Resident Physician Shortage Reduction Act of 2021

S.834, Resident Physician Shortage Reduction Act: To provide additional Medicare funds to support 14,000 new GME/residency training slots S.3018, Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage Program H.R 2256, Resident Physician Shortage Reduction Act: To provide additional Medicare funds to support 14,000 new GME/residency training slots H.R.2617, Consolidated Appropriations Act, 2023: To prevent Medicare payment cuts, funding for additional Medicare GME slots and prior authorization reform, extending telehealth flexibilities H.R. 3173, Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage Program H.R. 8800, Protecting Medicare Providers Act: To prevent a 4.42% Medicare payment cut No Bill: To prevent Medicare payment cuts and mandate that the Centers for Medicare & Medicaid Services value global codes appropriately No Bill: Urging Congressional oversight and review of Medicare's Quality Payment Program No Bill: Urging Congress to repeal the Appropriate Use Criteria program for diagnostic imaging

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.834, Resident Physician Shortage Reduction Act: To provide additional Medicare funds to support 14,000 new GME/residency training slots S.3018, Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage Program H.R 2256, Resident Physician Shortage Reduction Act: To provide additional Medicare funds to support 14,000 new GME/residency training slots H.R.2617, Consolidated Appropriations Act, 2023: To prevent Medicare payment cuts, funding for additional Medicare GME slots and prior authorization reform, extending telehealth flexibilities H.R. 3173, Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage Program H.R. 8800, Protecting Medicare Providers Act: To prevent a 4.42% Medicare payment cut No Bill: To prevent Medicare payment cuts and mandate that the Centers for Medicare & Medicaid Services value global codes appropriately No Bill: Urging Congressional oversight and review of Medicare's Quality Payment Program No Bill: Urging Congress to repeal the Appropriate Use Criteria program for diagnostic imaging

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 S.5194 - Protecting Medicare Patients and Physicians Act H.R. 8800 - Protecting Medicare Patients and Physicians Act H.R.9424 - Creating Access to Residency Education Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023 Fiscal Year 2023 Omnibus

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 S.5194 - Protecting Medicare Patients and Physicians Act H.R. 8800 - Protecting Medicare Patients and Physicians Act H.R.9424 - Creating Access to Residency Education Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023 Fiscal Year 2023 Omnibus

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 S.5194 - Protecting Medicare Patients and Physicians Act H.R. 8800 - Protecting Medicare Patients and Physicians Act H.R.9424 - Creating Access to Residency Education Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023 Fiscal Year 2023 Omnibus

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

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

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, H. Res. 909, Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update; 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

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

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

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

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

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

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

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

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

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

S. 834, H.R.2256 - The Resident Physician Shortage Reduction Act and similar efforts to increase federal funding for graduate medical education.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Coverage of blood transfusions under Medicare Hospice Benefit Improving Access to Transfusion Care for Hospice Patients Act of 2021 (S. 2566) Issues related to CAR-T/cellular and gene therapies Implementation of the Medicare Access and CHIP Reauthorization Act pf 2015 (P.L. 114-10) Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) CMS national coverage determinations Medicaid coverage for sickle cell disease Issues impacting opioid access/use for patients with hematologic disease and disorders Issues related to implementation of Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136) Issues related to health equity/disproportionate impact of COVID-19 on minority populations Issues related to telemedicine/telehealth COVID-19 vaccination policies/prioritization Resident Physician Shortage Reduction Act (H.R. 2256/S. 834) Healthcare Workforce Resilience Act (H.R. 2255/S. 1024) Cures 2.0 Act (H.R. 6000) Sickle cell disease/trait issues Sickle Cell Disease Comprehensive Care Act (H.R. 6216 / S.3389) Prior authorization Improving Seniors Timely Access to Care Act (H.R. 3173/S. 3018) Advancing Telehealth Beyond COVID Act (H.R. 4040) Supporting Medicare Providers Act (H.R. 8800) FY2023 Consolidated Appropriations Act (H.R. 2617)

Client expense: $30,000 · 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), SENATE

Resident Physician Shortage Reduction Act (H.R. 2256/S. 834) Healthcare Workforce Resilience Act (H.R. 2255/S. 1024) Implementation of the Patient Protection and Affordable Care Act (P.L. 111-148) Hematology/oncology drug research and approval issues Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) (P.L. 112-144) Clinical trials regulations and coverage Issues impacting coverage for hematologic diseases and conditions Issues related to CAR-T/cellular and gene therapies Issues impacting opioid access/use for patients with hematologic disease and disorders Issues impacting blood supply shortages/safety Issues related to convalescent plasma Issues related to health equity/disproportionate impact of COVID-19 on minority populations Issues related to diversity, equity, and inclusion (DEI) in hematology research, practice, and training Cures 2.0 Act (H.R. 6000) Implementation of No Surprises Act (P.L. 116-260) Cancer Patient Equity Act of 2021 (H.R.5377) HELP Copays Act (H.R. 5801) Cancer Drug Parity Act of 2021 (H.R. 4385 / S. 3080) Sickle cell disease/trait issues Sickle Cell Disease Comprehensive Care Act (H.R. 6216 / S.3389) Impact of climate change on health Resolution 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 (H.Res. 909) Sickle Cell Care Expansion Act (H.R. 7177/S.4425) Women's Health Protection Act (S. 1975/ H.R. 3755/S. 4132) Newborn Screening Saves Lives Reauthorization Act (H.R. 482/S. 350) Prior authorization Improving Seniors Timely Access to Care Act (H.R. 3173/S. 3018) Health Equity and Accountability Act (H.R. 7585) Issues related to maternal health care and abortion access Verifying Accurate Leading-edge IVCT Development (VALID) Act (H.R. 4128/S. 2209) Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act (S. 4348) Affordability of employer coverage for family members/"family glitch Sickle Cell Disease Treatment Centers Act of 2022 (S. 4866/ H.R. 8855) Advancing Telehealth Beyond COVID Act (H.R. 4040) Resolution supporting the designation of September 2022 as "Sickle Cell Disease Awareness Month" (H.Res.1330/S.Res.868) Let Doctors Provide Reproductive Health Care Act (S. 4723/H.R. 8650) FY2023 Consolidated Appropriations Act (H.R. 2617)

Client expense: $30,000 · 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), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), SENATE

S. 834/ H.R. 2256: Resident Physician Shortage Reduction Act S. 1024/H.R. 2255: Healthcare Workforce Resilience Act S. 1548/H.R. 3085: Equity in Neuroscience and Alzheimers Clinical Trials (ENACT) Act S. 1810/H.R. 3541: Conrad State 30 and Physician Access Reauthorization Act S. 3427: Neuroscience Center of Excellence Act of 2021 S.4348: FDASLA Act of 2022; section 506. S. 4906: National Neurological Conditions Surveillance System Reauthorization Act of 2022 H.R. 2754: COVID-19 Long Haulers Act H.R. 4122: Resident Education Deferred Interest Act of 2021 H.R. 5435: Bringing Regulatory Advances into Neuroscience (BRAIN) Act Urging reforms to proposed surprise billing regulations to align with congressional intent for payment disputes. Support for creating a Neuroscience Center of Excellence at FDA. Supporting policies to address the COVID-19 public health emergency, including maintaining telemedicine coverage and ensuring access to affordable health coverage and medications. Medical research funding related to NIH including the BRAIN Initiative, AHRQ, HEAL Initiative, and the Congressionally Directed Medical Research Programs at the Department of Defense. Support for funding for the Pediatric Subspecialty Loan Repayment Program.

Client expense: $140,000 · Firm income: Not reported

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

Reimbursement cuts associated with the Medicare and Medicaid Programs; CY2023 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies. Reimbursement cuts associated with the Clinical Labor update policy in the CY2022 Medicare Physician Fee Schedule Rule. Concerns with the Center for Medicare & Medicaid Services (CMS) failure to resolve outstanding issues regarding the Medicare Physician Fee Schedule (PFS) global surgical package. Issues relating to systemic/long-term reform to the Medicare Physician payment system. Support for expansion of funding for Graduate Medical Education (GME). Issues relating to valuation of global surgical codes. H.R. 3173/H.R. 8487/S. 3018: Improving Seniors Timely Access to Care Act H.R. 2256/S. 834: Resident Physician Shortage Reduction Act H.R. 2631: Amputation Reduction and Compassion Act or the ARC Act H.R. 8800: Supporting Medicare Providers Act of 2022 Issues relating to physician practice consolidation/access to care. Consolidated Appropriations Act, 2023; provisions relating to Medicare physician reimbursement

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

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

Q4 Lobbying Report (October 1-December 31) HCR Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act Build Back Better Act (H.R. 5376) Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) No Surprises Act regulations Public Health Emergency designation Blood shortages PREVENT Pandemics Act (S. 3799) CMS Region IX re: Guidance on California State Bill 311 The Compassionate Access to Medical Cannabis Act Meeting with OMB re: Physician Loan Forgiveness CMS Regional Office re: Admission, Discharge, and Transfer Patient Event Notification Conditions of Participation (42 CFR 482.24(d), 482.61(f), and 485.638(d)) Food and Drug Amendments of 2022 (H.R. 7667) Improving Seniors Timely Access to Care Act (H.R. 1587/S. 3018) Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 7961) Bipartisan Safer Communities Act (S. 2938) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666) Saving Access to Laboratory Services Act (SALSA Act) (H.R. 8188/S.4449) Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) Meetings with FEMA re: COVID-19 related reimbursement Train More Doctors Act of 2022 (H.R. 9156) H.R. 2617 2023 Omnibus MMM Accelerated and Advance Payment Program repayment flexibility (H.R. 1349, The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 (S. 834/H.R. 2256) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332) Hospital Inpatient Services Modernization Act (H.R. 7053) Annual Prospective Payment System Rules Organ acquisition payment policies Clinical lab fee schedule BUD FY2022 Appropriations bills Consolidated Appropriations Act of 2022 (HR 2471) - omnibus Further Additional Extending Government Funding Act, HR 6617 Nursing and allied health workforce funding FY 2023 budget request Submitted Comments Subject: CMS-9900-NC, Request for Information; Advanced Explanation of Benefits and Good Faith Estimate for Covered Individuals, Federal Register (Vol. 87, No. 179), September 16, 2022 Request for Information on Healthcare Access, Provider Experience, Health Equity, and PHE Flexibilities, November 4, 2022

Client expense: $370,000 · 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, Social Security Administration (SSA)

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

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

Monitor: S. 834 - Resident Physician Shortage Reduction Act of 2021 - complete legislation

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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. 2954, Securing a Strong Retirement Act of 2022, provisions relating to student loans H.R. 2917, Retirement Parity for Student Loans Act of 2021, all provisions S. 1443, Retirement Parity for Student Loans Act, 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 S. 54, Strengthening Americas Health Care Readiness Act, all provisions S. 924, Rural America Health Corps Act, all provisions H.R. 8850, Fair Access In Residency (FAIR) 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 S. 4330, Specialty Physicians Advancing Rural Care Act, all provisions H.R. 7539, Indian Health Service Health Professions Tax Fairness Act of 2022, all provisions S. 2874, Indian Health Service Health Professions Tax Fairness Act of 2021, all provisions H.R. 3671, Doctors of Community (DOC) Act, all provisions S. 1958, Doctors of Community (DOC) Act, all provisions H.R. 4122, Resident Education Deferred Interest (REDI) Act, all provisions S. 3658, Resident Education Deferred Interest (REDI) Act, all provisions Public Sector Loan Forgiveness Program (PSLF)

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE, White House Office

Medicare Graduate Medical Education S. 834/H.R. 2256 - the Physician Shortage Reduction Act of 2021 Health care delivery and payment reform proposals Legislative proposals aimed at combating COVID-19 impacting Medicare and Medicaid programs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce -Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.

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

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

Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Public Health Emergency designation COVID Data Reporting Infrastructure Investment and Jobs Act Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Regulatory relief in light of coronavirus Vaccine mandate policy Healthcare Cybersecurity Act (S.3904) - collaboration between the CISA and HHS H. Res. 909 condemning violence against health care workers Travel Nursing Agency Transparency Study Act Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) Train More Doctors Act of 2022 (H.R. 9156) H.R. 2617 2023 Omnibus

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Medicare Graduate Medical Education Site-neutral payment policies S 834 Resident Physician Shortage Act H.R. 1868, prohibition the sequester's 2% cut to Medicare provider payments from going to effect during 2022 Proposals to prevent future sequester cuts, including reductions in Medicare payments H.R. 3, "Elijah E. Cummings Lower Drug Prices Now Act" Proposals to reduce drug costs Amends to CLIA to Allow for Remote Pathology Extension of Medicare PHE telehealth waivers various bills in House and Senate Extend Medicare coverage for Hospital at Home (S.73792/HR 7053) Prevent Home Health Agency cuts (Preserving Access to Home Health Act of 2022 (H.R. 8581/S. 4605))

Client expense: $293,950 · Firm income: Not reported

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

Issues related to Graduate Medical Education including H.R. 2256/ S. 834, Issues related to price transparency. Issues related to coronavirus, including funding and regulatory flexibility for providers. Issues related to the HHS Provider Relief Fund. Issues related to training of rural physicians including H.R. 4970. Issues related to extension of Medicare sequester. Issues related to telehealth. Issues related to lab-developed tests in academic medical centers.

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

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

HR 366 Authorize HHS Secretary to waive or modify application of Medicare requirements with respect to telehealth services during any emergency period. HR 955 and S 285 To allow for medical assistance under Medicaid for inmates during 30-day period preceding release from a public institution. HR 1332 and S 368 Amends title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency. HR 1349 To provide for the conversion of certain accelerated and advance payments to grants under parts A and B of the Medicare program. S 834 To create an additional 14,000 Medicare-supported residency slots over seven years. HR 2166 To require the inclusion of certain audio-only diagnoses in the determination of risk adjustment for Medicare Advantage plans and PACE programs. HR 3371 To improve access to home health care furnished by telehealth amid PHEs. HR 3589 Medicare AAP loan repayment delay HR 3746 To improve the benchmarking process for the Medicare Shared Savings Program. S. 368 Amends title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency. HR 4587 To direct HHS to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage program participation. S. 2622 To provide for Medicaid coverage of comprehensive tobacco cessation services. HR 5514 To improve extended care services by providing Medicare beneficiaries with an option for cost effective home-based extended care. S 3018 To establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Oppose Medicare sequester. S. 3593 To extend certain telehealth services covered by Medicare and to evaluate the impact of telehealth services on Medicare beneficiaries HR 7573 To extend certain telehealth services covered by Medicare and to evaluate the impact of telehealth services on Medicare beneficiaries HR 4407/S 1568 To modify the methodology and application of Medicare Advantage nursing and allied health education payments for hospitals HR 4040 To extend telehealth flexibilities under the Medicare program HR 5370 To establish a CMS demo for medically tailored meals for Medicare beneficiaries. HR 8487 To establish requirements with respect to the use of prior authorization under Medicare Advantage plans. HR 8800 To extend certain increases in payments for physicians services under the Medicare program through 2023

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), 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. 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: $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

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

H.R. 2903/S. 1512, The CONNECT for Health Act and H.R. 1332/S. 368, The Telehealth Modernization Act, as they relate to telehealth. H.R. 2455, The Resetting the Impact (TRIA) Act, as it relates to payments for post-acute care providers. S. 2021/H.R. 3806, The SAFE Hospitals Act of 2021, as it relates to Medicaid disproportionate share hospital payments. S. 2689/H.R. 5414, Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 and issues related to the Medicaid institutions for mental diseases exclusion. H.R. 2256/S. 834, The Resident Physician Shortage Reduction Act of 2021. H.R. 4407/S. 1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act. S. 2069/H.R. 4323, Excellence in Mental Health Addiction Treatment Act. Monitored H.R.432, Mental Health Access Improvement Act. Issues involving mandatory COVID vaccines for health care providers. Issues related to Medicare sequestration. Issues related to the Hospital Inpatient Prospective Payment System (IPPS) rule for Fiscal Year 2023. H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act and issues related to Acute Hospital Care at Home program. H.R. 2617 (P.L. 117-328), the Consolidated Appropriations Act of 2023, as it relates to Medicare Dependent Hospitals, Low Volume Hospital Payments, telehealth flexibilities, the Acute Hospital Care at Home program, and graduate medical education residency positions. Issues related to Medicaid payments for safety net providers.

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

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

GI Bill benefits, Education related issues Monitor the following: Student Mental Health related issues Food Insecurity related issues PELL grant related issues Energy Workforce Development Agriculture research related issues Name, Image and Likeness related issues S.4855, Collegiate Athlete Compensation Rights Act, Entirety H.R.2256/S.834, Resident Physician Shortage Reduction Act of 2021, Graduate Medical Education issues Minority Serving Institutions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Health and Social Services Emergency Fund Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Public Health Emergency designation COVID Data Reporting H.R.7961 - the SAVE Act Restoring Hope for Mental Health and Well-being Act Infrastructure Investment and Jobs Act Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Regulatory relief in light of coronavirus Vaccine mandate policy Healthcare Cybersecurity Act (S.3904) - collaboration between the CISA and HHS H. Res. 909 condemning violence against health care workers PREVENT Pandemics Act (S. 3799) Bipartisan Safer Communities Act (S. 2938) Health Care Capacity for Pediatric Mental Health Act Kids Mental Health Improvement Act Continuing Systems of Care for Children Act, Strengthen Kids Mental Health Now Act Cost of Mental Illness Act Community Health Center Mental Health Screening Act Greater Mental Health Access Act National Defense Authorization Act Travel Nursing Agency Transparency Study Act Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) Train More Doctors Act of 2022 (H.R. 9156) H.R. 2617 2023 Omnibus

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

Government targets: HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), 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) 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 elimination of statutory PAY-GO reductions Support for fair and reasonable implementation of No Surprises Act regulations Support for Improving Seniors Timely Access to Care Act (H.R. 3173/S. 3018) Support for Healthcare Workforce Resilience Act of 2021 Support for delay/elimination of Medicare sequestration cuts Support for increased flexibility and expansion of eligible expenses eligible for reimbursement under COVID-19 FEMA Public Assistance program. Support for Hospital Inpatient Services Modernization Act (H.R. 7053) Support for additional Provider Relief Funding Support for Protecting Rural Access to Care Act (H.R. 489) Support for Substance Use Disorder Workforce Act of 2021 (H.R.3441)/Opioid Workforce Act of 2021 (S.1438) Support for bolstering Medicare Graduate Medical Education program including the Resident Physician Shortage Reduction Act of 2021 (H.R. 2256/S.834) Support for Rural Hospital Support Act (H.R. 1887) and making permanent the Medicare Dependent Hospital and enhanced Low-Volume Payment Adjustment Support for The Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) Support for Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015) and amending Medicaid DSH Cap policy established in Section 203 of CAA of 2021. Support for continuing telehealth flexibilities beyond COVID-19 pandemic including the Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Support for extending hospital at home program flexibilities including the Hospital Inpatient Services Modernization Act (H.R. 7053/S. 3792). Support for preserving Medicares previously longstanding Critical Access Hospital mileage requirements

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

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

Support for waiving the 4% statutory PAYGO sequester that would force cuts to Medicare and other health programs, and addressing cuts resulting from CMS 2023 Medicare Physician Fee Schedule Rule. Medicare support for Medicare Graduate Medical Education, including the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256), bipartisan legislation that would add 14,000 new Medicare-supported graduate medical education (GME) slots. Support for extending CMS's Acute Hospital Care at Home waiver through the Hospital Inpatient Services Modernization Act (H.R. S. 3792/7053), which would extend the waiver for two years beyond the end of the federal public health emergency. Support for the Access to Genetic Counselor Services Act (S. 1450/H.R. 2144) which would allow Medicare to reimburse genetic counselors directly and expand access to these services. . . Ensure that individuals eligible for Medicaid and CHIP have stable and comprehensive health coverage that provides affordable access to high-quality care, and closing coverage and care gaps for critical health and behavioral health services. Support for making CHIP funding permanent, and enacting a nationwide standard to ensure12-month continuous eligibility to children enrolled in CHIP and/or Medicaid.

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

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