Protecting Medicare and American Farmers from Sequester Cuts Act

Medicare physician payment; new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act of 2023 (HR 2389); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy; COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); implementation of the Consolidated Appropriations Act of 2022; Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 (H.R. 2583); Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 1406/S. 3021); Strengthening Medicare for Patients and Providers (H.R. 2474); site-neutrality; Providing Relief and Stability for Medicare Patients Act (H.R. 3674); Connected Maternal Online Monitoring Act (Connected Mom) (S. 712); Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699)

Client expense: $520,000 · 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), Office of Management & Budget (OMB), SENATE

Medicare physician payment; new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act of 2023 (HR 2389); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy; COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); implementation of the Consolidated Appropriations Act of 2022; Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 (H.R. 2583); Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 1406); Strengthening Medicare for Patients and Providers (H.R. 2474); site-neutrality; Providing Relief and Stability for Medicare Patients Act (H.R. 3674); Connected Maternal Online Monitoring Act (Connected Mom) (S. 712)

Client expense: $440,000 · 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), Office of Management & Budget (OMB), SENATE

Issues related to Protecting Access to Medicare Act Issues related to Medicare coverage reform Issues related to coverage of telehealth services Issues related to Medicare coverage for digital health technologies Issues related to Protecting Medicare and American Farmers from Sequesters Act (S.610) Issues related to physician fee schedule Issues related to H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Issues related to H.R. 4043 Ensuring Patient Access to Critical Breakthrough Products Act Issues related to H.R. S. 4449/H.R. 8188 Saving Access to Laboratory Services Act

Client expense: $840,000 · Firm income: Not reported

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

Medicare physician payment; new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act of 2023 (HR 2389); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy; COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); implementation of the Consolidated Appropriations Act of 2022; Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 (H.R. 2583); Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 1406); Strengthening Medicare for Patients and Providers (H.R. 2474)

Client expense: $490,000 · 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), Office of Management & Budget (OMB), SENATE

The Patient Protection and Affordable Care Act, Pub. L. No. 111-148, Section 4104; Colon cancer screening policies in Medicare; Medicare physician quality incentives; Advancement of physician quality registries as they relate to Medicare physician payment reform; Transparency in valuation of medical procedures under Medicare; Issues related to the Medicare physician fee schedule and payment policies for GI services, including budget neutrality and Medicare Economic Index; H.R.8800 - Supporting Medicare Providers Act of 2022; 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; physician burden reduction under Medicare, in general; H.R.1868/Pub. L. No. 117-7, To prevent across-the-board direct spending cuts, and for other purposes/Medicare sequester; Policies to waive cost of certain diagnostic colorectal cancer procedures under Medicare; Policies to continue coverage and payment for telehealth services under Medicare; S.610/Pub. L. No. 117-71, Protecting Medicare and American Farmers from Sequester Cuts Act; H.R.3173/S.3018, Improving Seniors' Timely Access to Care Act; H.R.7995, To amend title XVIII of the Social Security Act to exempt qualifying physicians from prior authorization requirements under Medicare Advantage plans, and for other purposes; H.R.2617, the Consolidated Appropriations Act, 2023.

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

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

Medicare geographic reclassification Pandemic preparedness S. 610 Protecting Medicare & American Farmers from Sequester Cuts Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1667/S. 610, Dr. Lorna Breene Health Care Provider Protection Act Issue: Support the authorization of funds to prevent mental and behavioral health conditions for health care professionals. H.R. 944, Expanding Access to Specialty Care in Rural Areas Issue: Support providing student loan forgiveness to specialty medicine physicians who serve in rural communities. H.R. 3021, Coronavirus Provider Protection Act Issue: Support COVID-19 related liability protections for health care providers during public health emergency. P.L. 116-260, Consolidated Appropriations Act of 2021, No Surprises Act Issue: Support Congressional efforts to ensure that the regulatory implementation of the No Surprises Act matches congressional intent. S. 3799,PREVENT Pandemics Act Issue: To prepare for, and respond to, existing viruses, emerging new threats, and pandemics. S. 3658, REDI Act Issue: This bill allows borrowers in medical or dental internships or residency programs to defer student loan payments until the completion of their programs.

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

Government targets: HOUSE OF REPRESENTATIVES, 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

H.R. 4014, Physician Shortage GME Cap Flex Act of 2021, provisions relating to Graduate Medical Education S. 2094, Physician Shortage GME Cap Flex Act of 2021, provisions relating to Graduate Medical Education H.R. 1332, Telehealth Modernization Act, all provisions S. 368, Telehealth Modernization Act, all provisions H.R. 4058, Telemental Health Care Access Act of 2021, all provisions S. 2061, Telemental Health Care Access Act of 2021, all provisions H.R. 3173, Improving Seniors Timely Access to Care Act of 2021, provisions relating to Prior Authorization and attachment standards S. 3018, Improving Seniors Timely Access to Care Act of 2021, provisions relating to Prior Authorization and attachment standards H.R. 7995, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2022, all provisions H.R. 3259, Non-Opioids Prevent Addiction In the Nation (NO PAIN) Act, all provisions S. 586, Non-Opioids Prevent Addiction In the Nation (NO PAIN) Act, all provisions H.R. 4587, Value in Health Care Act of 2021, all provisions H.R. 7213, Equitable Community Access to Pharmacist Services Act, all provisions S. 748, Medicare Sequester Relief Act, all provisions H.R. 2903, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions S. 1512, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 2256, Resident Physician Shortage Reduction Act, all provisions S. 834, Resident Physician Shortage Reduction Act, all provisions H.R. 1218, Data Mapping to Save Moms Lives Act, all provisions S. 198, Data Mapping to Save Moms Lives Act, all provisions H.R. 3407, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act, all provisions S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act, all provisions H.R. 3441, Substance Use Disorder Workforce Act, all provisions S. 1438, Opioid Workforce Act of 2021, all provisions H.R. 955, Medicaid Reentry Act of 2021, all provisions S. 285, Medicaid Reentry Act of 2021, all provisions H.R. 2654, Chiropractic Medicare Coverage Modernization Act of 2021, all provisions H.R. 6020, Supporting Medicare Providers Act of 2021, all provisions S. 3314, Supporting Medicare Providers 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. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 19, Lower Costs, More Cures Act of 2021, all provisions S. 801, Connected Maternal Online Monitoring Act, all provisions H.R. 1738, Stabilize Medicaid and CHIP Coverage Act, all provisions H.R. 1025, Kids Access to Primary Care Act of 2021, all provisions H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act, all provisions S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act, all provisions H.R. 6000, Cures 2.0 Act, all provisions H.R. 4043, Ensuring Patient Access to Critical Breakthrough Products Act of 2021, all provisions S. 2416, New Opportunities for Value that Extend Lives (NOVEL) Act of 2021, all provisions H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022, all provisions H.R. 3746, Accountable Care in Rural America Act, all provisions H.R. 4755, Seniors Chronic Care Management Improvement Act of 2021, all provisions H.R. 6308, ACO Assignment Improvement Act of 2021, all provisions H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes, all provisions H.R. 315, Medicare Sequester COVID Moratorium Act, all provisions H.R. 6048, Medicare Stability for Patients and Providers Act, all provisions H.R. 3348, SOS: Sustaining Outpatient Services Act, all provisions H.R. 366, Protecting Access to Post-COVID-19 Telehealth Act of 2021, all provisions H.R. 2166, Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021, all provisions H.R. 2228, Rural Behavioral Health Access Act of 2021, all provisions H.R. 3447, Permanency for Audio-Only Telehealth Act, all provisions H.R. 7051, Access to Prescription Digital Therapeutics Act of 2022, all provisions S. 3791, Access to Prescription Digital Therapeutics Act of 2022, all provisions H.R. 7878, Kidney Health Connect Act of 2022, all provisions S. 4307, Kidney Health Connect Act of 2022, all provisions H.R. 6202, Telehealth Extension Act of 2021, all provisions S. 987, CARA 3.0 Act of 2021, all provisions H.R. 1438, Opioid Workforce Act of 2021, all provisions H.R. 925, Data to Save Moms Act, all provisions H.R. 7475, Mamas First Act, all provisions H.R. 3746, Accountable Care in Rural America Act, all provisions H.R. 4587, Value in Health Care Act of 2021, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 3614, Menstrual Equity For All Act of 2021, provisions related to menstrual products coverage in Medicaid Medicare program: Physician Payment and Delivery Reform Medicare program: Impending Medicare payment cuts Medicare program: Medicare Evaluation and Management/budget neutrality Medicare program: Statutory PAYGO/Sequester Relief Medicare program: Accountable Care Organizations/specialty care Medicare program: Alternative Payment Models Medicare program: AMA Recovery Plan for Americas Physicians/payment reform Medicare program: Global and Professional Direct Contracting alternative payment model/REACH ACOs Medicare program: Appropriate Use Criteria and Prior Authorization Medicare program: Medicare Advantage/prior authorization regulation Medicare program: Automatic blood pressure measurement devices/coverage Medicare program: Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) Medicare program: MIPS/Promoting Interoperability/Cost/Improvement Activities Medicare program: MIPS/data sharing/transparency Medicare program: MACRA physician burdens Medicare program: Quality Payment Program Medicare program: Health IT burden Medicare program: Public Health Emergency COVID-19 /Accelerated and Advance Payments Medicare program: Primary Care First models Medicare program: Medicare Shared Savings Program (MSSP) Medicare program: Modifier 25 Medicare program: Split/shared billing Medicare program: Interoperability/data blocking/HIPAA Medicare program: Coding Medicare program: Provider compliance/Regulatory relief Medicare program: Provider Enrollment, Chain, and Ownership System (PECOS) Enrollment/Revalidation Medicare program: Open Payments Medicare program: Prescription drug pricing/Pharmacy Benefits Managers Medicare program: Step Therapy Medicare and Medicaid programs: Medicare Access and Chip Reauthorization Act (MACRA)/implementation Medicare and Medicaid programs: MACRA Oversight Medicaid program: Improving Access to Physical and Mental Health Care for Children and Youth Under Medicaid and CHIP draft Medicare and Medicaid programs: Health Equity Medicaid program: Maternal Mortality Medicaid program: Uninsured and healthcare coverage/COVID-19 Medicaid program: Special Enrollment Period Medicaid program: Sickle Cell Disease

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

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

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

The Patient Protection and Affordable Care Act, Pub. L. No. 111-148, Section 4104; Colon cancer screening policies in Medicare; Medicare physician quality incentives; Advancement of physician quality registries as they relate to Medicare physician payment reform; Transparency in valuation of medical procedures under Medicare; Issues related to the Medicare physician fee schedule and payment policies for GI services, including budget neutrality and Medicare Economic Index; H.R.8800 - Supporting Medicare Providers Act of 2022; 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; physician burden reduction under Medicare, in general; H.R.1868/Pub. L. No. 117-7, To prevent across-the-board direct spending cuts, and for other purposes/Medicare sequester; Policies to waive cost of certain diagnostic colorectal cancer procedures under Medicare; Policies to continue coverage and payment for telehealth services under Medicare; S.610/Pub. L. No. 117-71, Protecting Medicare and American Farmers from Sequester Cuts Act; H.R.3173/S.3018, Improving Seniors' Timely Access to Care Act; H.R.7995, To amend title XVIII of the Social Security Act to exempt qualifying physicians from prior authorization requirements under Medicare Advantage plans, and for other purposes; 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

Support for public health infrastructure Personal Protective Equipment Standards and access to Personal Protective Equipment, including supply chain issues Mental health resources for nurses S.308/H.R.1436 ‐ PPE in America Act H.R. 1384/S.445 - Mainstreaming Addiction Treatment (MAT) Act Issues surrounding telehealth, including removal of Medicare originating site and rural area restrictions S.610/H.R.1667 ‐ Dr. Lorna Breen Health Care Provider Protection Act H.R. 851/S.246 ‐ Future Advancement of Academic Nursing (FAAN) Act Issues surrounding nurse staffing shortages and remedies to address this crisis Pandemic preparedness S.3799 ‐ PREVENT Pandemics Act Extension of COVID‐19 public health emergency H.R. 7666 - Restoring Hope for Mental Health and Well‐Being Act of 2022 H.R. 8812 - Improving Care and Access to Nurses (ICAN) Act S.5212 - Improving Care and Access to Nurses (ICAN) Act Issues surrounding federal Monkeypox response

Client expense: $423,637 · Firm income: Not reported

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

- HR 1978/S 912, "Protecting Seniors Through Immunization Act", regarding all provisions - HR 6007, "To amend title XVIII of the Social Security Act to provide for the expansion of coverage of vaccines under part B of the Medicare program, and for other purposes", regarding all provisions - H.Res. 446, Expressing support for the goals and ideals of National Stroke Awareness Month, regarding all provisions - S 610/HR 1667, "The Dr. Lorna Breen Health Care Provider Protection Act", regarding all provisions - HR 3, "Elijah E. Cummings Lower Drug Costs Now Act", regarding all provisions - S 1784/HR 3353, Contact Lens Prescription Verification Modernization Act, regarding all provisions - HR 5030/S 2706, "The Diversifying Investigations Via Equitable Research Studies for Everyone (DIVERSE) Trials Act, regarding all provisions - S 3394, "Emergency Use Transparency Act", regarding all provisions - HR 3990/S 2047, "No PFAS in Cosmetics Act", regarding all provisions - HR 8299/S 4386, "To allow for devices with a predetermined change control plan to be marketed without submitting a supplemental application or premarket notification if the changes to such devices are consistent with such plan.", regarding all provisions - HR 7667/S 4348, "Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act", regarding provisions on accelerated approval and diversity in clinical studies - HR 5801, "HELP Copays Act", regarding all provisions - HR 3173/S 3018 - "Improving Seniors Timely Access to Care Act of 2021", regarding all provisions - S 3799 - "PREVENT Pandemics Act", regarding all provisions - HR 3932/S 2076 - "PASTEUR Act of 2021", regarding all provisions - HR 5376 - "Inflation Reduction Act", regarding provisions on drug pricing and provisions related to revenue - HR 7559 - Prescription Information Modernization Act of 2022, regarding all provisions - HR 2617 - "Consolidated Appropriations Act, 2023", regarding provisions related to pharmaceuticals, medical devices, mental health, and tax - Issues related to Dengue - Issues related to prescription drug pricing - Issues related to health care pricing transparency - Issues related to maternal health - Issues related to frontline health workers - Issues related to over the counter products - Issues related to the regulation of cosmetic products - Issues related to the regulation of dietary supplements - Issues related to stroke care - Issues related to counterfeit health care goods - Issues related to 340B drug pricing program - Issues related to antimicrobial resistance - Issues related to the COVID-19 vaccine development, including diversity in clinical trials - Issues related to Medicare Part D's 6 protected classes - Issues related to global public health and ending tuberculosis - Issues pertaining to health equity and social determinants of health - Issues related to FDA medical device shortage reporting requirements, including implementation of CARES Act requirements - Issues related to lung cancer screening - Issues related to clinical research diversity - Issues related to international harmonization of medical device regulation

Client expense: $2,270,000 · Firm income: Not reported

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

Medicare physician payment; new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; access to and supervision of Cardiac and Pulmonary Rehabilitation (HR 1956/ S 1986); graduate medical education policy including the Resident Physician Shortage Reduction Act of 2021 (HR 2256/S 834); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy; COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; Protecting Access to Post-COVID-19 Telehealth Act (HR 366); Medicare Stability for Patients and Providers Act (HR 6048); Protecting Medicare and American Farmers from Sequester Cuts Act (S 610); the Consolidated Appropriations Act of 2022; Sustainable Cardiopulmonary Rehabilitation Services in the Home Act (HR 9427)

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), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Health care quality; physician and hospital quality; health care innovation; Patient Protection and Affordable Care Act/health care reform implementation; unique device identifier policy and post-market surveillance for medical devices; clinical trial design; clinical data registries including HR 5394, Meaningful Access to Federal Health Plan Claims Data Act of 2021; HIPAA and registries; federal funding/appropriations for HHS, NIH, AHRQ, CDC, FDA, HRSA and the Childrens Hospital Graduate Medical Education payment program, the Prevention & Public Health Fund, medical research, and prevention; research and scholarly communication policy; implementation and oversight of 21st Century Cures Act; data blocking/interoperability of electronic data; health disparities; reduction/oversight of prior authorization and other administrative burdens; digital health; Sect. 1557 Nondiscrimination in Health Programs and Activities; cardiomyopathy education and awareness; peripheral arterial disease (PAD) education and awareness; research on valvular heart disease including the CAROL Act (HR 1193/ S 1133); VA Mission Act implementation; COVID-19 and implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act , the Coronavirus Aid, Relief, and Economic Security Act, Coronavirus Provider Protection Act (HR 3021), and clinician mental health including the Dr. Lorna Breen Health Care Provider Protection Act (HR 1667/S 610); patient identification; the Protecting and Transforming Cyber Health Care Act (HR 7084); the Diagnostic Device Advisory Committee Act (HR 7192); the Innovation and Competition Act (S. 1260)

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Support for public health infrastructure Personal Protective Equipment Standards and access to Personal Protective Equipment, including supply chain issues Mental health resources for nurses S.308/H.R.1436 ‐ PPE in America Act H.R. 1384/S.445 - Mainstreaming Addiction Treatment (MAT) Act Issues surrounding telehealth, including removal of Medicare originating site and rural area restrictions S.610/H.R.1667 ‐ Dr. Lorna Breen Health Care Provider Protection Act H.R. 851/S.246 ‐ Future Advancement of Academic Nursing (FAAN) Act Issues surrounding nurse staffing shortages and remedies to address this crisis Pandemic preparedness S.3799 ‐ PREVENT Pandemics Act Extension of COVID‐19 public health emergency H.R. 7666 - Restoring Hope for Mental Health and Well‐Being Act of 2022 H.R. 8812 - Improving Care and Access to Nurses (ICAN) Act S.5212 - Improving Care and Access to Nurses (ICAN) Act Issues surrounding federal Monkeypox response

Client expense: $380,000 · Firm income: Not reported

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

Issues related to Protecting Access to Medicare Act Issues related to Medicare coverage reform Issues related to coverage of telehealth services Issues related to Medicare coverage for digital health technologies Issues related to Protecting Medicare and American Farmers from Sequesters Act (S.610) Issues related to physician fee schedule Issues related to H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Issues related to H.R. 4043 Ensuring Patient Access to Critical Breakthrough Products Act Issues related to H.R. S. 4449/H.R. 8188 Saving Access to Laboratory Services Act

Client expense: $750,000 · Firm income: Not reported

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

Issues related to home care and hospice, telehealth, Medicare reimbursement.; Impact of COVID-19, including telehealth and the Provider Relief Fund.; COVID-19 relief funding within the American Rescue Plan Act (P.L. 117-2), HEAT Act (S. 4854/H.R.3371),; FY 2022 Appropriations, 1115 Waiver, and FMAP increase/HCBS.; HEAT Act (H.R. 3371).; FY 2022 Appropriations; 1115 Waiver; FMAP increase/HCBS; Workforce.; COVID-19 relief funding within the American Rescue Plan Act (P.L. 117-2), HEAT Act (S. 4854/H.R.3371), Choose Home Care Act of 2021 (S. 2562/H.R. 5514), Build Back Better Act (H.R.5376), the Protecting Medicare and American Farmers from Sequester Cuts Act (S.610), and FY 2022 Consolidated Appropriations Act (P.L. 117-103); HEAT Act (S. 4854/H.R.3371), Choose Home Care Act of 2021 (S. 2562/H.R. 5514).

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), Office of Management & Budget (OMB), SENATE, White House Office

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H. Res 436, sense of the House supporting state, local and community initiatives to curb incidences of skin cancer beginning with childhood skin cancer. Support H. Res 718, designating October 17, 2021 as National Vitiligo Awareness Day Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 Support H.R. 8437, the Improving Seniors Timely Access to Care Act of 2022 Support H.R. 4122/S. 3645, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Support H.R. 5054, Keep Physicians Serving Patients Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Advocate for legislative solution to access problems to iPLEDGE/REMS program for isotretinoin (H.R. 7667, Food and Drug Amendments of 2022/S. 4348 FDASLA Act of 2022, H.R. 2617, Consolidated Appropriations Act). Support H.R. 7649, a bill to direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes. Support H.R. 5030/S. 2706, the Diversifying Investigations and Equitable Research Studies for Everyone (DIVERSE) Trials Act Support H.R. 7995, GOLD CARD Act of 2022 Advocate to provide relief from the 2% Medicare sequester, replace scheduled and anticipated cuts in payments with positive, inflationary-based updates, eliminate the nearly 4.5% conversion factor cut in the CMS proposed rule for the 2023 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes, and waive the 4% PAYGO sequester to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2 (H.R. 2617, Consolidated Appropriations Act). Support H.R. 8800, Supporting Medicare Providers Act of 2022 Advocate against H.R 6708, Improving Access to Workers Compensation for Injured Federal Workers Act, which expands the role of nurse practitioners and physician assistants in providing services to injured federal workers under the federal workers' compensation program. Oppose H.R. 8812, the Improving Care & Access to Nurses Act (I CAN Act)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 8800, Supporting Medicare Providers Act of 2022, all provisions H.R. 3434, Territories Health Equity Act of 2021, all provisions H.R. 4406, Supporting Medicaid in the U.S. Territories Act of 2021, all provisions H.R. 1332, Telehealth Modernization Act, all provisions S. 368, Telehealth Modernization Act, all provisions H.R. 2903, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021, all provisions S. 1512, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021, all provisions H.R. 366, Protecting Access to Post-COVID-19 Telehealth Act of 2021, all provisions H.R. 7051, Access to Prescription Digital Therapeutics Act of 2022, provisions relating to COVID-19 flexibilities, and telemental health S. 3791, Access to Prescription Digital Therapeutics Act of 2022, provisions relating to COVID-19 flexibilities, and telemental health S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act, all provisions H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2022, all provisions H.R. 2654, Chiropractic Medicare Coverage Modernization Act of 2021, all provisions H.R. 7213, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act of 2022, all provisions H.R. 5067, Preserving Patient Access to Home Infusion Act, provisions relating to scope of practice S. 2652, Preserving Patient Access to Home Infusion Act, provisions relating to scope of practice H.R. 8812, Improving Care and Access to Nurses (I CAN) Act, all provisions S. 5212, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 9577, Increasing Mental Health Options Act of 2022, all provisions S. 5272, Increasing Mental Health Options Act of 2022, all provisions H.R. 3173, Improving Seniors Timely Access to Care Act of 2021, all provisions S. 3018, Improving Seniors Timely Access to Care Act of 2021, all provisions H.R. 8487, Improving Seniors' Timely Access to Care Act of 2022, all provisions H.R. 3259, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, all provisions S. 586, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, all provisions H.R. 1438, Opioid Workforce Act of 2021, all provisions S. 1438, Opioid Workforce Act of 2021, all provisions H.R. 3441, Substance Use Disorder Workforce Act, all provisions H.R. 3407, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act, provisions relating to Medicaid and CHIP, and maternal and infant mortality S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act, provisions relating to Medicaid and CHIP, and maternal and infant mortality H.R. 925, Data to Save Moms Act, all provisions H.R. 959, Black Maternal Health Momnibus Act of 2021, all provisions S. 346, Black Maternal Health Momnibus Act of 2021, all provisions H.R. 3746, Accountable Care in Rural America Act, all provisions H.R. 4587, Value in Health Care Act of 2021, all provisions H.R. 4755, Seniors Chronic Care Management Improvement Act of 2021, all provisions H.R. 6308, ACO Assignment Improvement Act of 2021, all provisions S. 5249, Preserving Patient Access to Value-Based Care Act, all provisions H.R. 8879, Inpatient Psychiatric Facility Improvement Act, all provisions H.R. 8878, To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program, all provisions H.R. 432, Mental Health Access Improvement Act of 2021, all provisions H.R. 8910, Behavioral Health Integration Awareness Act of 2022, all provisions H.R. 8884, Medicare Opioid Use Disorder Outreach Act, all provisions H.R. 8890, Physician Wellness Program Act of 2022, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 19, Lower Costs, More Cures Act of 2021, all provisions H.R. 4058, Telemental Health Care Access Act of 2021, all provisions S. 2061, Telemental Health Care Access Act of 2021, all provisions S. 801, Connected Maternal Online Monitoring Act, all provisions H.R. 1738, Stabilize Medicaid and CHIP Coverage Act, all provisions H.R. 1025, Kids Access to Primary Care Act of 2021, all provisions H.R. 2256, Resident Physician Shortage Reduction Act of 2021, all provisions S. 834, Resident Physician Shortage Reduction Act of 2021, all provisions H.R. 7995, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2022, all provisions H.R. 955, Medicaid Reentry Act of 2021, all provisions S. 285, Medicaid Reentry Act of 2021, 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 H.R. 4043, Ensuring Patient Access to Critical Breakthrough Products Act of 2021, all provisions S. 2416, New Opportunities for Value that Extend Lives (NOVEL) Act of 2021, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions H.R. 8594, Restore Protections for Dialysis Patients Act, all provisions S. 4750, Restore Protections for Dialysis Patients Act, all provisions H.R. 4014, Physician Shortage GME Cap Flex Act of 2021, all provisions S. 2094, Physician Shortage GME Cap Flex Act of 2021, all provisions H.R. 9378, Sunshine Act of 2022, all provisions H.R. 6576, Small Practice, Underserved, and Rural Support Program (SURS) Extension Act of 2022, all provisions Medicare program: Medicare and CHIP Reauthorization Act (MACRA) broad reform Medicare program: MACRA implementation Medicare program: MACRA burdens Medicare program: 21st Century Cures Act implementation Medicare program: Enhancing the Mental Health Workforce Medicare program: Improvement to Medicare Inpatient Psychiatric Facility Improvement Act Medicare program: Medicare program improvement/Physician Services and Education Medicare program: Accountable Care Organizations Medicare program: Medicare Economic Index (MEI)/inflation updates Medicare program: 2% Medicare sequester moratorium Medicare program: 4.5% payment rates reduction Medicare program: Medicare Physician Fee Schedule Conversion Factor/3% increase extension Medicare program: Global and Professional Direct Contracting alternative payment model/REACH ACOs Medicare program: Medicare physician payment Medicare program: Merit-based Incentive Payment Program (MIPS) improvement Medicare program: Alternative Payment Models (APMs) Medicare program: Medicare Physician Payment Reform/primary care/specialties Medicare program: Provider Enrollment, Chain, and Ownership System (PECOS)/Revalidation Medicare program: Recovery plan for Americas Physicians Medicare program: Physician-Owned Hospitals/Medicare Moratorium Medicare program: Health IT burdens Medicare program: EHR certification Medicare program: Provider Compliance/Regulatory Relief Medicare program: Quality Payment Program/physician burdens Medicare program: National provider directory Medicare program: Self-measured blood pressure (SMBP) devices/benefit category Medicare program: Information blocking Medicare program: Coding Medicare program: Skilled nursing facilities (SNF) Medicare and Medicaid programs: Cybersecurity Medicare and Medicaid programs: Puerto Rico/Medicaid caps/FMAP Medicaid program: Improving Access to Physical and Mental Health Care for Children and Youth Under Medicaid and CHIP Medicaid program: Ensuring Access to Telemental Health Services Medicaid program: Ensuring Access to Telemental Health Services Medicaid program: Enhancing the Mental Health Workforce Medicaid program: Improving Integration, Coordination, and Access to Care Medicaid program: Maternal mortality and morbidity/Equity

Client expense: $5,060,000 · 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

H.R. 1437, Further Continuing Appropriations and Extensions Act, 2023, provisions relating to Medicare and Medicaid, and Conrad State 30 H.R. 2617, Consolidated Appropriations Act, 2023, provisions relating to Medicare and Medicaid, Conrad State 30, telehealth flexibilities, and CDCs Office on Smoking and Health funding H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes, all provisions H.R. 315, Medicare Sequester COVID Moratorium Act, all provisions S. 748, Medicare Sequester Relief Act, all provisions H.R. 6020, Supporting Medicare Providers Act of 2021, all provisions S. 3314, Supporting Medicare Providers Act of 2021, all provisions S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act, provisions relating to 3% MPFS CF, 6-month extension of 2% sequester moratorium, Radiation Oncology APM, and clinical lab cuts H.R. 6048, Medicare Stability for Patients and Providers Act, all provisions H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act, all provisions H.R. 6617, Further Additional Extending Government Funding Act, provisions relating to Conrad State 30 H.R. 2471, Consolidated Appropriations Act, 2022, provisions relating to immigration H.R. 6833, Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023, provisions relating to Section 101, and Conrad 30 extension H.R. 5376, Inflation Reduction Act of 2022, all provisions H.R. 3671, Doctors of Community (DOC) Act, all provisions S. 1958, Doctors of Community (DOC) Act, all provisions

Client expense: $5,060,000 · Firm income: Not reported

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

Sequestration relief (Protecting Medicare and American Farmers from Sequester Cuts Act - S. 610) Rural hospital policies [Rural Health Clinic payment - Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885), Rural HELP Act - HR 1749; Rural Hospital Closure Relief Act (H.R. 1639/S.644)] Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 - S. 834/H.R. 2256; Opioid Workforce Act, S. 1438)/ Substance Use Disorder Workforce Act, H.R. 3441) H.R. 1749 (study on potential disparities in incurred costs for rural and urban hospitals and authorizing appropriate payment adjustments) S. 439, Coronavirus Medicaid Response Act (addressing FMAP) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340; CONNECT for Health Act S. 1512/H.R. 2903; Ensuring Parity in MA and PACE for Audio-Only Telehealth Act S. 150/H.R. 2166; Consolidated Appropriations Act of 2022, HR 2471) Prior Authorization reform - Improving Seniors Timely Access to Care Act of 2021 (H.R. 3173/S.3018) S.586 / H.R. 3259 - Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act Annual Prospective Payment System Rules S. 408, Supporting Best Practices for Healthy Moms Act (to reduce maternal mortality) Nursing and allied health education (NAHE) program funding Technical Reset to Advance the Instruction of Nurses (TRAIN) Act (S. 1568 / HR 4407) - Nursing and allied health education payments Organ acquisition payment policies Clinical lab fee schedule Medicare Mental Health Inpatient Equity Act (S. 3061/H.R. 5674) HR 4040: Advancing Telehealth Beyond COVID-19 Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.800/H.R. 4870 - Promoting Access to Diabetic Shoes Act H.R. 1956/S. 1986 - Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 H.R. 2067/S. 2235 - Medication Access and Training Expansion (MATE) Act S. 987 - Comprehensive Addiction and Recovery Act (CARA) 3.0 H.R. 1319 - American Rescue Plan Act [Public Law No: 117-2] H.R. 1716 - COVID-19 Mental Health Research Act H.R. 1195 - the Workplace Violence Prevention for Health Care and Social Service Workers Act S. 54 - Strengthening Americas Health Care Readiness Act H.R. 851/S. 246 - the Future Advancement of Academic Nursing (FAAN) Act H.R. 959/S.346 - Black Maternal Health Momnibus Act of 2021 H.R. 1384 - the Mainstreaming Addiction Treatment Act of 2021 H.R. 955 - the Medicaid Reentry Act of 2021 H.R. 1025 - the Kids Access to Primary Care Act of 2021 S. 1315/H.R. 3630 - the Lymphedema Treatment Act S. 1833 - the Ensuring Access to Primary Care for Women & Children Act H.R. 3550/S. 4905 - the Primary and Behavioral Health Care Access Act S. 1512/H.R. 2903 - the CONNECT for Health Act of 2021 S. 287/H.R. 945 - the Perinatal Workforce Act S. 1536/H.R. 3108 - the Medical Nutrition Therapy Act of 2021 H.R. 1667/S. 610 - the Dr. Lorna Breen Health Care Provider Protection Act H.R. 736 - the Community Immunity During COVID-19 Act of 2021 H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act H.R. 6000 - the Cures 2.0 Act S. 2652/H.R. 5067 - the Preserving Patient Access to Home Infusion Act S. 3149/H.R. 5848 - the Rural Health Equity Act H.R. 6308 - the ACO Assignment Improvement Act of 2021 H.R. 5248 - the Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021 H.R. 5376 - the Build Back Better Act H.R.3925 - the Reducing Barriers to Substance Use Treatment Act S. Res. 626 and H. Res. 1100 - honoring and recognizing May 6 through 12, 2022 as National Nurses Week S.3098/H.R. 7617 - Preventive Care Awareness Act S.4182 - the Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 7236 - the Strengthen Kids Mental Health Now Act of 2022 H.R. 2376 - the Excellence in Recovery Housing Act H.R. 4944 - the Helping Kids Cope Act of 2021 H.R. 5218 - the Collaborate in an Orderly and Cohesive Manner Act H.R. 7076 - the Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7232 - the 9-8-8 and Parity Assistance Act of 2022 H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S.4170 - the Mental Health Reform Reauthorization Act H.R. 8812/S. 5212 - Improving Care and Access to Nurses (ICAN) Act H.R. 8454 - Medical Marijuana and Cannabidiol Research Expansion Act [Public Law No: 117-215] H.R. 3352/S. 1697 - Midwives for MOMs Act H.R. 8817/S. 4844 - the National Nursing Workforce Center Act of 2022 H.R. 3259/S. 586 - the NOPAIN Act H.R. 2617 - Consolidated Appropriations Act, 2023 The Senate Finance Committee Bipartisan Mental Health Workforce Discussion Draft National Healthcare Provider Directory Department of Labor independent contractor classification Issues pertaining to White House Hunger, Nutrition, and Health Conference Issues surrounding federal Monkeypox response Clinical Laboratory Improvement Amendments (CLIA) Replenish the COVID-19 Uninsured Relief Fund Nursing faculty shortage Nursing Education Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Medicare sequestration Medicare restrictions pertaining to telehealth Include nurses, APRNs, and nursing students in all National Public Health Plans Provide resources to support nurses, APRNs, and nursing students mental health needs, especially for those responding to the pandemic Funding to ensure childcare coverage Increased Federal Medical Assistance Percentage (FMAP) funding to states Access to personal protective equipment Extension of CMS waivers beyond public health emergency Skilled Nursing Facility admitting examination and assessment requirements COVID-19 Pandemic relief: funding, removal of barriers, telehealth, mental health, personal protective equipment, and testing Telehealth, remote patient monitoring and other forms of health technology COVID-19 Pandemic Reducing Regulatory Burdens, including those relating to home infusion therapy, Medicare Conditions of Participation, and hospice certification Medication-Assisted Treatment (MATs) Opioid Abuse Epidemic Documentation of medical records Health plan coverage and program requirements including provider non-discrimination Issues relating to Mental and Substance Use Disorder Workforce Addressing Health Equity Medicare Provider Reimbursement Clinical labor pricing update Tobacco flavors and menthol Site specific restrictions on providers under DEA controlled substances policy

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), Labor, Dept of (DOL), Nuclear Regulatory Commission (NRC), Office of Special Counsel, SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

H.R. 1260 - The Bipartisan Solution to Cyclical Violence Act of 2021 H.R. 8/S. 529 - The Bipartisan Background Checks Act/Background Check Expansion Act H.R. 2256/S. 834 - The Resident Physician Shortage Reduction Act Public Law No. 117-105/S. 610/H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1319/PL 117-2 - American Rescue Plan Act H.R. 315 - Medicare Sequester COVID Moratorium Act H.R. 3173/S. 3018 - Improving Seniors' Timely Access to Care Act S. 1593/H.R. 5149 - Ensuring Access to General Surgery Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 5239/S. 2941 - Good Samaritan Health Professionals Act of 2021 H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act. H.R. 4502 - Labor HHS Appropriations H.R. 4350 National Defense Authorization Act for Fiscal Year 2022 H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 1332/S. 368 - Telehealth Modernization Act S. 2565 - Expanding Access to Palliative Care H.R. 5377 - Cancer Patient Equity Act H.R. 6020 the Supporting Medicare Providers Act of 2021 H.R.2256 - Build Back Better Act S. 3799 - PREVENT Pandemics Act H. Res 951/S. Res 532 - Recognizing 100 Years of the COT H. Res 997/S. Res 566 - ACS CoC anniversary resolution PL 109-417 - Pandemic and All Hazards Preparedness Act Reauthorization H.R. 7995 - Gold Card Act of 2022 S. 4269/H.R. 7850 - Prevent BLEEDing Act S. 4330 - SPARC Act S. 3658/H.R. 4122 - REDI Act S. 2938 - Bipartisan Safer Communities Act H.R. 2163/S. 464 - Safe Step Act H.R. 8163 - Improving Trauma Systems and Emergency Care Act H.R. 8800 - Supporting Medicare Providers Act of 2022 Department of Veterans Affairs Supremacy Project VA Scope of Practice Stop the Bleed training/program Rural health and equity NSA good faith estimate rule Global Surgery/Rare Surgery Commission on Cancer Legislative Agenda Appropriate Use Criteria (AUC) Firearms injury prevention, safety & research ACS Quality legislative proposal Local Coverage Determinations/Carrier Advisory Committees No Surprises Act Implementation Scope of Practice issues National Trauma and Emergency Preparedness System (NTEPS) Public Health Preparedness CY2022 Medicare Physician Fee Schedule Final Rule Multi-Cancer Early Detection Screening Coverage Act NO PAIN Act COVID-19 Vaccines and Mental Health Maternal and gender disparities in health care The role of immigrant physicians in the U.S. Healthcare system Local Coverage Determinations/Carrier Access Committee Issues New Hernia Repair CPT Codes for 2023 Regional medical operations centers (RMOCs) Remote Patient Monitoring Social Determinants of Health Sequestration relief Ocular Regional Clinical Centers of Excellence (RCOEs) 21st Century Cures 2.0 Act Price Transparency Legislation Medicare Physician Payment Cuts MACRA Improvements National Trauma Systems Legislation Mission Zero Funding Prior Authorization Unique Patient Identifier/Appropriations Surgical Workforce Shortages ACA coverage expansion Global Surgical Codes Graduate Medical Education (GME) Alternative Payment Models

Client expense: $23,000 · 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. 1260 - The Bipartisan Solution to Cyclical Violence Act of 2021 H.R. 8/S. 529 - The Bipartisan Background Checks Act/Background Check Expansion Act H.R. 2256/S. 834 - The Resident Physician Shortage Reduction Act Public Law No. 117-105/S. 610/H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1319/PL 117-2 - American Rescue Plan Act H.R. 315 - Medicare Sequester COVID Moratorium Act H.R. 3173/S. 3018 - Improving Seniors' Timely Access to Care Act S. 1593/H.R. 5149 - Ensuring Access to General Surgery Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 5239/S. 2941 - Good Samaritan Health Professionals Act of 2021 H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act. H.R. 4502 - Labor HHS Appropriations H.R. 4350 National Defense Authorization Act for Fiscal Year 2022 H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 1332/S. 368 - Telehealth Modernization Act S. 2565 - Expanding Access to Palliative Care H.R. 5377 - Cancer Patient Equity Act H.R. 6020 the Supporting Medicare Providers Act of 2021 H.R.2256 - Build Back Better Act S. 3799 - PREVENT Pandemics Act H. Res 951/S. Res 532 - Recognizing 100 Years of the COT H. Res 997/S. Res 566 - ACS CoC anniversary resolution PL 109-417 - Pandemic and All Hazards Preparedness Act Reauthorization H.R. 7995 - Gold Card Act of 2022 S. 4269/H.R. 7850 - Prevent BLEEDing Act S. 4330 - SPARC Act S. 3658/H.R. 4122 - REDI Act S. 2938 - Bipartisan Safer Communities Act H.R. 2163/S. 464 - Safe Step Act H.R. 8163 - Improving Trauma Systems and Emergency Care Act H.R. 8800 - Supporting Medicare Providers Act of 2022 Department of Veterans Affairs Supremacy Project VA Scope of Practice Stop the Bleed training/program Rural health and equity NSA good faith estimate rule Global Surgery/Rare Surgery Commission on Cancer Legislative Agenda Appropriate Use Criteria (AUC) Firearms injury prevention, safety & research ACS Quality legislative proposal Local Coverage Determinations/Carrier Advisory Committees No Surprises Act Implementation Scope of Practice issues National Trauma and Emergency Preparedness System (NTEPS) Public Health Preparedness CY2022 Medicare Physician Fee Schedule Final Rule Multi-Cancer Early Detection Screening Coverage Act NO PAIN Act COVID-19 Vaccines and Mental Health Maternal and gender disparities in health care The role of immigrant physicians in the U.S. Healthcare system Local Coverage Determinations/Carrier Access Committee Issues New Hernia Repair CPT Codes for 2023 Regional medical operations centers (RMOCs) Remote Patient Monitoring Social Determinants of Health Sequestration relief Ocular Regional Clinical Centers of Excellence (RCOEs) 21st Century Cures 2.0 Act Price Transparency Legislation Medicare Physician Payment Cuts MACRA Improvements National Trauma Systems Legislation Mission Zero Funding Prior Authorization Unique Patient Identifier/Appropriations Surgical Workforce Shortages ACA coverage expansion Global Surgical Codes Graduate Medical Education (GME) Alternative Payment Models

Client expense: $23,000 · 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. 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

gain of function research of concern diagnostic regulation H.R. 2148 VALID Act S. 2209, VALID Act H.R.6000 , Cures 2.0 pandemic preparedness and clinical lab role H.R.5602,BIO preparedness Workforce Act S. 3244, BIO Preparedness Workforce Act S. 610, Protecting Medicare and Farmers from Sequester Cuts Act SALSA Act H.R. 8188, S. 4449

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), Office of Science & Technology Policy (OSTP), SENATE

gain of function research of concern diagnostic regulation H.R. 2148 VALID Act S. 2209, VALID Act H.R.6000 , Cures 2.0 pandemic preparedness and clinical lab role H.R.5602,BIO preparedness Workforce Act S. 3244, BIO Preparedness Workforce Act S. 610, Protecting Medicare and Farmers from Sequester Cuts Act SALSA Act H.R. 8188, S. 4449

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), Office of Science & Technology Policy (OSTP), SENATE

H.R. 1260 - The Bipartisan Solution to Cyclical Violence Act of 2021 H.R. 8/S. 529 - The Bipartisan Background Checks Act/Background Check Expansion Act H.R. 2256/S. 834 - The Resident Physician Shortage Reduction Act Public Law No. 117-105/S. 610/H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1319/PL 117-2 - American Rescue Plan Act H.R. 315 - Medicare Sequester COVID Moratorium Act H.R. 3173/S. 3018 - Improving Seniors' Timely Access to Care Act S. 1593/H.R. 5149 - Ensuring Access to General Surgery Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 5239/S. 2941 - Good Samaritan Health Professionals Act of 2021 H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act. H.R. 4502 - Labor HHS Appropriations H.R. 4350 National Defense Authorization Act for Fiscal Year 2022 H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 1332/S. 368 - Telehealth Modernization Act S. 2565 - Expanding Access to Palliative Care H.R. 5377 - Cancer Patient Equity Act H.R. 6020 the Supporting Medicare Providers Act of 2021 H.R.2256 - Build Back Better Act S. 3799 - PREVENT Pandemics Act H. Res 951/S. Res 532 - Recognizing 100 Years of the COT H. Res 997/S. Res 566 - ACS CoC anniversary resolution PL 109-417 - Pandemic and All Hazards Preparedness Act Reauthorization H.R. 7995 - Gold Card Act of 2022 S. 4269/H.R. 7850 - Prevent BLEEDing Act S. 4330 - SPARC Act S. 3658/H.R. 4122 - REDI Act S. 2938 - Bipartisan Safer Communities Act H.R. 2163/S. 464 - Safe Step Act H.R. 8163 - Improving Trauma Systems and Emergency Care Act H.R. 8800 - Supporting Medicare Providers Act of 2022 Department of Veterans Affairs Supremacy Project VA Scope of Practice Stop the Bleed training/program Rural health and equity NSA good faith estimate rule Global Surgery/Rare Surgery Commission on Cancer Legislative Agenda Appropriate Use Criteria (AUC) Firearms injury prevention, safety & research ACS Quality legislative proposal Local Coverage Determinations/Carrier Advisory Committees No Surprises Act Implementation Scope of Practice issues National Trauma and Emergency Preparedness System (NTEPS) Public Health Preparedness CY2022 Medicare Physician Fee Schedule Final Rule Multi-Cancer Early Detection Screening Coverage Act NO PAIN Act COVID-19 Vaccines and Mental Health Maternal and gender disparities in health care The role of immigrant physicians in the U.S. Healthcare system Local Coverage Determinations/Carrier Access Committee Issues New Hernia Repair CPT Codes for 2023 Regional medical operations centers (RMOCs) Remote Patient Monitoring Social Determinants of Health Sequestration relief Ocular Regional Clinical Centers of Excellence (RCOEs) 21st Century Cures 2.0 Act Price Transparency Legislation Medicare Physician Payment Cuts MACRA Improvements National Trauma Systems Legislation Mission Zero Funding Prior Authorization Unique Patient Identifier/Appropriations Surgical Workforce Shortages ACA coverage expansion Global Surgical Codes Graduate Medical Education (GME) Alternative Payment Models

