Hospital Inpatient Services Modernization Act

General healthcare; health reform; healthcare value and quality; health information technology; clinical trials; tele-health; healthcare costs; healthcare interoperability. Promoting biomedical research. Rural health. Clinical laboratory capacity and reimbursement issues. Financial support for providers for diagnosis and treatment related to COVID-19, coverage of COVID-19 related conditions, access to PPE and other materials and equipment related to the treatment of patients with COVID-19. Telehealth. Medicare physician payment; Impact of statutory pay-go on health care providers; Delay of Protecting Access to Medicare Act (PAMA) laboratory reimbursement reporting requirements. H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act. Public Health Emergency. H.R. 4058/S. 2061 - Tele-mental Health Access to Care Act. Inflation Reduction Act (H.R. 5376) Public Law No. 117-169. H.R. 6833 - Continuing Resolution.

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

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

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

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

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

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, H. Res. 909, Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update; Provide comment letter to OSHA on the re-opening of comments on the Occupational Exposure to COVID-19 Rulemaking in which we urge OSHA not to finalize its rule for occupational exposure to COVID-19. In our comments, we indicate that we continue to oppose establishing new regulations that are not fully aligned with the Centers for Disease Control and Preventions evolving evidence-based guidance. With the constantly evolving, science-based CDC guidance and recommendations, CMS vaccination requirement and existing OSHA general standards, we strongly believe that an inconsistent and overly strict OSHA COVID-19 health care standard is not necessary, would cause confusion and will ultimately lower hospital employees morale and worsen unprecedented personnel shortages in hospitals. It is essential to a well-functioning health care system that only one set of science-based standards be applied to health care providers, and that these standards be aligned across federal agencies; Letter urging Congress to make the expanded tax credits permanent, ensuring millions of low- and middle-income families continue to have access to affordable coverage in 2023 and beyond; Express concerns with the letter to CMS from Congressman Murphy that makes a number of requests for data surrounding the COVID-19 add on payments for hospitals. We are concerned about the questions as they do not take into account the continued needs of the nations hospitals and health systems. Hospitals continue to face numerous challenges, including increased labor and supply costs and workforce shortages. These additional payments have helped to address some but not all of the high costs associated with COVID-19 patient care. The complexity of care is still higher than pre-pandemic levels as measured by length of stay, which further indicates that its still more resource intensive to treat COVID inpatients. In addition, the high costs associated personal protective equipment, isolation measures, and other additional resources are necessary when treating all patients, unless and until it is determined they do not have COVID-19; Submitted a letter to Ways and Means per their request for information on the health care industry and climate change. We support the sustainability efforts while acknowledging that for a variety of reasons, many hospitals and health systems face challenges and barriers to implementing this work, especially while responding to a pandemic; Letter urging HHS to maintain the COVID-19 public health emergency (PHE) until it is clear that the global pandemic has receded and the capabilities authorized by the PHE are no longer necessary. This will help prevent any future surges from threatening the health and safety of patients and the ability of health care professionals to care for them; Long COVID Best Clinical Practices Discussion with the White House Policy Advisor, Office of the COVID-19 Response; Submitted comment letter to the Federal Trade Commission outlining the impact pharmacy benefit managers (PBMs) practices have on the field. Specifically, urging the FTC to increase scrutiny on insured-mandated white bagging policies, as well as the impact of PBM-negotiated rebates and other business practices on the 340B drug discount pricing program and overall drug prices and drug price increases; Submit a comment letter to the Internal Revenue Service for their proposed rule amending how employer coverage affordability would be measured for family members of employees. We advocated for a fix to the current methodology for assessing affordability of employer coverage for family members, often referred to as the family glitch, which is estimated to affect about 5 million individuals. We commend the IRS on proposing to revise the regulation and improve access to health insurance coverage for millions of American families; Concerns S.4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 or the FDASLA Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological product; Comment letter on CMS Radiation Oncology (RO) Model proposed rule. We strongly supports CMS efforts to transform the delivery of cancer care. We also support the original intent of the RO Model, which was to protect access to care by ensuring fair, predictable payment for radiation oncologists. However, this important goal of the original RO Model has been marred by the incorporation of significant payment cuts and substantial administrative burdens for those participating in this mandatory model. As such, the AHA supports CMSs proposal to delay the start date of the RO model from Jan. 1, 2023 to a date to be determined through future rulemaking; Support S. 4352,Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Letter in response to CMS request for guidance on implementing the regulatory requirement for convening providers and facilities exchange information with co-providers and co-facilities to create a comprehensive good faith estimate as part of the implementation of the No Surprises Act. Due to the lack of currently available automated solutions, this process would require a significant manual effort by providers, which would undoubtedly result in the convening provider being unable to meet the short statutory timeframes for delivering good faith estimates to the patients and could also lead to inadvertent errors. AHA has requested an extension in enforcement direction until a technical solution has been identified and implemented; Support HR 7691, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purposes; Letter requesting that HHS, HRSA, and OIG take immediate enforcement action against the now 17 companies that are refusing to honor their obligations under the 340B program; Letter sent to HHS Secretary to discuss how best to ensure prompt repayment to 340B hospitals without penalizing the rest of the hospital field after the U.S. Supreme Court unanimously agreed that HHS outpatient payment cuts to hospitals in the 340B Drug Pricing Program were unlawful. The Courts decision did not determine a remedy for the unlawful payment cuts, instead, it remanded the case to the lower courts to address the proper remedy; Support HR 7084/ S 3983, Protecting and Transforming Cyber Health Care Act of 2022 or the PATCH Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to require, for purposes of ensuring cybersecurity, the inclusion in any premarket submission for a cyber device of information to demonstrate a reasonable assurance of safety and effectiveness throughout the lifecycle of the cyber device, and for other purposes; Submit Comment letter of support for CMS continued focus on strengthening health insurance coverage and ensuring ease of enrollment and limited gaps in coverage, including proposed updates to Medicare enrollment and eligibility rules; Submit letter for oversight hearing on Medicare Advantage (MA) plans expressing concerns about some MA plans inappropriate restrictions on beneficiary access to medically necessary care, including those highlighted in a recent report issued by the Department of Health and Human Services Office of Inspector General (HHS-OIG), and urge Congress to increase its oversight of these plans; Provided feedback on the Senate Finance Committees discussion draft addressing mental health care and telehealth. AHA supports allowing Medicare beneficiaries who seek treatment for mental health disorders to receive their care through audio-only services, removing the requirement for Medicare patients to receive an in-person visit prior to receiving mental health services through telehealth, and expanding beyond physicians and limited non-physician practitioners the types of providers who can deliver and bill for telehealth services; Support HR 8576/ S 4352 Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Support HR 8806 Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Submitted a statement for the record for the Senate Judiciary Subcommittee hearing on Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Health Care Workforce. This hearing examines the importance of improving the immigration process in order to help alleviate Americas health care workforce shortage. We encourage Congress to help address domestic health care workforce shortage;

Client expense: $6,950,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE, White House Office

Funding for Disproportionate Share Hospitals (Medicaid DSH); Funding for Medicare graduate medical education (GME); COVID-19 regulatory changes in general; Coronavirus Preparedness and Response Supplemental Appropriations (CPRSA) Act, The Consolidated Appropriations Act of 2021, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief and Economic Security (CARES) Act - issues impacting hospital financing, Medicaid DSH, telehealth expansion, Provider Relief Funds; H.R.266/P.L. 116-139, the Health Care Enhancement Act - provisions related to Public Health and Social Services Emergency Fund; support for issues regarding recognition of uncompensated care costs and addressing social determinants of health in the Medicaid and Medicare populations; H.R.7292 - The COVID-19 Hospital Forgiveness Act; support of telehealth policies, including for audio-only telehealth services; H.R.5376 - Build Back Better Act, policies concerning Medicare graduate medical education (GME); H.R.7053/S.3792 - acute hospital care at home waiver flexibility; policy proposals to address mental and physical/medical comorbidities of beneficiaries in the Medicare/Medicaid programs; H.R.1868/Pub. L. No. 117-7, To prevent across-the-board direct spending cuts, and for other purposes/Medicare sequester; in general - protecting access to physician services for Medicare beneficiaries per preventing reductions resulting from Medicare sequestration, Statutory PAYGO, and reduction in Medicare conversion factor for CY2023; H.R.2617, the Consolidated Appropriations Act, 2023.

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

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

Affordable prescription drugs; 340B Drug pricing program; Health care privacy; Patient privacy issues; Issues related to the American Rescue Plan Act, PL 117-2; Issues related to expanding health care coverage, including in non-Medicaid expansion states; Issues related to improving social determinants of health; Issues related to extending and expanding flexibilities for virtual care; Financial support for providers for diagnosis and treatment related to COVID-19, coverage of COVID-19 related conditions, access to PPE and other materials and equipment related to the treatment of patients with COVID-19, including funding for the Provider Relief Fund; Issues related to affordable health care coverage; H.R. 2228 - Rural Behavioral Health Access Act; Issues related to drug pricing; Issues related to Bipartisan Infrastructure Framework; Issues related to telehealth; Efforts to extend Medicare sequester delay, including H.R.1868; Issues related to Medicare policy on virtual care; Issues related to vaccine mandates; S. 168/H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S. 346/H.R. 959 - Black Maternal Health Momnibus Act; S. 773/H.R. 3203 - Legislation related to 340B eligibility; S. 834/H.R. 2256 - Resident Physician Shortage Reduction Act; S. 834/H.R. 2256 - Healthcare Workforce Resilience Act; S. 368/H.R. 1332 - Telehealth Modernization Act ; S. 1512/H.R. 2903 - CONNECT for Health Act; S. 1988 - Protecting Rural Telehealth Access Act; H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act; S.773/H.R. 3203 - A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; H.R. 4943 - Childrens Mental Health Infrastructure Act; H.R. 4944 - Helping Kids Cope Act; H.R. 5376 - Build Back Better Act; H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act; Issues related to workforce retention; H.R. 2471 - Consolidated Appropriations Act (FY 2022 Omnibus); H.R. 7007 - Covid-19 Supplemental Appropriations Act; H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act; issues related to the Acute Hospital Care at Home (AHCAH) waiver; H.R. 4407/S. 1568 - Technical Reset to Advance the Instruction of Nurses (TRAIN) Act; S. 3493 - Telehealth Extension and Evaluation Act; H.R. 6202 - Telehealth Extension Act; H.R. 5376 - Inflation Reduction Act (Public Law 117-169); H.R. 6833 - Continuing Resolution; H.R. 2617 - Consolidated Appropriations Act, 2023; Issues related to adequate financing for hospitals and providers; H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act; Issues related to extending the Medicare Dependent Hospital and Low Volume Hospital programs; Issues related to extending bonus payments for Advanced Alternative Payment models; H.R. 4587 - Value in Health Care Act; Issues related to coding and coverage of spiritual care through chaplain services; Issues related to value-based care programs, including the Bundled Payments for Care Improvement (BPCI) Advanced Model; Issues related to data and quality measure reporting and eligibility for corresponding reimbursements; Issues related to prior authorization; H.R. 3173 - Improving Seniors Timely Access to Care Act; Issues related to Rural Emergency Hospital designation; Issues related to safety net hospital reimbursements.

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 related to Medicare and Medicaid coverage and Medicaid disproportionate share program; Financial support for providers for diagnosis and treatment related to COVID-19; coverage of COVID-19 related conditions; access to PPE and other materials and equipment related to the treatment of patients with COVID-19, including funding for the Provider Relief Fund; PL 117-2; Issues related to Bipartisan Infrastructure Framework; Issues related to telehealth; Efforts to extend Medicare sequester delay, including H.R.1868; Issues related to Medicare policy on virtual care; Childrens Health Graduate Medical Education; issues related to drug pricing; Issues related to hospital DSH eligibility; Issues related to Home and Community Based Services (HCBS); Medicaid waiver-related issues; Childrens transplant program issues; S. 346/H.R. 959 - Black Maternal Health Momnibus Act; S.773/H.R. 3203 - legislation to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; S. 834/H.R. 2256 - Resident Physician Shortage Reduction Act; S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act; S. 368/H.R. 1332 - Telehealth Modernization Act; S. 1512/H.R. 2903 - CONNECT for Health Act ; S. 1988 - Protecting Rural Telehealth Access Act; H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act; H.R. 5376 - Build Back Better Act; H.R. 2617 - Consolidated Appropriations Act, 2023; Efforts to delay statutory PAYGO payment reductions; Efforts to offset physician payment reductions; Efforts to improve hospital reimbursement; Issues related to cuts to Medicaid DSH; Issues related to cuts to uncompensated care pools; Issues related to hospital at home programs; H.R. 2471 - Consolidated Appropriations Act (FY 2022 Omnibus); H.R. 7007 - Covid-19 Supplemental Appropriations Act; H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act; issues related to the Acute Hospital Care at Home (AHCAH) waiver; S. 3493 - Telehealth Extension and Evaluation Act; H.R. 6202 - Telehealth Extension Act; H.R. 5376 - Inflation Reduction Act (Public Law 117-169); H.R. 6833 - Continuing Resolution; Issues related to adequate financing for hospitals and providers; H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act; Issues related to extending the Medicare Dependent Hospital and Low Volume Hospital programs; Issues related to extending bonus payments for Advanced Alternative Payment models; H.R. 4587 - Value in Health Care Act; Issues related to coding and coverage of spiritual care through chaplain services; Issues related to value-based care programs, including the Bundled Payments for Care Improvement (BPCI) Advanced Model; Issues related to data and quality measure reporting and eligibility for corresponding reimbursements; Issues related to prior authorization; H.R. 3173 - Improving Seniors Timely Access to Care Act; Issues related to Rural Emergency Hospital designation; Issues related to safety net hospital reimbursements.

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

Medicare PAYGO Sequestration - (H.R 2617) - Supported inclusion of provisions in the Consolidated Appropriations Act to prevent 4% Medicare payment reductions due to sequestration required by statutory PAYGO requirements. Medicare Physician Reimbursement (H.R. 2617; H.R. 8800) - Supported legislation that would ease pending reimbursement cuts through the physician fee schedule conversion factor. Health Care Workforce (S.834/H.R. 2256; S. 1438/H.R. 3441; H.R. 2617) - Supported legislation to increase the number of Medicare-supported Graduate Medical Education slots. Advanced Alternative Payment Model (APM) Bonus Payment (H.R. 4587; H.R. 2617) - Supported passage of legislation to extend the APM bonus payments. Telehealth (H.R. 2617; H.R. 4040; S. 1512/H.R. 2903)- Advocated for Congress to extend or make permanent flexibilities related to distant site and geographic limitations, expanding the provider types and services available to be reimbursed by Medicare. Acute Hospital Care at Home Model (H.R. 2617; S. 3792/H.R. 7053) Supported passage of legislation to extend the Acute Hospital Care at Home Model beyond the end of the declared Public Health Emergency. Rural Health Care Extenders (H.R. 2617) - Supported extension of Medicare Dependent Hospital program and Medicare Low-Volume Adjustment. Mental and Behavioral Health (S. 4747; H.R. 7236; H.R. 2617) - Supported passage of legislation to better support access to mental and behavioral health needs for children and adults. Supported passage of the Improving Seniors' Timely Access to Care Act (S.3018/ H.R.3173). Supported passage of the Preserving Access to Home Infusion Act (H.R. 5067/S. 2652).

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

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

Actions by the Health Resources and Services Administration to redesignate health professional shortage areas, in relation to 86 FR 35808 S. 3792/H.R.7053 - the Hospital Inpatient Services Modernization Act - all provisions. H.R. 5883 - The Rural Health Fairness in Competition Act - all provisions. S. 4009 The Rural Hospital Support Act - all provisions. & H.R 8747- the The Assistance for Rural Community Hospitals (ARCH) Act - all provisions. H.R.4587 - The Value in Health Care Act of 2021 - all provisions. H.R. 3173/S.3018 - The Improving Seniors' Timely Access to Care Act of 2021 - All Provisions. Extending flexibilities to hospitals made possible by the public health emergency, including the critical access hospita 96-hour average length of stay condition of participation and 96-hour condition of payment rule, the skilled nursing facility 3-day rule, and Medicare telehealth flexibilities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Actions by the Health Resources and Services Administration to redesignate health professional shortage areas, in relation to 86 FR 35808 S. 3792/H.R.7053 - the Hospital Inpatient Services Modernization Act - all provisions. H.R. 5883 - The Rural Health Fairness in Competition Act - all provisions. S. 4009 The Rural Hospital Support Act - all provisions. & H.R 8747- the The Assistance for Rural Community Hospitals (ARCH) Act - all provisions. H.R.4587 - The Value in Health Care Act of 2021 - all provisions. H.R. 3173/S.3018 - The Improving Seniors' Timely Access to Care Act of 2021 - All Provisions. Extending flexibilities to hospitals made possible by the public health emergency, including the critical access hospita 96-hour average length of stay condition of participation and 96-hour condition of payment rule, the skilled nursing facility 3-day rule, and Medicare telehealth flexibilities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1512/H.R. 2903 - Connect for Health Act of 2021 - provisions related to reducing barriers to Medicare coverage for telehealth services and to promote expansion of telehealth Proposals to expand access to telehealth services Proposals to prevent future sequester cuts, reducing Medicare payments H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions related to extending the CMS Acute Hospital Care at Home Waiver Flexibilities H.R. 2617, the Consolidated Appropriations Act, 2023 - provisions related to Medicare, Medicaid, telehealth and the CMS Acute Hospital Care at Home Waiver

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage (Part C) and Prescription Drug (Part D) programs including: quality measures and star ratings; quality bonus payments; third-party marketing tactics; prescription drug costs; benchmark reform; and program integrity audits. Advocated for extending all COVID-19 related telehealth Medicare regulatory flexibilities for two years post-public health emergency (H.R. 4040). Advocated in support of extending the Acute Hospital Care at Home waiver to allow seniors to receive inpatient-level care at home beyond the public health emergency, including support for the "Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053). Advocated in support of improving Medicaid access and coverage, including 12-month coverage for post-partum and continuous eligibility for children in CHIP and Medicaid; advocated to strengthen and expand home- and community-based services (HCBS). Prior Authorization: Advocated for any legislation/regulation addressing electronic prior authorization to improve consumers access to appropriate care in a timely fashion, reduce instance of inappropriate or low-value care and create a standard for electronic prior authorization across all lines of business; Advocated for ensuring that health plans and providers share equally in the development and implementation of electronic prior authorization requirements. Advocated in favor of addressing Social Determinants of Health (SDOH), including maternal health and health equity, across Medicaid and Medicare. Advocated for Medicaid redeterminations to be conducted in chronological order, with added safeguards for mothers and children to ensure continuity of coverage; advocated for increased time granted to states to conduct redeterminations and ample lead time for plans to help assist enrollment efforts; advocated for increased flexibilities, including texting, to plans to conduct outreach for enrollees at risk of losing coverage during the redetermination process; advocated for additional time granted to plans to help transition Medicaid enrollees to other forms of coverage; advocated for phasing out of the enhanced FMAP upon the end of the PHE to help states with funding and staffing support as they conduct redeterminations. Advocated for reimbursement of food security interventions (e.g., Food Farmacies, Medically Tailored Meals) in publicly sponsored programs.

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

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

Hospital Inpatient Services Modernization Act (S. 3792); Choose Home Care Act of 2022 (S. 2562); Preserving Access to Home Health Act of 2022 (S. 4605/H.R. 8581); issues related to expanding care in the home; Consolidated Appropriations Act of 2022.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to transparency. Issues involving mandatory COVID vaccines for health care providers. Issues related to Medicare sequestration. Issues related to the extension of telehealth flexibilities. H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act and issues related to the extension of the acute hospital care at home program. Issues related to mental health. Issues related to the Hospital Inpatient Prospective Payment Systems (IPPS) rule for FY 2023. Issues related to payment to rural and metropolitan hospitals. Issues related to reimbursement for hospital services. H.R. 2617 (P.L. 117-328), the Consolidated Appropriations Act of 2023, and issues including Medicare Dependent Hospitals, Low Volume Hospital Payments, telehealth flexibilities, mental health and the Acute Hospital Care at Home Program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issue: Support policies to close the Medicaid coverage gap, including through ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. Issue: Support programs and funds for safety-net providers. Educate Congress about the impact of Section 203 of the Consolidated Appropriations Act, 2021 and its changes to the Medicaid DSH cap calculation methodology on academic medical centers. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF Issue: Support increased Medicare funding for graduate medical education, including 200 new Medicare-supported GME slots included in the Consolidated Appropriations Act, 2023. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 H.R. 5376, Build Back Better Act Issue: Support increased Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support targeted Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893 / H.R. 8508, Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. Support policy to ensure each qualifying hospital that applies for CAA, 2021 GME positions would receive at least 1 (or a fraction of 1) of the positions before any qualifying hospital receives more than 1 of such positions Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital, physician, and provider cuts. H.R. 8850, Fair Access In Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R.3173 / S.3018, Improving Seniors Timely Access to Care Act Issue: Protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs. Draft Medicare Part D benefit re-design legislation Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support expansion of Medicaid and CHIP coverage during the postpartum period. S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315, Medicare Sequester COVID Moratorium Act S. 748, Medicare Sequester Relief Act H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. P.L. 117-328, Consolidated Appropriations Act, 2023 Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF H.R.8800, Supporting Medicare Providers Act of 2022 Issue: Support a 4.42% increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support making permanent the interim final rule that allows hospitals that unknowingly trigger their Medicare GME caps and per resident amounts to not have that happen and instead retain the ability to build a new resident cap / PRA so long as the cap / PRA is not above a minimum amount. Issue: Oppose aspects of CMS hospital price transparency rule. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Oppose finalizing proposed rule for Medicare Coverage of Innovative Technology (MCIT) and definition of reasonable and necessary. Issue: Oppose enforcement of linking Medicare Conditions of Participation (CoP) compliance with requiring that hospitals report 38 COVID-19 related measures. Issue: Support continuation of the 3-Day Skilled Nursing Facility (SNF) Stay waiver after the conclusion of the COVID-19 public health emergency. Issue: Oppose policy of incorporating revenue distinctions into the Medicare Shared Savings Program. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Support 2 year or permanent extension of the waivers. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021 Issue: Support extension of COVID-19 telehealth waivers for two years beyond the end of the COVID-19 public health emergency. H.R. 7961 - Safety from Violence for Healthcare Employees Act (SAVE Act)Issue: Support funding for hospital-based violence intervention programs and community violence interventions Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support expanded Medicare reimbursement for integrated behavioral health Medicare payment codes. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. H.R. 4547, Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. P.L. 117-328, Consolidated Appropriations Act, 2023 Issue: Support extension of alternative payment model (APM) bonus. H.R. 3746, Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location. H.R. 4970, Rural Medical Residency Expansion Act of 2021 Issue: Support providing funds for rural teaching hospitals to expand their residency programs. Issue: Support efforts to investigate nurse-staffing agencies conduct during the COVID-19 pandemic.

Client expense: $876,000 · Firm income: Not reported

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

S.3792/H.R.7053, Hospital Inpatient Services Modernization Act H.R.4587, Value in Health Care Act Issues related to Statutory PAYGO Sequester Relief, in general Issues related to per diem payment and patient discharge/backlog concerns, in general Issues related to Physician Fee Schedule cuts, in general Issues related to the Medicare Access and CHIP Reauthorization Act (MACRA), in general Issues related to telehealth services and behavioral health access, in general

Client expense: $28,902 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Specific lobbying issues: Supporting S.3792/H.R.7053, Hospital Inpatient Services Modernization Act Supporting H.R.4587, Value in Health Care Act Issues related to Statutory PAYGO Sequester Relief, in general Issues related to per diem payment and patient discharge/backlog concerns, in general Issues related to the Medicare Access and CHIP Reauthorization Act (MACRA), in general Issues related to Physician Fee Schedule cuts, in general Issues related to telehealth services and behavioral health access, in general

Client expense: $28,902 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ARPA-H Act (H.R.5585) Food and Drug Amendments Act of 2022 (H.R.7667) SAVE Act (H.R. 2120) Hospital Inpatient Services Modernization Act (H.R. 7053; S. 3792)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2617, Consolidated Appropriations Act, 2023 H.R.7053/S.3792, Hospital Inpatient Services Modernization Act H.R.4040, the Advancing Telehealth Beyond COVID-19 Act H.R.3173/S.3018, the Improving Seniors Timely Access to Care Act H.R.2144/S.1450, Access to Genetic Counselor Services Act H.R.3089/S.1544, Accelerating Kids Access to Care Act Issues related to CMS telehealth policies. Issues related to the Acute Hospital Care at Home waiver program. Issues related to Medicare funding for GME. Legislative proposals to improve access to behavioral health and pediatric behavioral health services, including through workforce investments. Issues related to waivers and flexibilities tied to the COVID-19 Public Health Emergency. Issues relate to PAYGO and sequestration reductions to Medicare providers. Issues related to Medicare reimbursement cuts under the PFS. Issues related to expiration of the Advanced APM Bonus Payment.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues regarding telehealth flexibilities. Monitored issues regarding PPS exempt hospitals. Issues involving mandatory COVID vaccines for health care providers. Issues related to Medicare sequestration. H.R. 7053/S. 3792, The Hospital Inpatient Services Modernization Act and issues related to the extension of the acute hospital care at home program. Issues related to the Hospital Inpatient Prospective Payment Systems (IPPS) rule for fiscal year 2023. H.R. 2617 (P.L. 117-328), the Consolidated Appropriations Act of 2023, as it relates to Medicare Dependent Hospitals, Low-Volume Hospital payments, telehealth flexibilities, mental health, the Acute Hospital Care at Home Progam, and issues related to Medicare physician payment.

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

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

H.R. 7053, S. 3792 - the Hospital Inpatient Services Modernization Act: Provisions related to the extension of Medicare fee for service reimbursement and the Hospital at Home program. Issues related to cuts to the 340B drug discount program. Issues related to cuts in the PAYGO Medicare program. Issues related to CMS cuts to Home Health. Issues related to Advanced Alternative Payment Models (APMs).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2562, Choose Home Care Act of 2021; S. 3792/H.R. 7053, Hospital Inpatient Services Modernization Act; CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Requirements - Final Rule CMS-1766-F S. 4605/H.R. 8581, Preserving Access to Home Health Act of 2022 H.R. 2617, Consolidated Appropriations Act, 2023 - home health payment transparency, hospice cap

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to drug pricing, pharmacies, provider status, biosimilars, and DIR fees; H.R. 7213- Equitable Community Access to Pharmacist Services Act; H.R. 7053- The Hospital Inpatient Services Modernization Act(HR 7053/S 3792); Issues related to the Medical Device User Fee Amendments reauthorization, VALID Act (H.R. 4128/ S. 2209). Saving Access to Laboratory Services Act (SALSA) (HR 8188/S 4449); Improving Seniors Timely Access to Care Act of 2021 (HR 3173/S 3018); Issues related to Medicare provider cuts; Issues related to glucose monitors.

Client expense: $410,000 · Firm income: Not reported

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

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Medicare Graduate Medical Education S. 834/H.R. 2256 - the Physician Shortage Reduction Act of 2021 H.R. 1887/S. 4009, the Rural Hospital Support Act Site-neutral payment policies Build Back Better Act proposals related to health policy, Medicare, workforce and hospital emergency preparedness Proposals to prevent future sequester cuts, including reductions in Medicare payments H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans Proposals to reduce drug costs Hospital at Home Care Model H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions related to extending the CMS waiver beyond the end of the PHE H.R.2617 - Consolidated Appropriations Act, 2023 - provisions related to Medicare and Medicaid

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to ESRD / PPS transitional technology add-on payment adjustment for new and innovative equipment and supplies. Issues regarding dialysis in the home. Issues related to S. 2025 / H.R. 5331, Patient Access to ESRD New Innovative Devices Act. Monitored drug pricing issues related to H.R. 5376 (P.L. 117-169), the Inflation Reduction Act. Issues related to safe mobility, including H.Res. 1177. Monitored H.R. 7053/S. 3792, The Hospital Inpatient Services Modernization Act and issues related to extension of the acute hospital care at home program. H.R. 2617 (P.L. 117-328), the Consolidated Appropriations Act of 2023, as it relates to the extension of the Acute Hospital Care at Home program.

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

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

Proposals to prevent future sequester cuts, reducing Medicare payments Changes to Medicare policy Site-neutral payments H.R. 1227/S. 386, "Medicare-X Choice Act" - provisions related to the establishment of a public health plan H.R. 1976, To establish an improved Medicare for All national health insurance program - provisions related to establishment of a Medicare for America health program to provide for comprehensive health coverage for all Americans S. 834/H.R. 2256, the "Physician Shortage Reduction Act of 2021" H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions to extend the CMS waiver supporting Hospital at Home H.R.2617 - Consolidated Appropriations Act, 2023 - provisions related to Medicare and Medicaid

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Federal health program issues impacting hospitals; S.3792/H.R.7053, Hospital Inpatient Services Modernization Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Hospital and home health related payment and regulatory policies. Medicare sequestration delay; Statutory pay-go impact on health care providers. H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act. Public Health Emergency. Tele-Health issues. H.R. 2617 - Consolidated Appropriations Act, 2023. Medicare physician payment relief.

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

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

Hospital Consolidation Issues, COVID-19 Relief Issues; Hospital and home health related payment and regulatory policies. Labor-HHS FY 2023 Appropriations for House and Senate. H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act.

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

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

General healthcare; health reform; healthcare value and quality; health information technology; clinical trials; tele-health; healthcare costs; healthcare interoperability. Promoting biomedical research. Rural health. Clinical laboratory capacity and reimbursement issues. Financial support for providers for diagnosis and treatment related to COVID-19, coverage of COVID-19 related conditions, access to PPE and other materials and equipment related to the treatment of patients with COVID-19. Telehealth. Medicare physician payment; Impact of statutory pay-go on health care providers; Delay of Protecting Access to Medicare Act (PAMA) laboratory reimbursement reporting requirements. H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act. Public Health Emergency. H.R. 4058/S. 2061 - Tele-mental Health Access to Care Act. H.R. 2617 - Consolidated Appropriations Act, 2023.

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

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

COVID-19 response General hospital policies. Medicare transplant issues. Medicaid waiver policies. Statutory pay-go impact on heath care providers; Medicaid DSH. H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act. H.R. 4058/S. 2061 - Tele-mental Health Access to Care Act. H.R. 2617 - Consolidated Appropriations Act, 2023.

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

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

Medicaid issues. Medicare issues. Medicaid disproportionate share program. Financial support for providers for diagnosis and treatment related to COVID-19, coverage of COVID-19 related conditions, access to PPE and other materials and equipment related to the treatment of patients with COVID-19. H.R.1868 - To prevent across-the-board direct spending cuts, and for other purposes. Medicaid coverage, HCBS Medicaid waiver. Telehealth. Medicare sequestration delay. Impact of Statutory pay-go on provider reimbursement. 340B Drug pricing program. H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act. H.R. 2617 - Consolidated Appropriations Act, 2023. BCIPA model.

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

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

Medicare payment policies impacting physicians; Tele-health. Medicare sequestration delay; Statutory pay-go impact on provider reimbursement. Global and Professional Direct Contracting Model. H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act. H.R. 8800 - Supporting Medicare Providers Act of 2022. H.R. 2617 - Consolidated Appropriations Act, 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Funding for Disproportionate Share Hospitals (Medicaid DSH); Funding for Medicare graduate medical education (GME); Medicare site neutrality policies; COVID-19 regulatory changes in general; Coronavirus Preparedness and Response Supplemental Appropriations (CPRSA) Act, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief and Economic Security (CARES) Act - issues impacting hospital financing, Medicaid DSH, telehealth expansion, Provider Relief Funds; H.R. 266/P.L. 116-139, the Health Care Enhancement Act - provisions related to Public Health and Social Services Emergency Fund; increase in FMAP funding per COVID-10 PHE; support for reforms to CMS's Accelerated Advanced Payment Program; H.R. 7292 - The COVID-19 Hospital Forgiveness Act; support of telehealth policies, including for audio-only telehealth services; H.R. 5376 - Build Back Better Act, policies concerning Medicare graduate medical education (GME); H.R. 7053/S. 3792 - acute hospital care at home waiver flexibility; and H.R. 2617, the Consolidated Appropriations Act of 2023.

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

FY 2023 Labor, Health and Human Services, Education, and Related Agencies appropriations bill; Issues related to telehealth; Medicare value-based payment; Funding for National Institutes of Health; Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics (PREVENT Pandemics) Act (S. 3799), Hospital Inpatient Services Modernization Act (H.R. 7053 /S. 3792); issues related to the Global Health Institute

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1868, P.L. 117-7 - To prevent across-the-board direct spending cuts: Provisions related to Medicare sequester relief. S. 610, P.L. 117-71 - Protecting Medicare and American Farmers from Sequester Cuts Act: Provisions related to PAYGO delay. H.R. 7053, S. 3792 - Hospital Inpatient Services Modernization Act: Provisions related to Hospital at Home program. Issues related to Graduate Medical Education. Issues related to provider cuts in Medicare final inpatient prospective payment system rule (IPPS), outpatient prospective payment system (OPPS) and physician fee schedule (PFS).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2256/S. 834 - Resident Physician Shortage Reduction Act H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 4323/S. 2069 - Excellence in Mental Health and Addiction Treatment Act H.R.3345 - Helping MOMS Act H.R.4587 - Value in Health Care Act of 2021 H.R.7053/S. 3792 - Hospital Inpatient Services Modernization Act Issues related to Section 203 of the Consolidated Appropriations Act of 2021 Issues related to the Families First Coronavirus Response Act Issues related to the Medicare Accelerated and Advance Payment (AAP) programs Issues related to the Medicare sequester S.748 - Medicare Sequester Relief Act

Client expense: $490,000 · Firm income: Not reported

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

H.R. 3650/S.2048, Improving Access to Medicare Coverage Act of 2021; H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021; H.R. 7053/S.3792, Hospital Inpatient Services Modernization Act; and H.R. 6020/S. 3314, Supporting Medicare Providers Act of 2021; policies related to physicians contained in H.R.3684, Infrastructure Investment and Jobs Act; H.R. 5376, Build Back Better Act; P.L. 117-328, Consolidated Appropriations Act, 2023 Issues pertaining to physician payment, quality measurement, observation care, prior authorization and access to care through Medicare Advantage, generally; and policies in the CY2022 Medicare Physician Payment Fee Schedule rule; and policies that would enhance reimbursement for services provided in response to a public health emergency involving infectious diseases.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.7053/S.3792, Hospital at Home Program, Entirety Low Volume Hospitals and Medicare Dependent Hospitals Pay Go Medicare Cuts Medicare Physician Conversion Factor Reduction Medicare Sequestration Graduate Medical Education (GME) Medicare Wage Index Monitor the following: Disproportionate Share Hospital (DSH) Payments The Hospital Inpatient Payment Systems for Accute Care Hospitals and Long Term care Hospital Prospective Payment System (IPPS), Proposed Rule changes CMS Hospital Payment, Provider relief issues 340B issues Provider and insurer rate negotiation ACA expansion issues

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

Government targets: SENATE

Organ transplant issues H.R.4128/S.2209, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, Laboratory Developed Tests H.R.4407/S.1568, TRAIN Act, Nurse reimbursement related issues Graduate Medical Education (GME) H.R.7053/S.3792, Hospital at Home Program, Entirety Low Volume Hospitals and Medicare Dependent Hospitals Pay Go Medicare Cuts Medicare Physician Conversion Factor Reduction Medicare Sequestration Proposed Cuts to OPPS for Organ Acquisition Costs Monitor the following: Disproportionate Share Hospital (DSH) Payments Alabama Area Health Education Centers (AHEC) NIH grant related issues Public health and CDC related issues J1 Visa Waiver issues Opioid issues H.R.6000, CURES 2.0 Act OSHA Covid-19 Mandate Public Law 117-167, Supreme Court Security Funding Act of 2022, Division A--Creating Helpful Incentives to Produce Semiconductors (CHIPS Act), NSF and Energy related issues

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

Government targets: SENATE

H.R.7053/S.3792, Hospital at Home Program, Entirety Low Volume Hospitals and Medicare Dependent Hospitals Pay Go Medicare Cuts Medicare Physician Conversion Factor Reduction Medicare Sequestration Graduate Medical Education (GME) Medicare Wage Index Monitor the following: Disproportionate Share Hospital (DSH) Payments The Hospital Inpatient Payment Systems for Accute Care Hospitals and Long Term care Hospital Prospective Payment System (IPPS), Proposed Rule changes CMS Hospital Payment, Provider relief issues 340B issues Provider and insurer rate negotiation ACA expansion issues

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

Government targets: SENATE

Organ transplant issues H.R.4128/S.2209, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, Laboratory Developed Tests H.R.4407/S.1568, TRAIN Act, Nurse reimbursement related issues Graduate Medical Education (GME) H.R.7053/S.3792, Hospital at Home Program, Entirety Low Volume Hospitals and Medicare Dependent Hospitals Pay Go Medicare Cuts Medicare Physician Conversion Factor Reduction Medicare Sequestration Proposed Cuts to OPPS for Organ Acquisition Costs Monitor the following: Disproportionate Share Hospital (DSH) Payments Alabama Area Health Education Centers (AHEC) NIH grant related issues Public health and CDC related issues J1 Visa Waiver issues Opioid issues H.R.6000, CURES 2.0 Act OSHA Covid-19 Mandate Public Law 117-167, Supreme Court Security Funding Act of 2022, Division A--Creating Helpful Incentives to Produce Semiconductors (CHIPS Act), NSF and Energy related issues

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

Government targets: SENATE

- COVID-19 telehealth and provider relief; - 340B program; - Provider relief: Implementation of HR 748, CARES Act (PL 116-136); - Other issues including health equity, social determinants of health, mental health and nurse staffing - Outpatient physician payment and Medicare Physician Fee Schedule - Hunger and nutrition issues - H.R. 2617, Consolidated Appropriations Act, 2023 - Hospital at Home: S. 3792, H.R. 7053 - Hospital Inpatient Services Modernization Act - S. 1568, H.R. 4407 - Technical Reset to Advance the Instruction of Nurses Act (TRAIN Act)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5376 Inflation Reduction Act of 2022. Provisions related to health care coverage, Medicare, Medicaid, COVID funding and mental/behavioral health HR 4128 VALID Act HR 8487 - Improving Seniors' Timely Access to Care Act of 2022 S 3792 & HR 7053 Hospital Inpatient Services Modernization Act HR 959 Black Maternal Health Omnibus Act of 2021 HR 4074 Addressing Social Determinants in Medicare Advantage Act of 2021 HR 4911 Medicare Advantage Quality Payment Relief Act HR 5370 Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 HR 5376 Build Back Better Act, to provide for Budget Reconciliation HR 3 Elijah E. Cummings Lower Drug Costs Now Act HR 19 and S. 2164 Lower Costs, More Cures Act of 2021 HR 3063 Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (Mommies) Act HR 3172 Homes for Every Local Protector, Educator, and Responder (HELPER) Act of 2021 HR 2166 & S 150 Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 S 833 Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021 S 908 Medicare Drug Price Negotiation Act HR 2139 Medicare Drug Price Negotiation Act

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

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

Implementation of surprise billing legislation (No Surprises Act of the 2021 Consolidated Appropriations Act PL 116-260) General monitoring on Not-for-profit hospitals charity care and community benefits; Medicare payment issues; Health care reform, Hospital related issues and initiatives. Monitor generally as follows: H.R.7053/S.3792, Hospital Inpatient Services Modernization Act H.R.2256/S.834, Resident Physician Shortage Reduction Act H.R.1364, Parity Enforcement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Request cosponsorship of the Hospital Inpatient Services Modernization Act (S.3792), legislation that would extend the Acute Hospital Care at Home waiver program for two years from the date the public health emergency ends. Request inclusion of the following provisions in H.R. 2617, the Consolidated Appropriations Act of 2023: (1) Extend the current low-volume hospital adjustment criteria and Medicare dependent hospital program designation to enable rural hospitals in Texas to continue receiving appropriate Medicare payment adjustments; (2) Waive the statutory PAYGO reductions to avoid reductions in Medicare payments by an additional 4 percent in 2023; (3) extend telehealth flexibility's related to the COVID-19 pandemic emergency (including Hospital at Home program); (4) increase funding to address healthcare workforce shortages; (5) increase GME positions; and (6) require electronic prior authorization processes and other reforms to Medicare Advantage. Improving Seniors Timely Access to Care (HR 3173), endorsement of legislation that addresses preauthorization process in Medicare Advantage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE