-203, Dodd-Frank Wall Street Reform and Consumer Protection Act - provide financial regulatory reform, to protect consumers and investors, to enhance federal understanding of insurance issues, and other purposes. ISSUEAutonomous Vehicles ISSUE Federal Pandemic Risk Programs ISSUE Insurance Underwriting HR 842/S 420, Protecting the Right to Organize (PRO) Act - amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959, and for other purposes. HR 528, Financial Stability Oversight Council (FSOC) Reform Act - place FSOC and the Office of Financial Research under the regular appropriations process and to provide for certain quarterly reporting and public notice and comment requirements for the Office of Financial Research. HR 1523/S 526, Modern Worker Empowerment Act - to amend the Fair Labor Standards Act of 1938 to harmonize the definition of employee with the common law. HR 5, Equality Act - prohibits discrimination based on sex, sexual orientation, and gender identity in areas including public accommodations and facilities, education, federal funding, employment, housing, credit, and the jury system. HR 1277/S 374, Improving Corporate Governance Through Diversity Act - prohibits an automobile insurer from considering specified factors when determining a consumer's insurance rates or eligibility. HR 1270, PAID Act - prohibits an automobile insurer from considering specified factors when determining a consumer's insurance rates or eligibility. HR 1255/S 377, Living Donor Protection Act - promote and protect from discrimination living organ do HR 1816, Information Transparency & Personal Data Control Act - require the Federal Trade Commission to promulgate regulations related to sensitive personal information, and for other purposes. HR 1512, CLEAN Future Act - build a clean future by addressing the climate crisis, protecting the health, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050. S 524, Federal Insurance Abolishment Act - to eliminate the Federal Insurance Office. HR 1549/S 588, Addressing Climate Financial Risk Act - establish the Advisory Committee on Climate Risk on the Financial Stability Oversight Council. HR 1641/S 638, Promoting Infrastructure by Protecting Our Subcontractors and Taxpayers Act - to include a payment and performance security requirement for certain infrastructure financing. DRAFTDisaster Protection for Workers' Credit Act - suspend negative credit reporting in certain circumstances. HR 1187, ESG Disclosure Simplification Act of 2021 - requires an issuer of securities to annually disclose to shareholders certain environmental, social, and governance metrics. S 653, Coordination of Medicare Payments and Workers Compensation (COMP) Act - provide for the application of MSP rules to certain workers' compensation settlement agreements and qualified Medicare set-aside provisions. DRAFTDiverse Investment Advisers Act - require companies to consider diverse firms when seeking the services of investment advisers. HR 2068/S 862, CLAIM Act - safe harbor for insurers engaging in the business of insurance in connection with a cannabis-related legitimate business. HR 1996/S 910, SAFE Banking Act - create protections for financial institutions that provide financial services to cannabis-related legitimate businesses S 574, PROTECT Asbestos Victims Act - improve asbestos trust claim transparency. S 840, Litigation Funding Transparency Act - increase transparency and oversight of third-party litigation funding. HR 1780, Paris Climate Agreement Disclosure Act - amend the Securities Exchange Act of 1934 to require disclosures related to the Paris Climate Agreement. HR 358, FRESH Trucking Act - modifies service hour requirements for drivers transporting perishable agricultural, horticultural, or floricultural commodities. HR 1799, PPP Extension Act of 2021 - extend deadlines for the Paycheck Protection Program. HR 2467 PFAS Action Act of 2021 -- require EPA to designate per- and polyfluoroalkyl substances as hazardous substances HR 2570/S 1217 Climate Risk Disclosure Act of 2021 -- directs SEC to require issuers to disclose information regarding climate change-related risks. HR 2001 Diversity Data Accountability Act - requires regulated entities to report to the Offices of Women and Minority Inclusion within specified financial agencies. HR 1087 Shareholder Political Transparency Act -- requires disclosure of information related to expenditures for political activities HR 3099 Primary Regulators of Insurance Vote Act -- To include the State insurance commissioner as a voting member of the FSOC. HR 3962/S 1625 SECURE Notarization Act -- To authorize notaries public to perform, and to establish minimum standards for, electronic notarizations and remote notarizations S 1805SHELTER Act -- allows a tax credit to individuals and businesses for disaster mitigation expenditures. S 1896Algorithmic Justice and Online Platform Transparency Act -- To prohibit the discriminatory use of personal information by online platforms in any algorithmic process HR 3571/S 1876 Climate Change Financial Risk Act of 2021 -- To require the Fed to develop and conduct financial risk analyses relating to climate change, and for other purposes. HR 3664 SMART Act -- to provide for an exception from patent infringement for certain component parts of motor vehicles. HR 3676 To amend title 23, United States Code, to establish national standards relating to sanctions for individuals who drive a motor vehicle, with a child passenger in the vehicle, while intoxicated or impaired, and for other purposes. HR 3711 SELF DRIVE Act -- to provide safety measures for over highly automated vehicles HR 1187 Corporate Governance Improvement and Investor Protection Act - to require annual disclosure of certain ESG metrics. HR 3675 Drug-Impaired Driving Education Act -- To establish a grant program to educate the public on the dangers of drug-impaired driving, and for other purposes. HR 3757/S 1999 Multiple Substance Impaired Driving Prevention Act -- To authorize the use of certain Federal funds for multiple substance impaired driving countermeasures HR 3899 Financial Stability Oversight Council Improvement Act of 2021 -- To amend the Financial Stability Act of 2010 to require the Financial Stability Oversight Council to consider alternative approaches before determining that a U.S. nonbank financial company shall be supervised by the Board of Governors of the Federal Reserve System, and for other purposes. DRAFT Consumer Information Notification Requirement Act -- to provide a national standard for financial institution data security and breach notification. S 919 Data Care Act of 2021 -- imposes various duties on online service providers with respect to their handling of individual-identifying data 4614 Resilient Federal Forests Act of 2021 - improve forest management activities on National Forest System lands HR 4675/S 2432 Catastrophe Loss Mitigation Incentive and Tax Parity Act of 2021 - excludes from gross income qualified catastrophe mitigation payment made under a state-based catastrophe loss mitigation program. HR 4866 Federal Insurance Office Elimination Act - to abolish FIO HR 5823, Pandemic Risk Insurance Act (PRIA) 2022 - establish a Pandemic Risk Reinsurance Program HR 5736, Booster Seat Safety Act - direct the Secretary of Transportation to revise regulations relating to child restraint systems HR 5807/S 3065, DATA Privacy Act - establishes information security requirements for businesses that collect, process, store, or disclose information HR 963, Forced Arbitration Injustice Repeal Act - prohibits a pre-dispute arbitration agreement from being valid or enforceable if it requires arbitration of an employment, consumer, antitrust, or civil rights dispute HR 5734, Catastrophic Risk Transfer (CART) Act - to establish a system for the taxation of catastrophic risk transfer companies to ensure sufficient capital to cover catastrophic insurance losses HR 5689, Resilient AMERICA Act - improve the provision of Federal resources to help build capacity and fund risk-reducing, cost-effective mitigation projects HR 4006 Fair Repair Act -- requires an original equipment manufacturer (OEM) to make diagnostic, maintenance, and repair equipment available to independent repair providers HR 6580/S 3572 Algorithmic Accountability Act of 2022 -- direct the Federal Trade Commission to require impact assessments of automated decision systems and augmented critical decision processes HR 6570 REPAIR Act -- ensure consumers have access to data relating to their motor vehicles, critical repair information, and tools, and to provide them choices for the maintenance, service, and repair of their motor vehicles HR 4521 America COMPETES Act -- bill addresses U.S. technology and communications, foreign relations and national security, domestic manufacturing, education, trade, and other matters HR 4777/S 2497 Nondebtor Release Prohibition Act -- addresses the release by bankruptcy courts of creditor or other third-party claims against non-debtors S 3844Economic Continuity and Stability Act -- establish a clear and uniform process, on a nationwide basis, for replacing the London interbank offered rate in existing contracts S 3715E-SIGN Modernization Act -- repeals certain requirements regarding the use of electronic records in commerce S 3755Arbitration Fairness for Consumers Act -- amend the Consumer Financial Protection Act of 2010 with respect to arbitration HR 6027 Online Privacy Act -- establishes certain online privacy rights for personal information (including contents of communications) and certain requirements for data processors, service providers, and third parties S 3875, Community Disaster Resilience Zones Act -- require the President to develop and maintain products that show the risk of natural hazards across the United States DRAFT, Jumpstart our Business Startups Act of 2022 -- help accelerate economic growth and spur new business formation S 4110, Primary Regulators of Insurance Vote Act of 2022 -- establishes a state insurance commissioner as a voting member of the Financial Stability Oversight Council S 4299, Rebuilding Small Businesses After Disasters Act -- to repeal the sunset for collateral requirements for Small Business Administration disaster loans S 4274, National Wildland Fire Risk Reduction Program Act -- improve the Federal effort to reduce wildland fire risks ISSUE, SEC 144A/Rule 15c2-11 No Action Letter ISSUE, ESG, DEI, Climate-Related Financial Risk HR 8152, American Data Privacy and Protection Act - to create a federal privacy standard DRAFT, Data Breach and Security Notification Act of 2021- to establish data breach and security standards. DRAFT, Rep. McHenry/Financial Services Privacy Draft - to amend GLBA HR 8063, RAMP Act - to improve MSP statute by eliminating the private right of action

Client expense: $940,000 · Firm income: Not reported

Government targets: Federal Deposit Insurance Corporation (FDIC), Federal Emergency Management Agency (FEMA), Federal Reserve System, HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Postal Service (USPS)

Initiatives to increase and facilitate organ donation and transplantation. S. 377 and H.R. 1255, Living Donor Protection Act to prohibit discrimination in the issuing, pricing, and benefits level of life, disability or long-term care insurance for living organ donors. Activities to address COVID-19 impact and needs of kidney patients and caregivers, including supply change disruptions; prioritization for access to vaccination for dialysis patients and kidney transplant recipients; and, priority access to specific COVID-19 prescriptions. Comments on the Strategic National Stockpile. Healthy People 2030. Activities regarding the HHS Advancing American Kidney Health Initiative. Initiatives to address ethnic, racial and social disparities in health care and in chronic kidney disease detection, prevention, management and care. Activities included H.R. 7585, the Health Equity and Accountability Act (HEAA). H.R. 5030/S.2706, DIVERSE Trials Act to address clinical trails participation barriers by underrepresented patient populations. H.R. 7667, PDUFA reauthorization (support for clinical trial diversity provisions). Expand access to telemedicine. Support for limits on insulin prices for consumers. Prescription drug pricing and access. Affordable Care Act access and utilization.

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

Government targets: Centers For Disease Control & Prevention (CDC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Rural Emergency Hospital REH Model Sequestration ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

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