Client expense: $236,000 · 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. 1260 - The Bipartisan Solution to Cyclical Violence Act of 2021 H.R. 8/S. 529 - The Bipartisan Background Checks Act/Background Check Expansion Act H.R. 2256/S. 834 - The Resident Physician Shortage Reduction Act Public Law No. 117-105/S. 610/H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1319/PL 117-2 - American Rescue Plan Act H.R. 315 - Medicare Sequester COVID Moratorium Act H.R. 3173/S. 3018 - Improving Seniors' Timely Access to Care Act S. 1593/H.R. 5149 - Ensuring Access to General Surgery Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 5239/S. 2941 - Good Samaritan Health Professionals Act of 2021 H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act. H.R. 4502 - Labor HHS Appropriations H.R. 4350 National Defense Authorization Act for Fiscal Year 2022 H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 1332/S. 368 - Telehealth Modernization Act S. 2565 - Expanding Access to Palliative Care H.R. 5377 - Cancer Patient Equity Act H.R. 6020 the Supporting Medicare Providers Act of 2021 H.R.2256 - Build Back Better Act S. 3799 - PREVENT Pandemics Act H. Res 951/S. Res 532 - Recognizing 100 Years of the COT H. Res 997/S. Res 566 - ACS CoC anniversary resolution PL 109-417 - Pandemic and All Hazards Preparedness Act Reauthorization H.R. 7995 - Gold Card Act of 2022 S. 4269/H.R. 7850 - Prevent BLEEDing Act S. 4330 - SPARC Act S. 3658/H.R. 4122 - REDI Act S. 2938 - Bipartisan Safer Communities Act H.R. 2163/S. 464 - Safe Step Act H.R. 8163 - Improving Trauma Systems and Emergency Care Act H.R. 8800 - Supporting Medicare Providers Act of 2022 Department of Veterans Affairs Supremacy Project VA Scope of Practice Stop the Bleed training/program Rural health and equity NSA good faith estimate rule Global Surgery/Rare Surgery Commission on Cancer Legislative Agenda Appropriate Use Criteria (AUC) Firearms injury prevention, safety & research ACS Quality legislative proposal Local Coverage Determinations/Carrier Advisory Committees No Surprises Act Implementation Scope of Practice issues National Trauma and Emergency Preparedness System (NTEPS) Public Health Preparedness CY2022 Medicare Physician Fee Schedule Final Rule Multi-Cancer Early Detection Screening Coverage Act NO PAIN Act COVID-19 Vaccines and Mental Health Maternal and gender disparities in health care The role of immigrant physicians in the U.S. Healthcare system Local Coverage Determinations/Carrier Access Committee Issues New Hernia Repair CPT Codes for 2023 Regional medical operations centers (RMOCs) Remote Patient Monitoring Social Determinants of Health Sequestration relief Ocular Regional Clinical Centers of Excellence (RCOEs) 21st Century Cures 2.0 Act Price Transparency Legislation Medicare Physician Payment Cuts MACRA Improvements National Trauma Systems Legislation Mission Zero Funding Prior Authorization Unique Patient Identifier/Appropriations Surgical Workforce Shortages ACA coverage expansion Global Surgical Codes Graduate Medical Education (GME) Alternative Payment Models

Client expense: $236,000 · Firm income: Not reported

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

Practice Support/Grants to Practice Foreign physician immigration status Medical liability H.R. 7259, Medical Controlled Substances Transportation Act of 2022: to enable physicians to more easily transport controlled substances safely and legally across state lines H.R. 133, the Consolidated Appropriations Act, 2021: No Surprises Act, surprise medical billing H.R. 2630, Extending Temporary Emergency Scheduling of Fentanyl Analogues Act: Opioids H.R. 3502, Protecting People From Surprise Medical Bills Act: Surprise Medical Bills S. 445, Mainstreaming Addiction Treatment Act of 2021: Opioids H.R. 4387, Maternal Health Quality Improvement Act of 2021: Maternal health H.R. 1565, Saving Lives, Saving Costs S. 1475, Saving Lives, Saving Costs S. 610, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness S. 987, CARA 3.0 Act of 2021: Opioids H.R. 3259, NOPAIN Act: Opioids S. 586, NOPAIN Act: Opioids S. 1292, Non-Opioid Directive Act: Opioids H.R. 7961, SAVE Act: To protect hospital personnel from violence, and for other purposes. FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Pre-authorization; prior authorization Affordable Care Act reform efforts Medical Controlled Substances Transportation 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care Resident Education Deferred Interest Act (REDI Act): Student loan relief Student Loan Forgiveness for Frontline Health Workers Act: Student loan relief H.R. 842, Protecting the Right to Organize Act of 2021: PRO Act, labor protections 21st Century Cures Initiative H.R. 4369, National Centers of Excellence in Continuous Pharmaceutical Manufacturing Act: Drug shortages DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Ketamine use by law enforcement Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health Certified Anesthesiologist Assistants Blood management Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, scope of Practice (waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20 Long COVID research Anesthesia workforce shortages CDC Opioid Prescribing Guideline

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. S.3799 PREVENT Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Gun Violence Protection and Safety Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education S.3658 /H.R. 4122 - Resident Education Deferred Interest (REDI) Act Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment H.R.5376 - Inflation Reduction Act of 2022 Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment H.R. 8800 - Supporting Medicare Providers Act of 2022 S. 5194 - Protecting Medicare Patients and Physicians Act Issues related to implementation of the No Surprises Act Issues related to telehealth H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act of 2022 Issues related to health equity

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

Government targets: 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), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. S.3799 PREVENT Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Gun Violence Protection and Safety Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education S.3658 /H.R. 4122 - Resident Education Deferred Interest (REDI) Act Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment H.R.5376 - Inflation Reduction Act of 2022 Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment H.R. 8800 - Supporting Medicare Providers Act of 2022 S. 5194 - Protecting Medicare Patients and Physicians Act Issues related to implementation of the No Surprises Act Issues related to telehealth H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act of 2022 Issues related to health equity

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

Government targets: 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), Labor, Dept of (DOL), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

American Rescue Plan - H.R. 1319 - Sec. 1002 Emergency Rural Development Grants for Rural Health Care American Rescue Plan - H.R. 1319 - Sec. 9911 Funding for Providers Relating to COVID-19 Implementation of Provider Relief Fund Reporting Requirements Sen. Murray RFI to develop a public option Covid Relief funding for small hospitals and RHCs S. 610 - Protecting Medicare and American Farmers from Sequester Cuts Act Adding G2025 to the list of codes that can be Risk Adjusted Consolidated Appropriations Act of 2023 ~ HR 2617

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

RHC Payment Modernization, Rural Emergency Hospital Program - Consolidated Appropriations Act of 2021 - H.R. 133 H.R. 1868 - To Prevent across-the-board direct spending cuts, and for other purposes RHC payments by Medicare COVID relief payments for small hospitals, CAHs and RHCs S. 610 - Protecting Medicare and American Farmers from Sequester Cuts Act Consolidated Appropriations Act of 2023 ~ HR 2617

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

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

Implementation of Appropriate Use Criteria Policy from the Protecting Access to Medicare Act of 2014 Revaluation of Medicare Conversion Factor due to added weight to the Evaluation and Management CPT Codes S. 610 - Protecting Medicare and American Farmers from Sequester Cuts Act Consolidated Appropriations Act of 2023 ~ HR 2617

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

Government targets: Centers For Medicare and Medicaid Services (CMS)

Consolidated Appropriations Act of 2021 - H.R. 133 - No Surprises Act - Title 1 S. 610 - Protecting Medicare and American Farmers from Sequester Cuts Act Good Faith Estimate Implementation Appropriate Use Criteria Implementation Consolidated Appropriations Act of 2023 ~ HR 2617

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

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

Sequestration relief (Protecting Medicare and American Farmers from Sequester Cuts Act - S. 610) Rural hospital policies [Rural Health Clinic payment - Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885), Rural HELP Act - HR 1749; Rural Hospital Closure Relief Act (H.R. 1639/S.644)] Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 - S. 834/H.R. 2256; Opioid Workforce Act, S. 1438)/ Substance Use Disorder Workforce Act, H.R. 3441) H.R. 1749 (study on potential disparities in incurred costs for rural and urban hospitals and authorizing appropriate payment adjustments) S. 439, Coronavirus Medicaid Response Act (addressing FMAP) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340; CONNECT for Health Act S. 1512/H.R. 2903; Ensuring Parity in MA and PACE for Audio-Only Telehealth Act S. 150/H.R. 2166; Consolidated Appropriations Act of 2022, HR 2471) Resetting the Impact (TRIA) Act of 2021 (H.R. 2455) Prior Authorization reform - Improving Seniors Timely Access to Care Act of 2021 (H.R. 3173/S.3018) S.586 / H.R. 3259 - Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act Annual Prospective Payment System Rules Accelerated and Advance Payment Program repayment flexibility (H.R. 1349, The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021; H.R. 2407, Better Way for Providers to Repay Act of 2021) S. 408, Supporting Best Practices for Healthy Moms Act (to reduce maternal mortality) Nursing and allied health education (NAHE) program funding Technical Reset to Advance the Instruction of Nurses (TRAIN) Act (S. 1568 / HR 4407) - Nursing and allied health education payments Organ acquisition payment policies Clinical lab fee schedule False Claims Act amendments CMS Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule Hospital Inpatient Services Modernization Act (H.R. 7053 /S. 3792) - to extend the hospital at home waiver program Medicare Mental Health Inpatient Equity Act (S. 3061/H.R. 5674) HR 4040: Advancing Telehealth Beyond COVID-19 Act HELP Act Inpatient Psychiatric Facility Improvement Act MIND Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for public health infrastructure Personal Protective Equipment Standards and access to Personal Protective Equipment, including supply chain issues Mental health resources for nurses S.308/H.R.1436 - PPE in America Act H.R. 1384/S.445 - Mainstreaming Addiction Treatment (MAT) Act Issues surrounding telehealth, including removal of Medicare originating site and rural area restrictions S.610/H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 851/S.246 - Future Advancement of Academic Nursing (FAAN) Act Issues surrounding nurse staffing shortages and remedies to address this crisis Pandemic preparedness S.3799 - PREVENT Pandemics Act Extension of COVID-19 public health emergency H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S. 5212/H.R. 8812 - Improving Care and Access to Nurses (ICAN) Act Issues surrounding federal Monkeypox response

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

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

- Medicare geographic reclassification - Pandemic preparedness - S 610 Protecting Medicare & American Farmers from Sequester Cuts Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 167/H.R. 736: Community Immunity During COVID-19 Act-Public health infrastructure - state and local public health $$ for vaccines S.245: States Achieve Medicaid Expansion - Enhanced Federal matching for states that expand Medicaid coverage S. 368: Telehealth Modernization Act- Expands telehealth flexibilities in Medicare beyond the PHEq S. 748/HR 315: Medicare Sequestration - Prevent the 2 percent sequester for Medicare under the BCA HR 959: Black Maternal Health Momnibus Act - Comprehensive reforms to address maternal health challenges HR 1025: Kids Access to Primary Care Act - Create parity between Medicaid/Medicare reimbursement for women and children HR 1319: American Rescue Plan - Expansion of ACA coverage, investments in public health workforce, funding for COVID-19 response H.R. 4770: Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act H.R. 5054: Physicians Serving Patients Act of 2021 S. 610: Protecting Medicare and American Farmers from Sequester Act H.R. 3713/S.3018: Improving Seniors' Timely Access to Care Act H.R. 6020: Supporting Medicare Providers Act No Bill No.: Congressional Primary Care Caucus;117th Congress membership in the bipartisan CPCC No Bill No. COVID Medicaid Response Act: Increase Medicaid funding for states impacted by COVID 19 No Bill No.: FY 2022 Appropriations Requests - CDC Programs (Climate/Health; Gun Violence Research; vaccine infrastructure); HRSA; AHRQ; CMS No Bill No.: Telehealth Expansion - Preserve key telehealth flexibilities beyond COVID-19 PHE No Bill No.: Medicare GME allocation - Advocate for equitable distribution of additional GME slots NO Bill No.: Medicare physician fee schedule No Bill No.: MACRA/value-based payment No Bill No.: FY22 COVID-19 supplemental No Bill No.: Medicaid Redeterminations No Bill No.: Behavioral Health Integration No Bill No.: Save America's Rural Hospitals Act No Bill No.: Behavioral health integration w/i primary care No Bill No.: Medicare Part B provider payment No Bill No.: CY23 Medicare Physician Fee Schedule H.R. 8800: Supporting Medicare Providers Act H.R. 4040: Advancing Telehealth Beyond COVID-19 Act of 2021 H.R. 6576: SURS Extension Act Consolidated Appropriations Act of 2023

Client expense: $788,015 · 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. 2631 - Amputation Reduction and Compassion Act (ARC) H.R. 3173 - Improving Seniors' Timely Access to Care Act H.R. 1319 - American Rescue Plan Act of 2021 - Support Legislative relief from Statutory PAYGO Medicare cuts FY 2022 Medicare Physician Fee Schedule Proposed Rule S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 6048 the Medicare Stability for Patients and Providers Act H.R. 8800 Supporting Medicare Providers Act of 2022 H.R. 1193 - Cardiovascular Advances in Research and Opportunities Legacy (CAROL) Act

Client expense: $36,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2631 - Amputation Reduction and Compassion Act (ARC) H.R. 3173 - Improving Seniors' Timely Access to Care Act H.R. 1319 - American Rescue Plan Act of 2021 - Support Legislative relief from Statutory PAYGO Medicare cuts FY 2022 Medicare Physician Fee Schedule Proposed Rule H.R. 2631 - Amputation Reduction and Compassion Act (ARC) H.R. 3173 - Improving Seniors' Timely Access to Care Act H.R. 1319 - American Rescue Plan Act of 2021 - Support Legislative relief from Statutory PAYGO Medicare cuts FY 2022 Medicare Physician Fee Schedule Proposed Rule S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 8800 Supporting Medicare Providers Act of 2022 H.R. 6048, the Medicare Stability for Patients and Providers Act Clinical labor index/clinical labor cuts

Client expense: $36,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2631 - Amputation Reduction and Compassion Act (ARC) H.R. 3173 - Improving Seniors' Timely Access to Care Act H.R. 1319 - American Rescue Plan Act of 2021 - Support Legislative relief from Statutory PAYGO Medicare cuts H.R. 8800 Supporting Medicare Providers Act of 2022 H.R. 6048 the Medicare Stability for Patients and Providers Act FY 2022 Medicare Physician Fee Schedule Proposed Rule S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act Clinical labor index/clinical labor cuts H.R. 2631 - Amputation Reduction and Compassion Act (ARC) H.R. 3173 - Improving Seniors' Timely Access to Care Act H.R. 1319 - American Rescue Plan Act of 2021 - Support Legislative relief from Statutory PAYGO Medicare cuts FY 2022 Medicare Physician Fee Schedule Proposed Rule S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 6048 the Medicare Stability for Patients and Providers Act H.R. 8800 Supporting Medicare Providers Act of 2022 H.R. 1193 - Cardiovascular Advances in Research and Opportunities Legacy (CAROL) Act

Client expense: $36,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE