Handgun Permit to Purchase Act

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supports a similar bill, S. 5035, introduced by Sen. Boozman. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, by Rep. Underwood to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. We support similar legislation introduced by Sen. Shaheen in the Senate. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vi, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language. Urged Congress to support year-end Continuing Resolution (CR) that contained PBM reform, averting Medicare physician payment cuts by 2.5%, provided bonus payment to physicians participating in APMs, and extended telehealth flexibilities adopted during the COVID-19 pandemic for 2 years. Also advocated that streamlined prior authorization process for Medicare Advantage plans be included in the CR. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. We support the Senate Title X spending for pregnancy and family planning over the Houses bill, which eliminates funding in its bill. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process in the reintroduced the Improving Seniors' Timely Access to Care Act, S.4532. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Cures 2.0: Reviewed and supported Cures 2.0 legislation.

Client expense: $124,919 · 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), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supports a similar bill, S. 5035, introduced by Sen. Boozman. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported the Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, by Rep. Underwood to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. We support similar legislation introduced by Sen. Shaheen in the Senate. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vi, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. We support the Senate Title X spending for pregnancy and family planning over the Houses bill, which eliminates funding in its bill. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process in the reintroduced the Improving Seniors' Timely Access to Care Act, S.4532. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supports a similar bill, S. 5035, introduced by Sen. Boozman. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported the Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, by Rep. Underwood to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. We support similar legislation introduced by Sen. Shaheen in the Senate. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vi, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. We support the Senate Title X spending for pregnancy and family planning over the Houses bill, which eliminates funding in its bill. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process in the reintroduced the Improving Seniors' Timely Access to Care Act, S.4532. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported the Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usuage. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported the Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usuage. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported the Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usuage. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported the Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usuage. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

H.R. 38 - Concealed Carry Reciprocity Act H.R. 46 - Mental Health Access and Gun Violence Prevention Act of 2023 H.R. 48 - Gun Violence Reduction Resources Act of 2023 H.R. 52 - Kimberly Vaughan Firearm Safe Storage Act H.R. 53 - Firearm Industry Non-Discrimination Act H.R. 60 - Accidental Firearms Transfers Reporting Act of 2023 H.R. 100 - No SmartPay for Anti-2A Companies Act H.R. 151 - No Frivolous Application for Short-Barreled Shotguns (NFA SBS) Act H.R. 152 - Hearing Protection Act H.R. 168 - To amend chapter 44 of title 18, United States Code, to more comprehensively address the interstate transportation of firearms or ammunition H.R. 173 - Home Defense and Competitive Shooting Act of 2023 H.R. 182 - To promote accountability and transparency in future executive orders H.R. 283 - Preventing Unjust Red Flag Laws Act of 2023 H.R. 331 - Illicit Arms Trafficking Security Enforcement Act H.R. 341 - Protect Our Military Families 2nd Amendment Rights Act H.R. 363 - Second Amendment Protection Act H.R. 374 - Abolish the ATF Act H.R. 381 - Protecting Individual Sovereignty Through Our Laws (PISTOL) Act H.R. 385 - No User Fees for Gun Owners Act H.R. 391 - Safe Bases Act H.R. 396 - Closing the Bump Stock Loophole Act of 2023 H.Res.45 - Expressing the sense of the House of Representatives that New York State's Concealed Carry Improvement Act is unconstitutional H.R. 450 - Repeal the NFA Act H.R. 508 - ATF Accountability Act of 2023 H.R. 569 - Handgun Permit to Purchase Act H.R. 584 - Stop Online Ammunition Sales Act of 2023 H.R. 625 - Keep Americans Safe Act H.R. 646 - Stop Harassing Owners of Rifles Today (SHORT) Act H.R. 660 - Ethan's Law H.R. 667 - Choosing Our Own Lives Over Fast Firearms (COOL OFF) Act H.R. 698 - Assault Weapons Ban of 2023 H.R. 705 - Veterans 2nd Amendment Protection Act H.R. 715 - Bipartisan Background Checks Act of 2023 H.R. 730 - Crime Gun Tracing Modernization Act of 2023 H.R. 768 - Extreme Risk Protection Order Expansion Act of 2023 H.R. 771 - Firearm Lockbox Protection Act of 2023 H.R. 790 - Repealing Illegal Freedom and Liberty Excises Act (RIFLE) Act H.R. 816 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act H.R. 817 - Default Proceed Sale Transparency Act H.R. 850 - To direct the Attorney General to conduct a study on the efficacy of extreme risk protection orders on reducing gun violence H.R. 851 - Iron Pipeline Review Act H.R. 962 - Protecting Gun Owners in Bankruptcy Act of 2023 H.R. 974 - ATF Improvement and Modernization (AIM) Act of 2023 H.R. 1145 - Safe Guns, Safe Kids Act H.R. 1258 - Protecting Gun Rights and Due Process Act H.R. 1271 - No Retaining Every Gun In a System That Restricts Your Rights Act H.R. 1302 - Gun Records Restoration and Preservation Act H.R. 1361 - Safer Neighborhoods Gun Buyback Act of 2023 H.R. 1478 - Federal Firearm Licensee Act H.R. 1566 - Safe Storage Lockers for House Office Buildings Act H.R. 1595 - State Firearms Dealer Licensing Enhancement Act H.J.Res.44 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" H.R. 1678 - Protecting Legal Firearms Ownership Act of 2023 H.R. 1699 - Office of Gun Violence Prevention Act of 2023 H.R. 1700 - ATF Transparency Act H.Res.244 - Expressing the sense of the House of Representatives that mandates imposed on manufacturers requiring inclusion of unproven and unreliable technology in firearms is costly and punitive, and the prohibition of firearms without such features is an infringement on the rights of citizens under the Second Amendment H.R. 1830 - Closing the Loophole on Interstate Firearm Sales Act H.R. 2390 - Gun Violence Prevention Research Act of 2023 H.R. 2391 - No Crime Left Behind Act H.R. 2392 - Pause for Gun Safety Act H.R. 2403 - Enhanced Background Checks Act of 2023 H.R. 2418 - Gun Trafficker Detection Act S.14 - Age 21 Act S.25 - Assault Weapons Ban of 2023 S.117 - Handgun Permit to Purchase Act S.118 - ATF Improvement and Modernization (AIM) Act of 2023 S.163 - Stop Harassing Owners of Rifles Today (SHORT) Act S.173 - Ethan's Law S.203 - Crime Gun Tracing Modernization Act of 2023 S.214 - Constitutional Concealed Carry Reciprocity Act of 2023 S.246 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act S.247 - Extreme Risk Protection Order Expansion Act of 2023 S.252 - Protecting Kids from Gun Marketing Act S.298 - Keep Americans Safe Act S.361 - Pistol Brace Protection Act S.401 - Hearing Protection Act S.428 - Firearm Industry Non-Discrimination (FIND) Act S.494 - Background Check Expansion Act S.598 - Gun Records Restoration and Preservation Act S.632 - ATF Transparency Act S.827 - A bill to provide that no Federal funds may be used to implement, administer, or enforce the rule of the Department of Justice entitled "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" S.J.Res.20 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Justice and the Bureau of Alcohol, Tobacco, Firearms and Explosives relating to "Factoring Criteria for Firearms With Attached 'Stabilizing Braces'" S.840 - Respect for the Second Amendment Act S.867 - State Firearms Dealer Licensing Enhancement Act S.951 - Office of Gun Violence Prevention Act of 2023 S.Amdt.38 - Prohibition on registry of lawful firearm owners S.1026 - Gun Violence Prevention Research Act of 2023 S.1116 - Background Check Completion Act of 2023 H.R.2471 - Vote Without Fear Act H.R.2477 - Protect Against School Shootings (PASS) Act H.R.2491 - SAFE School Act H.R.2502 - Safe Students Act H.R.2538 - Firearm Risk Protection Act of 2023 H.R.2620 - Federal Firearms Licensee Protection Act of 2023 H.R.2753 - Firearms Retailer Code of Conduct Act of 2023 H.R.2870 - Raise the Age Act of 2023 H.R.2897 - End Gun Violence Act of 2023 H.R.2898 - Secure Background Checks Act of 2023 H.R.2909 - Preventing Illegal Weapons Trafficking Act of 2023 H.R.2985 - Help Empower Americans to Respond (HEAR) Act of 2023 H.R.2991 - Teachers Empowered Against Classroom Harm (TEACH) Act of 2023 H.R.3018 - Federal Extreme Risk Protection Order Act of 2023 H.R.3021 - Protecting the Second Amendment in Financial Services Act H.Res.348 - Declaring gun violence a public health crisis H.R.3096 - Firearm Safety Act of 2023 H.R.3122 - Gun Show Loophole Closing Act of 2023 H.R.3155 - Protecting the Second Amendment through Responsible Gun Ownership Act H.R.3212 - Shall Not Be Infringed Act of 2023 H.R.3492 - Gun Owner Registration Information Protection Act H.R.3502 - Responsible Firearms Marketing Act H.R.3529 - Forbidding the Increase of Rogue Enforcers Act (FIRE) Act H.R.3687 - Protect Children Through Safe Gun Ownership Act H.Res.453 - Providing for consideration of the bill (H.R. 2403) to amend chapter 44 of title 18, United States Code, to strengthen the background check procedures to be followed before a Federal firearms licensee may transfer a firearm to a person who is not such a licensee H.Res.454 - Providing for consideration of the bill (H.R. 715) to require a background check for every firearm sale H.R.3824 - Trafficking Reduction And Criminal Enforcement (TRACE) Act H.R.3863 - Keeping Gun Dealers Honest Act of 2023 H.R.3931 - Angellyh Yambo Gun Free Zone Expansion Act of 2023 H.R.3993 - To provide a private right of action against the maker of any component of a ghost gun, and any person who facilitated a sale of the ghost gun, for injury or death resulting from the use of the ghost gun H.Res.495 - Providing for consideration of the joint resolution (H.J. Res. 44) providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'stabilizing braces'" H.R.4074 - 3D Printed Gun Safety Act of 2023 H.R.4158 - Gun Violence Prevention Through Financial Intelligence Act H.R.4159 - Background Check Point of Contact Act of 2023 H.R.4160 - Undetectable Firearms Modernization Act H.R.4184 - Equal Access to Justice for Victims of Gun Violence Act of 2023 H.R.4201 - Safe Storage Saves Lives Act H.R.4202 - Multiple Firearm Sales Reporting Modernization Act of 2023 H.R.4243 - To amend the consumer product safety laws to repeal the exclusion of pistols, revolvers, and other firearms from the definition of consumer product under such laws H.R.4283 - To amend the Internal Revenue Code of 1986 to increase certain taxes related to firearms, and for other purposes S.1825 - Gun Violence Prevention Through Financial Intelligence Act S.1319 - Preventing Illegal Weapons Trafficking Act of 2023 S.1383 - Help Empower Americans to Respond (HEAR) Act of 2023 S.1460 - Firearm Safety Act of 2023 S.1680 - Gun Owner Registration Information Protection Act S.1737 - Responsible Firearms Marketing Act S.1819 - 3D Printed Gun Safety Act of 2023 S.1824 - Making America Safe and Secure (MASS) Act S.1825 - Gun Violence Prevention Through Financial Intelligence Act S.1826 - Keeping Gun Dealers Honest Act of 2023 S.1907 - Federal Firearms Licensee Protection Act of 2023 S.1909 - Banning Unlawful Machinegun Parts (BUMP) Act of 2023 H.Amdt. 297 - An amendment numbered 35 printed in House Report 118-158 to prohibit the VA from using funds to submit a beneficiary's name to the NICS list based on VA's appointment of a fiduciary. H.R. 2897 - End Gun Violence Act of 2023 H.R. 4365 - Department of Homeland Security Appropriations Act, 2025 H.R. 4394 - Energy and Water Development and Related Agencies Appropriations Act, 2024 H.R. 4637 - Jaime's Law H.R. 4664 - Making appropriations for financial services and general government for the fiscal year ending September 30, 2024, and for other purposes. H.R. 4665 - Department of State, Foreign Operations, and Related Programs Appropriations Act, 2024 H.R. 4679 - Ghost Guns and Untraceable Firearms Act of 2023 H.R. 4780 - Language Access to Gun Violence Prevention Strategies Act of 2023 H.R. 4820 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2024 H.R. 4821 - Department of the Interior, Environment, and Related Agencies Appropriations Act, 2024 H.R. 4854 - Fair Legal Access Grants Act H.R. 4860 - PROTECT the Second Amendment Act H.R. 4965 - Kimberly Vaughan Firearm Safe Storage Act H.R. 4966 - Protecting Americans from Reckless Gun Dealers Act of 2023 H.R. 4992 - Ghost Guns and Untraceable Firearms Act of 2023 H.R. 5003 - Break the Cycle of Violence Act H.R. 5010 - Recognizing Gun Violence as a Public Health Emergency Act H.R. 5110 - Protecting Hunting Heritage and Education Act H.R. 5135 - Assault Weapons Excise Act H.R. 5184 - School Security Enhancement Act H.R. 5281 - LEAD Act of 2023 H.R. 5285 - Staff Safety Act H.R. 5286 - Defending Veterans' Second Amendment Rights Act H.R. 5435 - Disarm Hate Act H.R. 5449 - Stopping the Fraudulent Sales of Firearms Act H.R. 5460 - Bolstering Security Against Ghost Guns Act H.R. 5467 - Gun Suicide Prevention Act H.R. 5497 - Active Shooter Alert System Improvements Act of 2023 H.R. 5505 - Educating Responsible Future Hunters Act H.R. 5508 - Respect for the Second Amendment Act H.R. 5525 - Continuing Appropriations and Border Security Enhancement Act, 2024 H.R. 5561 - Protecting the Right to Keep and Bear Arms Act of 2023 H.R. 5727 - National Instant Criminal Background Check System (NICS) Data Integrity Act of 2023 H.R. 5767 - No Gun Rights Infringement Sham Act H.R. 5894 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes. H.R. 615 - Protecting Access for Hunters and Anglers Act of 2023 H.Res. 591 - Condemning the horrific gun violence in Fort Worth, Texas, and acknowledging the human toll of gun violence in this country. H.Res. 611 - Providing for consideration of the bill (H.R. 660) to amend chapter 44 of title 18, United States Code, to require the safe storage of firearms, and for other purposes. H.Res. 651 - Condemning the decision of the Secretary of Education to prohibit the use of funds under the Elementary and Secondary Education Act of 1965 for hunter, archery, and other shooting sports education programs in schools and explicitly affirming that school programs that train students in archery, hunting, or other shooting sports are eligible for Federal funding under such Act. H.Res. 684 - Condemning the actions of Governor of New Mexico, Michelle Lujan Grisham, for subverting the Second Amendment to the Constitution and depriving the citizens of New Mexico of their right to bear arms. H.Res. 737 - Expressing the sense of the House of Representatives regarding the relationship between firearm violence and intimate partner violence and to honor the memory of Gladys Ricart and other victims of intimate partner homicide killed by firearms, and for other purposes. S. 1185 - Protecting Access for Hunters and Anglers Act of 2023 S. 2214 - Fair Legal Access Grants Act S. 2226 - National Defense Authorization Act for Fiscal Year 2024 S. 2302 - Legislative Branch Appropriations Act, 2024 S. 2309 - Financial Services and General Government Appropriations Act, 2024 S. 2321 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2024 S. 2381 - National Instant Criminal Background Check System (NICS) Data Integrity Act of 2023 S. 2437 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2024 S. 2438 - Department of State, Foreign Operations, and Related Programs Appropriations Act, 2024 S. 2443 - Energy and Water Development and Related Agencies Appropriations Act, 2024 S. 2565 - Language Access to Gun Violence Prevention Strategies Act of 2023 S. 2587 - Department of Defense Appropriations Act, 2024 S. 2605 - Department of the Interior, Environment, and Related Agencies Appropriations Act, 2024 S. 2624 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 S. 2625 - Department of Homeland Security Appropriations Act, 2024 S. 2638 - Break the Cycle of Violence Act S. 2652 - Ghost Guns and Untraceable Firearms Act of 2023 S. 2732 - End Gun Violence Act of 2023 S. 2753 - Jaime's Law S. 2776 - Disarm Hate Act S. 2794 - Stopping the Fraudulent Sales of Firearms Act S. 2802 - Educating Responsible Future Hunters Act S. 2828 - Protecting Hunting Heritage and Education Act S. 2860 - SAFER Banking Act S. 2911 - Protecting the Right To Keep and Bear Arms Act of 2023 S. 2926 - Stop Arming Cartels Act of 2023 S.Amdt. 1201 - H.R. 4366 S.Amdt. 1288 - Amends H.R. 4366 S.Amdt. 636 - S. 2226 S.Amdt. 728 - S. 2226 S.Amdt. 729 - S. 2226 S.Amdt. 730 - S. 2226 S.Amdt. 732 - S. 2226 S.Amdt. 905 - S. 2226 S.Res. 303 - A resolution congratulating the University of Alaska Fairbanks rifle team for winning the 2023 National Collegiate Athletic Association championship, the program's 11th title overall. H.R. 6824 - NICS Data Reporting Act H.R. 6782 - SAFER Voter Act H.R. 6775 - Public Banking Act of 2023 H.R. 6754 - School Violence Prevention Act H.R. 6734 - Stopping Unconstitutional Background Checks Act H.R. 6697 - Advancing Gun Safety Technology Act H.R. 6618 - ARMAS Act of 2023 H.R. 6613 - PLAN for School Safety Act of 2023 H.R. 6611 - FISA Reform and Reauthorization Act of 2023 H.R. 6596 - Gun Violence Prevention and Community Safety Act of 2023 H.R. 6566 - Stronger Schools Act H.R. 6504 - Protect American Gun Exporters Act H.R. 6405 - Lori Jackson-Nicolette Elias Domestic Violence Survivor Protection Act H.R. 6404 - Disarming Cartels Act H.R. 6363 - Further Continuing Appropriations and Other Extensions Act, 2024 H.R. 6352 - Tax Stamp Revenue Transfer for Wildlife and Recreation Act H.R. 6262 - Government Surveillance Reform Act of 2023 H.R. 6211 - SAFE Act of 2023 H.R. 6172 - AMMO Act H.R. 6154 - Responsible Gun Ownership Licensing Act H.R. 6151 - IMPROVE Safety for Schools Act H.R. 6028 - States Reform Act of 2023 H.R. 6014 - Fire Sale Loophole Closing Act H.R. 5949 - Protecting Gun Owners Privacy Act of 2023 H.R. 5948 - To terminate the Office of Gun Violence Prevention in the Executive Office of the President and prohibit the establishment of any similar successor office, and for other purposes H.R. 5894 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes. H.R. 5893 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2024 H.R. 4639 - Fourth Amendment Is Not For Sale Act H.Amdt. 713 toH.R.4664Defunding of White House Office of Gun Violence Prevention H.Amdt. 790 - Description: An amendment numbered 123 printed in Part B of House Report 118-272 to prohibit funding for Centers for Disease Control and Prevention's firearm injury and mortality prevention research. H.Amdt. 660 - An amendment numbered 12 printed in Part B of House Report 118-269 to increase and decrease funding for the Internal Revenue Service by $5,000 with the intent to direct the agency to provide Congress with the quantity and types(s) of: weapons, weapons systems, ammunition, explosive devices, armored vehicles, drones/UAVs, and chemical weapons such as tear gas and calming agents in their possession. H.Amdt. 661 - Description: An amendment numbered 15 printed in Part B of House Report 118-269 to strike funding for firearms and ammunition for the Internal Revenue Service. H.Res. 819 - Recognizing the 5-year anniversary of the horrific antisemitic attack at the Tree of Life Synagogue in Pittsburgh, Pennsylvania, on October 27, 2018, and condemning antisemitism. H.Res. 827 - Expressing the sense of the House of Representatives regarding the relationships between firearm violence, misogyny, and violence against women, and reaffirming the importance of preventing individuals with a history of violence against women from accessing a firearm. H.Res. 879 - Expressing support for the designation of November 20, 2023, through December 20, 2023, as "National Survivors of Homicide Victims Awareness Month". H.Res. 886 - Supporting the goals and principles of Transgender Day of Remembrance by recognizing the epidemic of violence toward transgender people and memorializing the lives lost this year. H.Res. 928 - Honoring the victims of the mass shooting at the University of Nevada, Las Vegas on December 6, 2023. S. 3531 - Protect American Gun Exporters Act S. 3529 - ATF Accountability Act of 2023 S. 3407 - Gun Violence Prevention and Community Safety Act of 2023 S. 3369 - OSAFE Act S. 3351 - FISA Reform and Reauthorization Act of 2023 S. 3303 - Lori Jackson-Nicolette Elias Domestic Violence Survivor Protection Act S. 3234 - Government Surveillance Reform Act of 2023 S. 3223 - AMMO Act S. 3212 - Federal Firearm Licensing Act S. 3100 - Fire Sale Loophole Closing Act of 2023 S. 2576 - Fourth Amendment Is Not For Sale Act S. 2190 - RECOUP Act of 2023 S.Amdt. - 1354To prohibit the availability of funds for the Secretary of Veterans Affairs to report certain information to the Department of Justice for use by the National Instant Criminal Background Check System. S.Res. 465 - A resolution expressing support for the designation of November 20, 2023, through December 20, 2023, as "National Survivors of Homicide Victims Awareness Month". S.Res. 467 - A resolution recognizing the first commemoration of the anti-LGBTQ+ attack that occurred on November 19-20, 2022, at Club Q, an LGBTQ+ bar in Colorado Springs, Colorado. S.Res. 509 - A resolution recognizing the first commemoration of the anti-LGBTQ+ attack that occurred on November 19-20, 2022, at Club Q, an LGBTQ+ bar in Colorado Springs, Colorado. H.R. 7834 - Prevent Illegal Gun Resales Act H.R. 7746 - Destroy Zombie Guns Act H.R. 7450 - Protecting Privacy in Purchases Act H.R. 7352 - Identify Gun Stores Act H.R. 7195 - Protecting the Mailing of Firearms Act H.R. 7042 - RIFLE Act of 2024 H.R. 7040 - Undetectable Firearms Reauthorization Act H.R. 6981 - Preventing Private Paramilitary Activity Act of 2024 S. 4067 - CATCH Act S. 3852 - LEAD Act of 2024 S. 3812 - FIREARM Act S. 3677 - A bill to permanently authorize the Undetectable Firearms Act of 1988 S. 3589 - Preventing Private Paramilitary Activity Act of 2024

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. G2211 Add on Code Implementation: Urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols Mental and Behavioral Health: Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. G2211 Add on Code Implementation: Urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols Mental and Behavioral Health: Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Lobbied in support of gun control legislation, specifically in H.R.396: Closing the Bump Stock Loophole Act; H.R. 817: Default Proceed Sale Transparency Act; H.R.816/S.246: SECURE Gun Storage Act; H.R.1830: Closing the Loophole on Interstate Firearm Sales Act; H.R.1478: Federal Firearm Licensee Act; H.R.1595/S.867: State Firearms Dealer Licensing Enhancement Act; H.R.698/S.25: Assault Weapons Ban of 2023; H.R.768/S.247: Extreme Risk Protection Order Expansion Act of 2023; H.R.715: Bipartisan Background Checks Act of 2023; S.494: Background Check Expansion Act; H.R.2043: Enhanced Background Checks Act of 2023; S.116: Background Check Completion Act of 2023; H.R.660/S.173: Ethan's Law; S.14: Age 21 Act; H.R.569/S.117: Handgun Permit to Purchase Act; H.R.625/S.298: Keep Americans Safe Act; S.252: Protecting Kids from Gun Marketing Act; H.R.1302/S.598: Gun Records Restoration and Preservation Act; H.R.1699/S.951: Office of Gun Violence Prevention Act of 2023; H.R.2418: Gun Trafficker Detection Act; H.R.2753: Firearms Retailer Code of Conduct Act of 2023; H.R.3962/S.1893: Resources for Victims of Gun Violence Act of 2023; H.R.4637: Jaimes Law; H.R.4992/S.2652: Ghost Guns and Untraceable Firearms Act of 2023; H.R.5010: Recognizing Gun Violence as a Public Health Emergency Act; H.R.5449/S.2794: Stopping the Fraudulent Sales of Firearms Act; H.R.5435/S.2776: Disarm Hate Act; H.R.4283: Gun Violence Prevention and Safe Communities Act of 2023; H.R.5460: Bolstering Security Against Ghost Guns Act; S.2926: Stop Arming Cartels Act of 2023; H.R.4160: Undetectable Firearms Modernization Act; H.R.6697: Advancing Gun Safety Technology Act; S.3303/H.R.6405: Lori Jackson-Nicolette Elias Domestic Violence Survivor Protection Act; H.R.4366: Consolidated Appropriations Act, 2024; H.R.2882: Further Consolidated Appropriations Act, 2024; H.R.2670: National Defense Authorization Act for Fiscal Year 2024; H.R. 2770: Prevent Family Fire Act of 2023; H.R. 7272: Shining a Spotlight on Safer Communities Act; H.R. 7352: Identify Gun Stores Act; and H.R. 7746: Destroy Zombie Guns Act. Lobbied in opposition to H.R.38: Concealed Carry Reciprocity Act; H.R.152/S/401: Hearing Protection Act; H.R.5893: Making appropriations for the Departments of Commerce and Justice, Science, and Related Agencies for the fiscal year ending September 30, 2024, and for other purposes; and H.R.4664: Making appropriations for financial services and general government for the fiscal year ending September 30, 2024, and for other purposes.

H.R. 38 - Concealed Carry Reciprocity Act H.R. 46 - Mental Health Access and Gun Violence Prevention Act of 2023 H.R. 48 - Gun Violence Reduction Resources Act of 2023 H.R. 52 - Kimberly Vaughan Firearm Safe Storage Act H.R. 53 - Firearm Industry Non-Discrimination Act H.R. 60 - Accidental Firearms Transfers Reporting Act of 2023 H.R. 100 - No SmartPay for Anti-2A Companies Act H.R. 151 - No Frivolous Application for Short-Barreled Shotguns (NFA SBS) Act H.R. 152 - Hearing Protection Act H.R. 168 - To amend chapter 44 of title 18, United States Code, to more comprehensively address the interstate transportation of firearms or ammunition H.R. 173 - Home Defense and Competitive Shooting Act of 2023 H.R. 182 - To promote accountability and transparency in future executive orders H.R. 283 - Preventing Unjust Red Flag Laws Act of 2023 H.R. 331 - Illicit Arms Trafficking Security Enforcement Act H.R. 341 - Protect Our Military Families 2nd Amendment Rights Act H.R. 363 - Second Amendment Protection Act H.R. 374 - Abolish the ATF Act H.R. 381 - Protecting Individual Sovereignty Through Our Laws (PISTOL) Act H.R. 385 - No User Fees for Gun Owners Act H.R. 391 - Safe Bases Act H.R. 396 - Closing the Bump Stock Loophole Act of 2023 H.Res.45 - Expressing the sense of the House of Representatives that New York State's Concealed Carry Improvement Act is unconstitutional H.R. 450 - Repeal the NFA Act H.R. 508 - ATF Accountability Act of 2023 H.R. 569 - Handgun Permit to Purchase Act H.R. 584 - Stop Online Ammunition Sales Act of 2023 H.R. 625 - Keep Americans Safe Act H.R. 646 - Stop Harassing Owners of Rifles Today (SHORT) Act H.R. 660 - Ethan's Law H.R. 667 - Choosing Our Own Lives Over Fast Firearms (COOL OFF) Act H.R. 698 - Assault Weapons Ban of 2023 H.R. 705 - Veterans 2nd Amendment Protection Act H.R. 715 - Bipartisan Background Checks Act of 2023 H.R. 730 - Crime Gun Tracing Modernization Act of 2023 H.R. 768 - Extreme Risk Protection Order Expansion Act of 2023 H.R. 771 - Firearm Lockbox Protection Act of 2023 H.R. 790 - Repealing Illegal Freedom and Liberty Excises Act (RIFLE) Act H.R. 816 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act H.R. 817 - Default Proceed Sale Transparency Act H.R. 850 - To direct the Attorney General to conduct a study on the efficacy of extreme risk protection orders on reducing gun violence H.R. 851 - Iron Pipeline Review Act H.R. 962 - Protecting Gun Owners in Bankruptcy Act of 2023 H.R. 974 - ATF Improvement and Modernization (AIM) Act of 2023 H.R. 1145 - Safe Guns, Safe Kids Act H.R. 1258 - Protecting Gun Rights and Due Process Act H.R. 1271 - No Retaining Every Gun In a System That Restricts Your Rights Act H.R. 1302 - Gun Records Restoration and Preservation Act H.R. 1361 - Safer Neighborhoods Gun Buyback Act of 2023 H.R. 1478 - Federal Firearm Licensee Act H.R. 1566 - Safe Storage Lockers for House Office Buildings Act H.R. 1595 - State Firearms Dealer Licensing Enhancement Act H.J.Res.44 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" H.R. 1678 - Protecting Legal Firearms Ownership Act of 2023 H.R. 1699 - Office of Gun Violence Prevention Act of 2023 H.R. 1700 - ATF Transparency Act H.Res.244 - Expressing the sense of the House of Representatives that mandates imposed on manufacturers requiring inclusion of unproven and unreliable technology in firearms is costly and punitive, and the prohibition of firearms without such features is an infringement on the rights of citizens under the Second Amendment H.R. 1830 - Closing the Loophole on Interstate Firearm Sales Act H.R. 2390 - Gun Violence Prevention Research Act of 2023 H.R. 2391 - No Crime Left Behind Act H.R. 2392 - Pause for Gun Safety Act H.R. 2403 - Enhanced Background Checks Act of 2023 H.R. 2418 - Gun Trafficker Detection Act S.14 - Age 21 Act S.25 - Assault Weapons Ban of 2023 S.117 - Handgun Permit to Purchase Act S.118 - ATF Improvement and Modernization (AIM) Act of 2023 S.163 - Stop Harassing Owners of Rifles Today (SHORT) Act S.173 - Ethan's Law S.203 - Crime Gun Tracing Modernization Act of 2023 S.214 - Constitutional Concealed Carry Reciprocity Act of 2023 S.246 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act S.247 - Extreme Risk Protection Order Expansion Act of 2023 S.252 - Protecting Kids from Gun Marketing Act S.298 - Keep Americans Safe Act S.361 - Pistol Brace Protection Act S.401 - Hearing Protection Act S.428 - Firearm Industry Non-Discrimination (FIND) Act S.494 - Background Check Expansion Act S.598 - Gun Records Restoration and Preservation Act S.632 - ATF Transparency Act S.827 - A bill to provide that no Federal funds may be used to implement, administer, or enforce the rule of the Department of Justice entitled "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" S.J.Res.20 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Justice and the Bureau of Alcohol, Tobacco, Firearms and Explosives relating to "Factoring Criteria for Firearms With Attached 'Stabilizing Braces'" S.840 - Respect for the Second Amendment Act S.867 - State Firearms Dealer Licensing Enhancement Act S.951 - Office of Gun Violence Prevention Act of 2023 S.Amdt.38 - Prohibition on registry of lawful firearm owners S.1026 - Gun Violence Prevention Research Act of 2023 S.1116 - Background Check Completion Act of 2023 H.R.2471 - Vote Without Fear Act H.R.2477 - Protect Against School Shootings (PASS) Act H.R.2491 - SAFE School Act H.R.2502 - Safe Students Act H.R.2538 - Firearm Risk Protection Act of 2023 H.R.2620 - Federal Firearms Licensee Protection Act of 2023 H.R.2753 - Firearms Retailer Code of Conduct Act of 2023 H.R.2870 - Raise the Age Act of 2023 H.R.2897 - End Gun Violence Act of 2023 H.R.2898 - Secure Background Checks Act of 2023 H.R.2909 - Preventing Illegal Weapons Trafficking Act of 2023 H.R.2985 - Help Empower Americans to Respond (HEAR) Act of 2023 H.R.2991 - Teachers Empowered Against Classroom Harm (TEACH) Act of 2023 H.R.3018 - Federal Extreme Risk Protection Order Act of 2023 H.R.3021 - Protecting the Second Amendment in Financial Services Act H.Res.348 - Declaring gun violence a public health crisis H.R.3096 - Firearm Safety Act of 2023 H.R.3122 - Gun Show Loophole Closing Act of 2023 H.R.3155 - Protecting the Second Amendment through Responsible Gun Ownership Act H.R.3212 - Shall Not Be Infringed Act of 2023 H.R.3492 - Gun Owner Registration Information Protection Act H.R.3502 - Responsible Firearms Marketing Act H.R.3529 - Forbidding the Increase of Rogue Enforcers Act (FIRE) Act H.R.3687 - Protect Children Through Safe Gun Ownership Act H.Res.453 - Providing for consideration of the bill (H.R. 2403) to amend chapter 44 of title 18, United States Code, to strengthen the background check procedures to be followed before a Federal firearms licensee may transfer a firearm to a person who is not such a licensee H.Res.454 - Providing for consideration of the bill (H.R. 715) to require a background check for every firearm sale H.R.3824 - Trafficking Reduction And Criminal Enforcement (TRACE) Act H.R.3863 - Keeping Gun Dealers Honest Act of 2023 H.R.3931 - Angellyh Yambo Gun Free Zone Expansion Act of 2023 H.R.3993 - To provide a private right of action against the maker of any component of a ghost gun, and any person who facilitated a sale of the ghost gun, for injury or death resulting from the use of the ghost gun H.Res.495 - Providing for consideration of the joint resolution (H.J. Res. 44) providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'stabilizing braces'" H.R.4074 - 3D Printed Gun Safety Act of 2023 H.R.4158 - Gun Violence Prevention Through Financial Intelligence Act H.R.4159 - Background Check Point of Contact Act of 2023 H.R.4160 - Undetectable Firearms Modernization Act H.R.4184 - Equal Access to Justice for Victims of Gun Violence Act of 2023 H.R.4201 - Safe Storage Saves Lives Act H.R.4202 - Multiple Firearm Sales Reporting Modernization Act of 2023 H.R.4243 - To amend the consumer product safety laws to repeal the exclusion of pistols, revolvers, and other firearms from the definition of consumer product under such laws H.R.4283 - To amend the Internal Revenue Code of 1986 to increase certain taxes related to firearms, and for other purposes S.1825 - Gun Violence Prevention Through Financial Intelligence Act S.1319 - Preventing Illegal Weapons Trafficking Act of 2023 S.1383 - Help Empower Americans to Respond (HEAR) Act of 2023 S.1460 - Firearm Safety Act of 2023 S.1680 - Gun Owner Registration Information Protection Act S.1737 - Responsible Firearms Marketing Act S.1819 - 3D Printed Gun Safety Act of 2023 S.1824 - Making America Safe and Secure (MASS) Act S.1825 - Gun Violence Prevention Through Financial Intelligence Act S.1826 - Keeping Gun Dealers Honest Act of 2023 S.1907 - Federal Firearms Licensee Protection Act of 2023 S.1909 - Banning Unlawful Machinegun Parts (BUMP) Act of 2023 H.Amdt. 297 - An amendment numbered 35 printed in House Report 118-158 to prohibit the VA from using funds to submit a beneficiary's name to the NICS list based on VA's appointment of a fiduciary. H.R. 2897 - End Gun Violence Act of 2023 H.R. 4365 - Department of Homeland Security Appropriations Act, 2025 H.R. 4394 - Energy and Water Development and Related Agencies Appropriations Act, 2024 H.R. 4637 - Jaime's Law H.R. 4664 - Making appropriations for financial services and general government for the fiscal year ending September 30, 2024, and for other purposes. H.R. 4665 - Department of State, Foreign Operations, and Related Programs Appropriations Act, 2024 H.R. 4679 - Ghost Guns and Untraceable Firearms Act of 2023 H.R. 4780 - Language Access to Gun Violence Prevention Strategies Act of 2023 H.R. 4820 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2024 H.R. 4821 - Department of the Interior, Environment, and Related Agencies Appropriations Act, 2024 H.R. 4854 - Fair Legal Access Grants Act H.R. 4860 - PROTECT the Second Amendment Act H.R. 4965 - Kimberly Vaughan Firearm Safe Storage Act H.R. 4966 - Protecting Americans from Reckless Gun Dealers Act of 2023 H.R. 4992 - Ghost Guns and Untraceable Firearms Act of 2023 H.R. 5003 - Break the Cycle of Violence Act H.R. 5010 - Recognizing Gun Violence as a Public Health Emergency Act H.R. 5110 - Protecting Hunting Heritage and Education Act H.R. 5135 - Assault Weapons Excise Act H.R. 5184 - School Security Enhancement Act H.R. 5281 - LEAD Act of 2023 H.R. 5285 - Staff Safety Act H.R. 5286 - Defending Veterans' Second Amendment Rights Act H.R. 5435 - Disarm Hate Act H.R. 5449 - Stopping the Fraudulent Sales of Firearms Act H.R. 5460 - Bolstering Security Against Ghost Guns Act H.R. 5467 - Gun Suicide Prevention Act H.R. 5497 - Active Shooter Alert System Improvements Act of 2023 H.R. 5505 - Educating Responsible Future Hunters Act H.R. 5508 - Respect for the Second Amendment Act H.R. 5525 - Continuing Appropriations and Border Security Enhancement Act, 2024 H.R. 5561 - Protecting the Right to Keep and Bear Arms Act of 2023 H.R. 5727 - National Instant Criminal Background Check System (NICS) Data Integrity Act of 2023 H.R. 5767 - No Gun Rights Infringement Sham Act H.R. 5894 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes. H.R. 615 - Protecting Access for Hunters and Anglers Act of 2023 H.Res. 591 - Condemning the horrific gun violence in Fort Worth, Texas, and acknowledging the human toll of gun violence in this country. H.Res. 611 - Providing for consideration of the bill (H.R. 660) to amend chapter 44 of title 18, United States Code, to require the safe storage of firearms, and for other purposes. H.Res. 651 - Condemning the decision of the Secretary of Education to prohibit the use of funds under the Elementary and Secondary Education Act of 1965 for hunter, archery, and other shooting sports education programs in schools and explicitly affirming that school programs that train students in archery, hunting, or other shooting sports are eligible for Federal funding under such Act. H.Res. 684 - Condemning the actions of Governor of New Mexico, Michelle Lujan Grisham, for subverting the Second Amendment to the Constitution and depriving the citizens of New Mexico of their right to bear arms. H.Res. 737 - Expressing the sense of the House of Representatives regarding the relationship between firearm violence and intimate partner violence and to honor the memory of Gladys Ricart and other victims of intimate partner homicide killed by firearms, and for other purposes. S. 1185 - Protecting Access for Hunters and Anglers Act of 2023 S. 2214 - Fair Legal Access Grants Act S. 2226 - National Defense Authorization Act for Fiscal Year 2024 S. 2302 - Legislative Branch Appropriations Act, 2024 S. 2309 - Financial Services and General Government Appropriations Act, 2024 S. 2321 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2024 S. 2381 - National Instant Criminal Background Check System (NICS) Data Integrity Act of 2023 S. 2437 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2024 S. 2438 - Department of State, Foreign Operations, and Related Programs Appropriations Act, 2024 S. 2443 - Energy and Water Development and Related Agencies Appropriations Act, 2024 S. 2565 - Language Access to Gun Violence Prevention Strategies Act of 2023 S. 2587 - Department of Defense Appropriations Act, 2024 S. 2605 - Department of the Interior, Environment, and Related Agencies Appropriations Act, 2024 S. 2624 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 S. 2625 - Department of Homeland Security Appropriations Act, 2024 S. 2638 - Break the Cycle of Violence Act S. 2652 - Ghost Guns and Untraceable Firearms Act of 2023 S. 2732 - End Gun Violence Act of 2023 S. 2753 - Jaime's Law S. 2776 - Disarm Hate Act S. 2794 - Stopping the Fraudulent Sales of Firearms Act S. 2802 - Educating Responsible Future Hunters Act S. 2828 - Protecting Hunting Heritage and Education Act S. 2860 - SAFER Banking Act S. 2911 - Protecting the Right To Keep and Bear Arms Act of 2023 S. 2926 - Stop Arming Cartels Act of 2023 S.Amdt. 1201 - H.R. 4366 S.Amdt. 1288 - Amends H.R. 4366 S.Amdt. 636 - S. 2226 S.Amdt. 728 - S. 2226 S.Amdt. 729 - S. 2226 S.Amdt. 730 - S. 2226 S.Amdt. 732 - S. 2226 S.Amdt. 905 - S. 2226 S.Res. 303 - A resolution congratulating the University of Alaska Fairbanks rifle team for winning the 2023 National Collegiate Athletic Association championship, the program's 11th title overall. H.R. 6824 - NICS Data Reporting Act H.R. 6782 - SAFER Voter Act H.R. 6775 - Public Banking Act of 2023 H.R. 6754 - School Violence Prevention Act H.R. 6734 - Stopping Unconstitutional Background Checks Act H.R. 6697 - Advancing Gun Safety Technology Act H.R. 6618 - ARMAS Act of 2023 H.R. 6613 - PLAN for School Safety Act of 2023 H.R. 6611 - FISA Reform and Reauthorization Act of 2023 H.R. 6596 - Gun Violence Prevention and Community Safety Act of 2023 H.R. 6566 - Stronger Schools Act H.R. 6504 - Protect American Gun Exporters Act H.R. 6405 - Lori Jackson-Nicolette Elias Domestic Violence Survivor Protection Act H.R. 6404 - Disarming Cartels Act H.R. 6363 - Further Continuing Appropriations and Other Extensions Act, 2024 H.R. 6352 - Tax Stamp Revenue Transfer for Wildlife and Recreation Act H.R. 6262 - Government Surveillance Reform Act of 2023 H.R. 6211 - SAFE Act of 2023 H.R. 6172 - AMMO Act H.R. 6154 - Responsible Gun Ownership Licensing Act H.R. 6151 - IMPROVE Safety for Schools Act H.R. 6028 - States Reform Act of 2023 H.R. 6014 - Fire Sale Loophole Closing Act H.R. 5949 - Protecting Gun Owners Privacy Act of 2023 H.R. 5948 - To terminate the Office of Gun Violence Prevention in the Executive Office of the President and prohibit the establishment of any similar successor office, and for other purposes H.R. 5894 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes. H.R. 5893 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2024 H.R. 4639 - Fourth Amendment Is Not For Sale Act H.Amdt. 713 toH.R.4664Defunding of White House Office of Gun Violence Prevention H.Amdt. 790 - Description: An amendment numbered 123 printed in Part B of House Report 118-272 to prohibit funding for Centers for Disease Control and Prevention's firearm injury and mortality prevention research. H.Amdt. 660 - An amendment numbered 12 printed in Part B of House Report 118-269 to increase and decrease funding for the Internal Revenue Service by $5,000 with the intent to direct the agency to provide Congress with the quantity and types(s) of: weapons, weapons systems, ammunition, explosive devices, armored vehicles, drones/UAVs, and chemical weapons such as tear gas and calming agents in their possession. H.Amdt. 661 - Description: An amendment numbered 15 printed in Part B of House Report 118-269 to strike funding for firearms and ammunition for the Internal Revenue Service. H.Res. 819 - Recognizing the 5-year anniversary of the horrific antisemitic attack at the Tree of Life Synagogue in Pittsburgh, Pennsylvania, on October 27, 2018, and condemning antisemitism. H.Res. 827 - Expressing the sense of the House of Representatives regarding the relationships between firearm violence, misogyny, and violence against women, and reaffirming the importance of preventing individuals with a history of violence against women from accessing a firearm. H.Res. 879 - Expressing support for the designation of November 20, 2023, through December 20, 2023, as "National Survivors of Homicide Victims Awareness Month". H.Res. 886 - Supporting the goals and principles of Transgender Day of Remembrance by recognizing the epidemic of violence toward transgender people and memorializing the lives lost this year. H.Res. 928 - Honoring the victims of the mass shooting at the University of Nevada, Las Vegas on December 6, 2023. S. 3531 - Protect American Gun Exporters Act S. 3529 - ATF Accountability Act of 2023 S. 3407 - Gun Violence Prevention and Community Safety Act of 2023 S. 3369 - OSAFE Act S. 3351 - FISA Reform and Reauthorization Act of 2023 S. 3303 - Lori Jackson-Nicolette Elias Domestic Violence Survivor Protection Act S. 3234 - Government Surveillance Reform Act of 2023 S. 3223 - AMMO Act S. 3212 - Federal Firearm Licensing Act S. 3100 - Fire Sale Loophole Closing Act of 2023 S. 2576 - Fourth Amendment Is Not For Sale Act S. 2190 - RECOUP Act of 2023 S.Amdt. - 1354To prohibit the availability of funds for the Secretary of Veterans Affairs to report certain information to the Department of Justice for use by the National Instant Criminal Background Check System. S.Res. 465 - A resolution expressing support for the designation of November 20, 2023, through December 20, 2023, as "National Survivors of Homicide Victims Awareness Month". S.Res. 467 - A resolution recognizing the first commemoration of the anti-LGBTQ+ attack that occurred on November 19-20, 2022, at Club Q, an LGBTQ+ bar in Colorado Springs, Colorado. S.Res. 509 - A resolution recognizing the first commemoration of the anti-LGBTQ+ attack that occurred on November 19-20, 2022, at Club Q, an LGBTQ+ bar in Colorado Springs, Colorado.

H.R. 38 - Concealed Carry Reciprocity Act H.R. 46 - Mental Health Access and Gun Violence Prevention Act of 2023 H.R. 48 - Gun Violence Reduction Resources Act of 2023 H.R. 52 - Kimberly Vaughan Firearm Safe Storage Act H.R. 53 - Firearm Industry Non-Discrimination Act H.R. 60 - Accidental Firearms Transfers Reporting Act of 2023 H.R. 100 - No SmartPay for Anti-2A Companies Act H.R. 151 - No Frivolous Application for Short-Barreled Shotguns (NFA SBS) Act H.R. 152 - Hearing Protection Act H.R. 168 - To amend chapter 44 of title 18, United States Code, to more comprehensively address the interstate transportation of firearms or ammunition H.R. 173 - Home Defense and Competitive Shooting Act of 2023 H.R. 182 - To promote accountability and transparency in future executive orders H.R. 283 - Preventing Unjust Red Flag Laws Act of 2023 H.R. 331 - Illicit Arms Trafficking Security Enforcement Act H.R. 341 - Protect Our Military Families 2nd Amendment Rights Act H.R. 363 - Second Amendment Protection Act H.R. 374 - Abolish the ATF Act H.R. 381 - Protecting Individual Sovereignty Through Our Laws (PISTOL) Act H.R. 385 - No User Fees for Gun Owners Act H.R. 391 - Safe Bases Act H.R. 396 - Closing the Bump Stock Loophole Act of 2023 H.Res.45 - Expressing the sense of the House of Representatives that New York State's Concealed Carry Improvement Act is unconstitutional H.R. 450 - Repeal the NFA Act H.R. 508 - ATF Accountability Act of 2023 H.R. 569 - Handgun Permit to Purchase Act H.R. 584 - Stop Online Ammunition Sales Act of 2023 H.R. 625 - Keep Americans Safe Act H.R. 646 - Stop Harassing Owners of Rifles Today (SHORT) Act H.R. 660 - Ethan's Law H.R. 667 - Choosing Our Own Lives Over Fast Firearms (COOL OFF) Act H.R. 698 - Assault Weapons Ban of 2023 H.R. 705 - Veterans 2nd Amendment Protection Act H.R. 715 - Bipartisan Background Checks Act of 2023 H.R. 730 - Crime Gun Tracing Modernization Act of 2023 H.R. 768 - Extreme Risk Protection Order Expansion Act of 2023 H.R. 771 - Firearm Lockbox Protection Act of 2023 H.R. 790 - Repealing Illegal Freedom and Liberty Excises Act (RIFLE) Act H.R. 816 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act H.R. 817 - Default Proceed Sale Transparency Act H.R. 850 - To direct the Attorney General to conduct a study on the efficacy of extreme risk protection orders on reducing gun violence H.R. 851 - Iron Pipeline Review Act H.R. 962 - Protecting Gun Owners in Bankruptcy Act of 2023 H.R. 974 - ATF Improvement and Modernization (AIM) Act of 2023 H.R. 1145 - Safe Guns, Safe Kids Act H.R. 1258 - Protecting Gun Rights and Due Process Act H.R. 1271 - No Retaining Every Gun In a System That Restricts Your Rights Act H.R. 1302 - Gun Records Restoration and Preservation Act H.R. 1361 - Safer Neighborhoods Gun Buyback Act of 2023 H.R. 1478 - Federal Firearm Licensee Act H.R. 1566 - Safe Storage Lockers for House Office Buildings Act H.R. 1595 - State Firearms Dealer Licensing Enhancement Act H.J.Res.44 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" H.R. 1678 - Protecting Legal Firearms Ownership Act of 2023 H.R. 1699 - Office of Gun Violence Prevention Act of 2023 H.R. 1700 - ATF Transparency Act H.Res.244 - Expressing the sense of the House of Representatives that mandates imposed on manufacturers requiring inclusion of unproven and unreliable technology in firearms is costly and punitive, and the prohibition of firearms without such features is an infringement on the rights of citizens under the Second Amendment H.R. 1830 - Closing the Loophole on Interstate Firearm Sales Act H.R. 2390 - Gun Violence Prevention Research Act of 2023 H.R. 2391 - No Crime Left Behind Act H.R. 2392 - Pause for Gun Safety Act H.R. 2403 - Enhanced Background Checks Act of 2023 H.R. 2418 - Gun Trafficker Detection Act S.14 - Age 21 Act S.25 - Assault Weapons Ban of 2023 S.117 - Handgun Permit to Purchase Act S.118 - ATF Improvement and Modernization (AIM) Act of 2023 S.163 - Stop Harassing Owners of Rifles Today (SHORT) Act S.173 - Ethan's Law S.203 - Crime Gun Tracing Modernization Act of 2023 S.214 - Constitutional Concealed Carry Reciprocity Act of 2023 S.246 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act S.247 - Extreme Risk Protection Order Expansion Act of 2023 S.252 - Protecting Kids from Gun Marketing Act S.298 - Keep Americans Safe Act S.361 - Pistol Brace Protection Act S.401 - Hearing Protection Act S.428 - Firearm Industry Non-Discrimination (FIND) Act S.494 - Background Check Expansion Act S.598 - Gun Records Restoration and Preservation Act S.632 - ATF Transparency Act S.827 - A bill to provide that no Federal funds may be used to implement, administer, or enforce the rule of the Department of Justice entitled "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" S.J.Res.20 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Justice and the Bureau of Alcohol, Tobacco, Firearms and Explosives relating to "Factoring Criteria for Firearms With Attached 'Stabilizing Braces'" S.840 - Respect for the Second Amendment Act S.867 - State Firearms Dealer Licensing Enhancement Act S.951 - Office of Gun Violence Prevention Act of 2023 S.Amdt.38 - Prohibition on registry of lawful firearm owners S.1026 - Gun Violence Prevention Research Act of 2023 S.1116 - Background Check Completion Act of 2023 H.R.2471 - Vote Without Fear Act H.R.2477 - Protect Against School Shootings (PASS) Act H.R.2491 - SAFE School Act H.R.2502 - Safe Students Act H.R.2538 - Firearm Risk Protection Act of 2023 H.R.2620 - Federal Firearms Licensee Protection Act of 2023 H.R.2753 - Firearms Retailer Code of Conduct Act of 2023 H.R.2870 - Raise the Age Act of 2023 H.R.2897 - End Gun Violence Act of 2023 H.R.2898 - Secure Background Checks Act of 2023 H.R.2909 - Preventing Illegal Weapons Trafficking Act of 2023 H.R.2985 - Help Empower Americans to Respond (HEAR) Act of 2023 H.R.2991 - Teachers Empowered Against Classroom Harm (TEACH) Act of 2023 H.R.3018 - Federal Extreme Risk Protection Order Act of 2023 H.R.3021 - Protecting the Second Amendment in Financial Services Act H.Res.348 - Declaring gun violence a public health crisis H.R.3096 - Firearm Safety Act of 2023 H.R.3122 - Gun Show Loophole Closing Act of 2023 H.R.3155 - Protecting the Second Amendment through Responsible Gun Ownership Act H.R.3212 - Shall Not Be Infringed Act of 2023 H.R.3492 - Gun Owner Registration Information Protection Act H.R.3502 - Responsible Firearms Marketing Act H.R.3529 - Forbidding the Increase of Rogue Enforcers Act (FIRE) Act H.R.3687 - Protect Children Through Safe Gun Ownership Act H.Res.453 - Providing for consideration of the bill (H.R. 2403) to amend chapter 44 of title 18, United States Code, to strengthen the background check procedures to be followed before a Federal firearms licensee may transfer a firearm to a person who is not such a licensee H.Res.454 - Providing for consideration of the bill (H.R. 715) to require a background check for every firearm sale H.R.3824 - Trafficking Reduction And Criminal Enforcement (TRACE) Act H.R.3863 - Keeping Gun Dealers Honest Act of 2023 H.R.3931 - Angellyh Yambo Gun Free Zone Expansion Act of 2023 H.R.3993 - To provide a private right of action against the maker of any component of a ghost gun, and any person who facilitated a sale of the ghost gun, for injury or death resulting from the use of the ghost gun H.Res.495 - Providing for consideration of the joint resolution (H.J. Res. 44) providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'stabilizing braces'" H.R.4074 - 3D Printed Gun Safety Act of 2023 H.R.4158 - Gun Violence Prevention Through Financial Intelligence Act H.R.4159 - Background Check Point of Contact Act of 2023 H.R.4160 - Undetectable Firearms Modernization Act H.R.4184 - Equal Access to Justice for Victims of Gun Violence Act of 2023 H.R.4201 - Safe Storage Saves Lives Act H.R.4202 - Multiple Firearm Sales Reporting Modernization Act of 2023 H.R.4243 - To amend the consumer product safety laws to repeal the exclusion of pistols, revolvers, and other firearms from the definition of consumer product under such laws H.R.4283 - To amend the Internal Revenue Code of 1986 to increase certain taxes related to firearms, and for other purposes S.1825 - Gun Violence Prevention Through Financial Intelligence Act S.1319 - Preventing Illegal Weapons Trafficking Act of 2023 S.1383 - Help Empower Americans to Respond (HEAR) Act of 2023 S.1460 - Firearm Safety Act of 2023 S.1680 - Gun Owner Registration Information Protection Act S.1737 - Responsible Firearms Marketing Act S.1819 - 3D Printed Gun Safety Act of 2023 S.1824 - Making America Safe and Secure (MASS) Act S.1825 - Gun Violence Prevention Through Financial Intelligence Act S.1826 - Keeping Gun Dealers Honest Act of 2023 S.1907 - Federal Firearms Licensee Protection Act of 2023 S.1909 - Banning Unlawful Machinegun Parts (BUMP) Act of 2023 H.Amdt. 297 - An amendment numbered 35 printed in House Report 118-158 to prohibit the VA from using funds to submit a beneficiary's name to the NICS list based on VA's appointment of a fiduciary. H.R. 2897 - End Gun Violence Act of 2023 H.R. 4365 - Department of Homeland Security Appropriations Act, 2025 H.R. 4394 - Energy and Water Development and Related Agencies Appropriations Act, 2024 H.R. 4637 - Jaime's Law H.R. 4664 - Making appropriations for financial services and general government for the fiscal year ending September 30, 2024, and for other purposes. H.R. 4665 - Department of State, Foreign Operations, and Related Programs Appropriations Act, 2024 H.R. 4679 - Ghost Guns and Untraceable Firearms Act of 2023 H.R. 4780 - Language Access to Gun Violence Prevention Strategies Act of 2023 H.R. 4820 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2024 H.R. 4821 - Department of the Interior, Environment, and Related Agencies Appropriations Act, 2024 H.R. 4854 - Fair Legal Access Grants Act H.R. 4860 - PROTECT the Second Amendment Act H.R. 4965 - Kimberly Vaughan Firearm Safe Storage Act H.R. 4966 - Protecting Americans from Reckless Gun Dealers Act of 2023 H.R. 4992 - Ghost Guns and Untraceable Firearms Act of 2023 H.R. 5003 - Break the Cycle of Violence Act H.R. 5010 - Recognizing Gun Violence as a Public Health Emergency Act H.R. 5110 - Protecting Hunting Heritage and Education Act H.R. 5135 - Assault Weapons Excise Act H.R. 5184 - School Security Enhancement Act H.R. 5281 - LEAD Act of 2023 H.R. 5285 - Staff Safety Act H.R. 5286 - Defending Veterans' Second Amendment Rights Act H.R. 5435 - Disarm Hate Act H.R. 5449 - Stopping the Fraudulent Sales of Firearms Act H.R. 5460 - Bolstering Security Against Ghost Guns Act H.R. 5467 - Gun Suicide Prevention Act H.R. 5497 - Active Shooter Alert System Improvements Act of 2023 H.R. 5505 - Educating Responsible Future Hunters Act H.R. 5508 - Respect for the Second Amendment Act H.R. 5525 - Continuing Appropriations and Border Security Enhancement Act, 2024 H.R. 5561 - Protecting the Right to Keep and Bear Arms Act of 2023 H.R. 5727 - National Instant Criminal Background Check System (NICS) Data Integrity Act of 2023 H.R. 5767 - No Gun Rights Infringement Sham Act H.R. 5894 - Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes. H.R. 615 - Protecting Access for Hunters and Anglers Act of 2023 H.Res. 591 - Condemning the horrific gun violence in Fort Worth, Texas, and acknowledging the human toll of gun violence in this country. H.Res. 611 - Providing for consideration of the bill (H.R. 660) to amend chapter 44 of title 18, United States Code, to require the safe storage of firearms, and for other purposes. H.Res. 651 - Condemning the decision of the Secretary of Education to prohibit the use of funds under the Elementary and Secondary Education Act of 1965 for hunter, archery, and other shooting sports education programs in schools and explicitly affirming that school programs that train students in archery, hunting, or other shooting sports are eligible for Federal funding under such Act. H.Res. 684 - Condemning the actions of Governor of New Mexico, Michelle Lujan Grisham, for subverting the Second Amendment to the Constitution and depriving the citizens of New Mexico of their right to bear arms. H.Res. 737 - Expressing the sense of the House of Representatives regarding the relationship between firearm violence and intimate partner violence and to honor the memory of Gladys Ricart and other victims of intimate partner homicide killed by firearms, and for other purposes. S. 1185 - Protecting Access for Hunters and Anglers Act of 2023 S. 2214 - Fair Legal Access Grants Act S. 2226 - National Defense Authorization Act for Fiscal Year 2024 S. 2302 - Legislative Branch Appropriations Act, 2024 S. 2309 - Financial Services and General Government Appropriations Act, 2024 S. 2321 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2024 S. 2381 - National Instant Criminal Background Check System (NICS) Data Integrity Act of 2023 S. 2437 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2024 S. 2438 - Department of State, Foreign Operations, and Related Programs Appropriations Act, 2024 S. 2443 - Energy and Water Development and Related Agencies Appropriations Act, 2024 S. 2565 - Language Access to Gun Violence Prevention Strategies Act of 2023 S. 2587 - Department of Defense Appropriations Act, 2024 S. 2605 - Department of the Interior, Environment, and Related Agencies Appropriations Act, 2024 S. 2624 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 S. 2625 - Department of Homeland Security Appropriations Act, 2024 S. 2638 - Break the Cycle of Violence Act S. 2652 - Ghost Guns and Untraceable Firearms Act of 2023 S. 2732 - End Gun Violence Act of 2023 S. 2753 - Jaime's Law S. 2776 - Disarm Hate Act S. 2794 - Stopping the Fraudulent Sales of Firearms Act S. 2802 - Educating Responsible Future Hunters Act S. 2828 - Protecting Hunting Heritage and Education Act S. 2860 - SAFER Banking Act S. 2911 - Protecting the Right To Keep and Bear Arms Act of 2023 S. 2926 - Stop Arming Cartels Act of 2023 S.Amdt. 1201 - H.R. 4366 S.Amdt. 1288 - Amends H.R. 4366 S.Amdt. 636 - S. 2226 S.Amdt. 728 - S. 2226 S.Amdt. 729 - S. 2226 S.Amdt. 730 - S. 2226 S.Amdt. 732 - S. 2226 S.Amdt. 905 - S. 2226 S.Res. 303 - A resolution congratulating the University of Alaska Fairbanks rifle team for winning the 2023 National Collegiate Athletic Association championship, the program's 11th title overall.

Lobbied in support of gun control legislation, specifically in H.R.396: Closing the Bump Stock Loophole Act; H.R. 817: Default Proceed Sale Transparency Act; H.R.816/S.246: SECURE Gun Storage Act; H.R.1830: Closing the Loophole on Interstate Firearm Sales Act; H.R.1478: Federal Firearm Licensee Act; H.R.1595/S.867: State Firearms Dealer Licensing Enhancement Act; H.R.698/S.25: Assault Weapons Ban of 2023; H.R.768/S.247: Extreme Risk Protection Order Expansion Act of 2023; H.R.715: Bipartisan Background Checks Act of 2023; S.494: Background Check Expansion Act; H.R.2043: Enhanced Background Checks Act of 2023; S.116: Background Check Completion Act of 2023; H.R.660/S.173: Ethan's Law; S.14: Age 21 Act; H.R.569/S.117: Handgun Permit to Purchase Act; H.R.625/S.298: Keep Americans Safe Act; S.252: Protecting Kids from Gun Marketing Act; H.R.1302/S.598: Gun Records Restoration and Preservation Act; H.R.1699/S.951: Office of Gun Violence Prevention Act of 2023; H.R.2418: Gun Trafficker Detection Act; H.R.2753: Firearms Retailer Code of Conduct Act of 2023; H.R.3962/S.1893: Resources for Victims of Gun Violence Act of 2023; H.R.4637: Jaimes Law; H.R.4992/S.2652: Ghost Guns and Untraceable Firearms Act of 2023; H.R.5010: Recognizing Gun Violence as a Public Health Emergency Act; H.R.5449/S.2794: Stopping the Fraudulent Sales of Firearms Act; H.R.5435/S.2776: Disarm Hate Act; H.R.4283: Gun Violence Prevention and Safe Communities Act of 2023; H.R.5460: Bolstering Security Against Ghost Guns Act; S.2926: Stop Arming Cartels Act of 2023; H.R.4160: Undetectable Firearms Modernization Act; H.R.6697: Advancing Gun Safety Technology Act; and S.3303/H.R.6405: Lori Jackson-Nicolette Elias Domestic Violence Survivor Protection Act. Lobbied in opposition to H.R.38: Concealed Carry Reciprocity Act; H.R.152/S/401: Hearing Protection Act; H.R.5893: Making appropriations for the Departments of Commerce and Justice, Science, and Related Agencies for the fiscal year ending September 30, 2024, and for other purposes; H.R.4664: Making appropriations for financial services and general government for the fiscal year ending September 30, 2024, and for other purposes.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. G2211 Add on Code Implementation: Urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; and 3) a sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medic

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. G2211 Add on Code Implementation: Urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; and 3) a sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medic

Lobbied in support of gun control legislation, specifically in H.R.396: Closing the Bump Stock Loophole Act; H.R. 817: Default Proceed Sale Transparency Act; H.R.816/S.246: SECURE Gun Storage Act; H.R.1830: Closing the Loophole on Interstate Firearm Sales Act; H.R.1478: Federal Firearm Licensee Act; H.R.1595/S.867: State Firearms Dealer Licensing Enhancement Act; H.R.698/S.25: Assault Weapons Ban of 2023; H.R.768/S.247: Extreme Risk Protection Order Expansion Act of 2023; H.R.715: Bipartisan Background Checks Act of 2023; S.494: Background Check Expansion Act; H.R.2043: Enhanced Background Checks Act of 2023; S.116: Background Check Completion Act of 2023; H.R.660/S.173: Ethan's Law; S.14: Age 21 Act; H.R.569/S.117: Handgun Permit to Purchase Act; H.R.625/S.298: Keep Americans Safe Act; S.252: Protecting Kids from Gun Marketing Act; H.R.1302/S.598: Gun Records Restoration and Preservation Act; H.R.1699/S.951: Office of Gun Violence Prevention Act of 2023; H.R.2418: Gun Trafficker Detection Act; H.R.2753: Firearms Retailer Code of Conduct Act of 2023; H.R.3962/S.1893: Resources for Victims of Gun Violence Act of 2023; H.R.4637: Jaimes Law; H.R.4992/S.2652: Ghost Guns and Untraceable Firearms Act of 2023; H.R.5010: Recognizing Gun Violence as a Public Health Emergency Act; H.R.5449/S.2794: Stopping the Fraudulent Sales of Firearms Act; H.R.5435/S.2776: Disarm Hate Act; H.R.4283: Gun Violence Prevention and Safe Communities Act of 2023; H.R.5460: Bolstering Security Against Ghost Guns Act; S.2926: Stop Arming Cartels Act of 2023; and H.R.4160: Undetectable Firearms Modernization Act. Lobbied in opposition to H.R.38: Concealed Carry Reciprocity Act; H.R.152/S/401: Hearing Protection Act; H.R.5893: Making appropriations for the Departments of Commerce and Justice, Science, and Related Agencies for the fiscal year ending September 30, 2024, and for other purposes; H.R.4664: Making appropriations for financial services and general government for the fiscal year ending September 30, 2024, and for other purposes.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. G2211 Add on Code Implementation: ACP urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) Positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) Meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; AND 3) A sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. We supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. G2211 Add on Code Implementation: ACP urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) Positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) Meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; AND 3) A sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. We supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supporting those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. G2211 Add on Code Implementation: ACP urged Congress to support the full implementation of a Medicare add-on code, known as G2211, in 2024. This code will improve Medicare beneficiaries access to high-quality, continuous care and help sustain the physician practices beneficiaries rely on for comprehensive health care. G2211 would be billed alongside codes for office/outpatient evaluation and management (E/M) visits to better account for the unique and inherent complexity of services provided through longitudinal patient care that is based on a clinicians ongoing relationship with a patient and is related to a patients single, serious condition or a complex condition. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. MACRA Reform Hearings: We requested Congressional hearings on The Medicare Access and CHIP Reauthorization Act (MACRA) to focus upon whether the current system achieves the Congressional intent to move towards value- based care and to consider the long-term viability of the current Medicare physician payment system. These hearings should focus on the characteristics of a rational Medicare payment system. This should include: 1) Positive consistent and stable annual payment updates that offer the financial stability needed for our physicians to transition their practices to value-based payment models; 2) Meaningful and actionable quality reporting initiatives that adequately measure the quality of care our physicians provide to their patients; AND 3) A sufficient number of Advanced APMs for our physicians to join to provide high quality value-based care to their patients. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. We supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

H.R. 38 - Concealed Carry Reciprocity Act H.R. 46 - Mental Health Access and Gun Violence Prevention Act of 2023 H.R. 48 - Gun Violence Reduction Resources Act of 2023 H.R. 52 - Kimberly Vaughan Firearm Safe Storage Act H.R. 53 - Firearm Industry Non-Discrimination Act H.R. 60 - Accidental Firearms Transfers Reporting Act of 2023 H.R. 100 - No SmartPay for Anti-2A Companies Act H.R. 151 - No Frivolous Application for Short-Barreled Shotguns (NFA SBS) Act H.R. 152 - Hearing Protection Act H.R. 168 - To amend chapter 44 of title 18, United States Code, to more comprehensively address the interstate transportation of firearms or ammunition H.R. 173 - Home Defense and Competitive Shooting Act of 2023 H.R. 182 - To promote accountability and transparency in future executive orders H.R. 283 - Preventing Unjust Red Flag Laws Act of 2023 H.R. 331 - Illicit Arms Trafficking Security Enforcement Act H.R. 341 - Protect Our Military Families 2nd Amendment Rights Act H.R. 363 - Second Amendment Protection Act H.R. 374 - Abolish the ATF Act H.R. 381 - Protecting Individual Sovereignty Through Our Laws (PISTOL) Act H.R. 385 - No User Fees for Gun Owners Act H.R. 391 - Safe Bases Act H.R. 396 - Closing the Bump Stock Loophole Act of 2023 H.Res.45 - Expressing the sense of the House of Representatives that New York State's Concealed Carry Improvement Act is unconstitutional H.R. 450 - Repeal the NFA Act H.R. 508 - ATF Accountability Act of 2023 H.R. 569 - Handgun Permit to Purchase Act H.R. 584 - Stop Online Ammunition Sales Act of 2023 H.R. 625 - Keep Americans Safe Act H.R. 646 - Stop Harassing Owners of Rifles Today (SHORT) Act H.R. 660 - Ethan's Law H.R. 667 - Choosing Our Own Lives Over Fast Firearms (COOL OFF) Act H.R. 698 - Assault Weapons Ban of 2023 H.R. 705 - Veterans 2nd Amendment Protection Act H.R. 715 - Bipartisan Background Checks Act of 2023 H.R. 730 - Crime Gun Tracing Modernization Act of 2023 H.R. 768 - Extreme Risk Protection Order Expansion Act of 2023 H.R. 771 - Firearm Lockbox Protection Act of 2023 H.R. 790 - Repealing Illegal Freedom and Liberty Excises Act (RIFLE) Act H.R. 816 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act H.R. 817 - Default Proceed Sale Transparency Act H.R. 850 - To direct the Attorney General to conduct a study on the efficacy of extreme risk protection orders on reducing gun violence H.R. 851 - Iron Pipeline Review Act H.R. 962 - Protecting Gun Owners in Bankruptcy Act of 2023 H.R. 974 - ATF Improvement and Modernization (AIM) Act of 2023 H.R. 1145 - Safe Guns, Safe Kids Act H.R. 1258 - Protecting Gun Rights and Due Process Act H.R. 1271 - No Retaining Every Gun In a System That Restricts Your Rights Act H.R. 1302 - Gun Records Restoration and Preservation Act H.R. 1361 - Safer Neighborhoods Gun Buyback Act of 2023 H.R. 1478 - Federal Firearm Licensee Act H.R. 1566 - Safe Storage Lockers for House Office Buildings Act H.R. 1595 - State Firearms Dealer Licensing Enhancement Act H.J.Res.44 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" H.R. 1678 - Protecting Legal Firearms Ownership Act of 2023 H.R. 1699 - Office of Gun Violence Prevention Act of 2023 H.R. 1700 - ATF Transparency Act H.Res.244 - Expressing the sense of the House of Representatives that mandates imposed on manufacturers requiring inclusion of unproven and unreliable technology in firearms is costly and punitive, and the prohibition of firearms without such features is an infringement on the rights of citizens under the Second Amendment H.R. 1830 - Closing the Loophole on Interstate Firearm Sales Act H.R. 2390 - Gun Violence Prevention Research Act of 2023 H.R. 2391 - No Crime Left Behind Act H.R. 2392 - Pause for Gun Safety Act H.R. 2403 - Enhanced Background Checks Act of 2023 H.R. 2418 - Gun Trafficker Detection Act H.R.2471 - 118th Congress (2023-2024) Vote Without Fear Act H.R.2477 - Protect Against School Shootings (PASS) Act H.R.2491 - 118th Congress (2023-2024) SAFE School Act H.R.2502 - 118th Congress (2023-2024) Safe Students Act H.R.2538 - 118th Congress (2023-2024) Firearm Risk Protection Act of 2023 H.R.2620 - 118th Congress (2023-2024) Federal Firearms Licensee Protection Act of 2023 H.R.2753 - 118th Congress (2023-2024) Firearms Retailer Code of Conduct Act of 2023 H.R.2870 - 118th Congress (2023-2024) Raise the Age Act of 2023 H.R.2897 - 118th Congress (2023-2024) End Gun Violence Act of 2023 H.R.2898 - 118th Congress (2023-2024) Secure Background Checks Act of 2023 H.R.2909 - 118th Congress (2023-2024) Preventing Illegal Weapons Trafficking Act of 2023 H.R.2985 - 118th Congress (2023-2024) Help Empower Americans to Respond (HEAR) Act of 2023 H.R.2991 - 118th Congress (2023-2024) Teachers Empowered Against Classroom Harm (TEACH) Act of 2023 H.R.3018 - 118th Congress (2023-2024) Federal Extreme Risk Protection Order Act of 2023 H.R.3021 - 118th Congress (2023-2024) Protecting the Second Amendment in Financial Services Act H.Res.348 - 118th Congress (2023-2024) Declaring gun violence a public health crisis H.R.3096 - 118th Congress (2023-2024) Firearm Safety Act of 2023 H.R.3122 - 118th Congress (2023-2024)Gun Show Loophole Closing Act of 2023 H.R.3155 - 118th Congress (2023-2024) Protecting the Second Amendment through Responsible Gun Ownership Act H.R.3212 - 118th Congress (2023-2024) Shall Not Be Infringed Act of 2023 H.R.3492 - 118th Congress (2023-2024) Gun Owner Registration Information Protection Act H.R.3502 - 118th Congress (2023-2024) Responsible Firearms Marketing Act H.R.3529 - 118th Congress (2023-2024) Forbidding the Increase of Rogue Enforcers Act (FIRE) Act H.R.3687 - 118th Congress (2023-2024) Protect Children Through Safe Gun Ownership Act H.Res.453 - 118th Congress (2023-2024) Providing for consideration of the bill (H.R. 2403) to amend chapter 44 of title 18, United States Code, to strengthen the background check procedures to be followed before a Federal firearms licensee may transfer a firearm to a person who is not such a licensee H.Res.454 - 118th Congress (2023-2024) Providing for consideration of the bill (H.R. 715) to require a background check for every firearm sale H.R.3824 - 118th Congress (2023-2024) Trafficking Reduction And Criminal Enforcement (TRACE) Act H.R.3863 - 118th Congress (2023-2024) Keeping Gun Dealers Honest Act of 2023 H.R.3931 - 118th Congress (2023-2024) Angellyh Yambo Gun Free Zone Expansion Act of 2023 H.R.3993 - 118th Congress (2023-2024) To provide a private right of action against the maker of any component of a ghost gun, and any person who facilitated a sale of the ghost gun, for injury or death resulting from the use of the ghost gun H.Res.495 - 118th Congress (2023-2024) Providing for consideration of the joint resolution (H.J. Res. 44) providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'stabilizing braces'" H.R.4074 - 118th Congress (2023-2024) 3D Printed Gun Safety Act of 2023 H.R.4158 - 118th Congress (2023-2024) Gun Violence Prevention Through Financial Intelligence Act H.R.4159 - 118th Congress (2023-2024) Background Check Point of Contact Act of 2023 H.R.4160 - 118th Congress (2023-2024) Undetectable Firearms Modernization Act H.R.4184 - 118th Congress (2023-2024) Equal Access to Justice for Victims of Gun Violence Act of 2023 H.R.4201 - 118th Congress (2023-2024) Safe Storage Saves Lives Act H.R.4202 - 118th Congress (2023-2024) Multiple Firearm Sales Reporting Modernization Act of 2023 H.R.4243 - 118th Congress (2023-2024) To amend the consumer product safety laws to repeal the exclusion of pistols, revolvers, and other firearms from the definition of consumer product under such laws H.R.4283 - 118th Congress (2023-2024) To amend the Internal Revenue Code of 1986 to increase certain taxes related to firearms, and for other purposes S.14 - Age 21 Act S.25 - Assault Weapons Ban of 2023 S.117 - Handgun Permit to Purchase Act S.118 - ATF Improvement and Modernization (AIM) Act of 2023 S.163 - Stop Harassing Owners of Rifles Today (SHORT) Act S.173 - Ethan's Law S.203 - Crime Gun Tracing Modernization Act of 2023 S.214 - Constitutional Concealed Carry Reciprocity Act of 2023 S.246 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act S.247 - Extreme Risk Protection Order Expansion Act of 2023 S.252 - Protecting Kids from Gun Marketing Act S.298 - Keep Americans Safe Act S.361 - Pistol Brace Protection Act S.401 - Hearing Protection Act S.428 - Firearm Industry Non-Discrimination (FIND) Act S.494 - Background Check Expansion Act S.598 - Gun Records Restoration and Preservation Act S.632 - ATF Transparency Act S.827 - A bill to provide that no Federal funds may be used to implement, administer, or enforce the rule of the Department of Justice entitled "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" S.J.Res.20 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Justice and the Bureau of Alcohol, Tobacco, Firearms and Explosives relating to "Factoring Criteria for Firearms With Attached 'Stabilizing Braces'" S.840 - Respect for the Second Amendment Act S.867 - State Firearms Dealer Licensing Enhancement Act S.951 - Office of Gun Violence Prevention Act of 2023 S.Amdt.38 - Prohibition on registry of lawful firearm owners S.1026 - Gun Violence Prevention Research Act of 2023 S.1116 - Background Check Completion Act of 2023 S.1825 - 118th Congress (2023-2024) Gun Violence Prevention Through Financial Intelligence Act S.1319 - 118th Congress (2023-2024) Preventing Illegal Weapons Trafficking Act of 2023 S.1383 - 118th Congress (2023-2024) Help Empower Americans to Respond (HEAR) Act of 2023 S.1460 - 118th Congress (2023-2024) Firearm Safety Act of 2023 S.1680 - 118th Congress (2023-2024) Gun Owner Registration Information Protection Act S.1737 - 118th Congress (2023-2024) Responsible Firearms Marketing Act S.1819 - 118th Congress (2023-2024) 3D Printed Gun Safety Act of 2023 S.1824 - 118th Congress (2023-2024) Making America Safe and Secure (MASS) Act S.1825 - 118th Congress (2023-2024) Gun Violence Prevention Through Financial Intelligence Act S.1826 - 118th Congress (2023-2024) Keeping Gun Dealers Honest Act of 2023 S.1907 - 118th Congress (2023-2024) Federal Firearms Licensee Protection Act of 2023 S.1909 - 118th Congress (2023-2024) Banning Unlawful Machinegun Parts (BUMP) Act of 2023

H.R. 38 - Concealed Carry Reciprocity Act H.R. 46 - Mental Health Access and Gun Violence Prevention Act of 2023 H.R. 48 - Gun Violence Reduction Resources Act of 2023 H.R. 52 - Kimberly Vaughan Firearm Safe Storage Act H.R. 53 - Firearm Industry Non-Discrimination Act H.R. 60 - Accidental Firearms Transfers Reporting Act of 2023 H.R. 100 - No SmartPay for Anti-2A Companies Act H.R. 151 - No Frivolous Application for Short-Barreled Shotguns (NFA SBS) Act H.R. 152 - Hearing Protection Act H.R. 168 - To amend chapter 44 of title 18, United States Code, to more comprehensively address the interstate transportation of firearms or ammunition H.R. 173 - Home Defense and Competitive Shooting Act of 2023 H.R. 182 - To promote accountability and transparency in future executive orders H.R. 283 - Preventing Unjust Red Flag Laws Act of 2023 H.R. 331 - Illicit Arms Trafficking Security Enforcement Act H.R. 341 - Protect Our Military Families 2nd Amendment Rights Act H.R. 363 - Second Amendment Protection Act H.R. 374 - Abolish the ATF Act H.R. 381 - Protecting Individual Sovereignty Through Our Laws (PISTOL) Act H.R. 385 - No User Fees for Gun Owners Act H.R. 391 - Safe Bases Act H.R. 396 - Closing the Bump Stock Loophole Act of 2023 H.Res.45 - Expressing the sense of the House of Representatives that New York State's Concealed Carry Improvement Act is unconstitutional H.R. 450 - Repeal the NFA Act H.R. 508 - ATF Accountability Act of 2023 H.R. 569 - Handgun Permit to Purchase Act H.R. 584 - Stop Online Ammunition Sales Act of 2023 H.R. 625 - Keep Americans Safe Act H.R. 646 - Stop Harassing Owners of Rifles Today (SHORT) Act H.R. 660 - Ethan's Law H.R. 667 - Choosing Our Own Lives Over Fast Firearms (COOL OFF) Act H.R. 698 - Assault Weapons Ban of 2023 H.R. 705 - Veterans 2nd Amendment Protection Act H.R. 715 - Bipartisan Background Checks Act of 2023 H.R. 730 - Crime Gun Tracing Modernization Act of 2023 H.R. 768 - Extreme Risk Protection Order Expansion Act of 2023 H.R. 771 - Firearm Lockbox Protection Act of 2023 H.R. 790 - Repealing Illegal Freedom and Liberty Excises Act (RIFLE) Act H.R. 816 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act H.R. 817 - Default Proceed Sale Transparency Act H.R. 850 - To direct the Attorney General to conduct a study on the efficacy of extreme risk protection orders on reducing gun violence H.R. 851 - Iron Pipeline Review Act H.R. 962 - Protecting Gun Owners in Bankruptcy Act of 2023 H.R. 974 - ATF Improvement and Modernization (AIM) Act of 2023 H.R. 1145 - Safe Guns, Safe Kids Act H.R. 1258 - Protecting Gun Rights and Due Process Act H.R. 1271 - No Retaining Every Gun In a System That Restricts Your Rights Act H.R. 1302 - Gun Records Restoration and Preservation Act H.R. 1361 - Safer Neighborhoods Gun Buyback Act of 2023 H.R. 1478 - Federal Firearm Licensee Act H.R. 1566 - Safe Storage Lockers for House Office Buildings Act H.R. 1595 - State Firearms Dealer Licensing Enhancement Act H.J.Res.44 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" H.R. 1678 - Protecting Legal Firearms Ownership Act of 2023 H.R. 1699 - Office of Gun Violence Prevention Act of 2023 H.R. 1700 - ATF Transparency Act H.Res.244 - Expressing the sense of the House of Representatives that mandates imposed on manufacturers requiring inclusion of unproven and unreliable technology in firearms is costly and punitive, and the prohibition of firearms without such features is an infringement on the rights of citizens under the Second Amendment H.R. 1830 - Closing the Loophole on Interstate Firearm Sales Act H.R. 2390 - Gun Violence Prevention Research Act of 2023 H.R. 2391 - No Crime Left Behind Act H.R. 2392 - Pause for Gun Safety Act H.R. 2403 - Enhanced Background Checks Act of 2023 H.R. 2418 - Gun Trafficker Detection Act S.14 - Age 21 Act S.25 - Assault Weapons Ban of 2023 S.117 - Handgun Permit to Purchase Act S.118 - ATF Improvement and Modernization (AIM) Act of 2023 S.163 - Stop Harassing Owners of Rifles Today (SHORT) Act S.173 - Ethan's Law S.203 - Crime Gun Tracing Modernization Act of 2023 S.214 - Constitutional Concealed Carry Reciprocity Act of 2023 S.246 - Safety Enhancements for Communities Using Reasonable and Effective (SECURE) Firearm Storage Act S.247 - Extreme Risk Protection Order Expansion Act of 2023 S.252 - Protecting Kids from Gun Marketing Act S.298 - Keep Americans Safe Act S.361 - Pistol Brace Protection Act S.401 - Hearing Protection Act S.428 - Firearm Industry Non-Discrimination (FIND) Act S.494 - Background Check Expansion Act S.598 - Gun Records Restoration and Preservation Act S.632 - ATF Transparency Act S.827 - A bill to provide that no Federal funds may be used to implement, administer, or enforce the rule of the Department of Justice entitled "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'" S.J.Res.20 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Justice and the Bureau of Alcohol, Tobacco, Firearms and Explosives relating to "Factoring Criteria for Firearms With Attached 'Stabilizing Braces'" S.840 - Respect for the Second Amendment Act S.867 - State Firearms Dealer Licensing Enhancement Act S.951 - Office of Gun Violence Prevention Act of 2023 S.Amdt.38 - Prohibition on registry of lawful firearm owners S.1026 - Gun Violence Prevention Research Act of 2023 S.1116 - Background Check Completion Act of 2023

Lobbied in support of gun control legislation, specifically in H.R.396: Closing the Bump Stock Loophole Act; H.R. 817: Default Proceed Sale Transparency Act; H.R.816/S.246: SECURE Gun Storage Act; H.R.1830: Closing the Loophole on Interstate Firearm Sales Act; H.R.1478: Federal Firearm Licensee Act; H.R.1595/S.867: State Firearms Dealer Licensing Enhancement Act; H.R.698/S.25: Assault Weapons Ban of 2023; H.R.768/S.247: Extreme Risk Protection Order Expansion Act of 2023; H.R.715: Bipartisan Background Checks Act of 2023; S.494: Background Check Expansion Act; H.R.2043: Enhanced Background Checks Act of 2023; S.116: Background Check Completion Act of 2023; H.R.660/S.173: Ethan's Law; S.14: Age 21 Act; H.R.569/S.117: Handgun Permit to Purchase Act; H.R.625/S.298: Keep Americans Safe Act; S.252: Protecting Kids from Gun Marketing Act; H.R.1302/S.598: Gun Records Restoration and Preservation Act; H.R.1699/S.951: Office of Gun Violence Prevention Act of 2023; H.R.2418: Gun Trafficker Detection Act; H.R.2753: Firearms Retailer Code of Conduct Act of 2023; H.R.2770: Prevent Family Fire Act of 2023; H.R.2899: STOP Violence Act of 2023; H.R.2898: Secure Background Checks Act of 2023; H.R.3096/S.1460: Firearm Safety Act of 2023; H.R.3247: Aaron Salter, Jr., Responsible Body Armor Possession Act; H.Res.459: Expressing support for the designation of June 2, 2023, as "National Gun Violence Awareness Day" and June 2023 as "National Gun Violence Awareness Month"; H.R.3962/S.1893: Resources for Victims of Gun Violence Act of 2023; H.R.3824: Trafficking Reduction And Criminal Enforcement (TRACE) Act; H.R.3863/S.1826: Keeping Gun Dealers Honest Act of 2023; H.R.4074/S.1819: 3D Printed Gun Safety Act of 2023; S.1824: MASS Act; H.R.4184/S.2048: Equal Access to Justice for Victims of Gun Violence Act of 2023; S.1909: BUMP Act; H.R.4201: Safe Storage, Save Lives Act; H.R.4283: Gun Violence Prevention and Safe Communities Act; H.R.4202: Multiple Firearm Sales Reporting Modernization Act; H.R.4289: Assault Weapon Financing Accountability Act; H.Res.530: Expressing support for the designation of June 21, 2023, as National ASK (Asking Saves Kids) Day to promote children's health and safe storage of guns in the home. Lobbied in opposition to H.J.Res. 44: Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'"; and in opposition to concealed carry reciprocity and the removal of silencers from the definition of "firearm," specifically in H.R.38: Concealed Carry Reciprocity Act; and H.R.152/S.401: Hearing Protection Act.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported Chronic Care Management Act that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supports those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S.323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of2 I and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported Chronic Care Management Act that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supports those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S.323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of2 I and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Lobbied in support of gun control legislation, specifically in H.R. 817: Default Proceed Sale Transparency Act; H.R.816, S.246: SECURE Gun Storage Act; H.R.1830: Closing the Loophole on Interstate Firearm Sales Act; H.R.1478: Federal Firearm Licensee Act; H.R.1595, S.867: State Firearms Dealer Licensing Enhancement Act; H.R.698, S.25: Assault Weapons Ban of 2023; H.R.768, S.247: Extreme Risk Protection Order Expansion Act of 2023; H.R.715: Bipartisan Background Checks Act of 2023; S.494: Background Check Expansion Act; H.R.2043: Enhanced Background Checks Act of 2023; S.116: Background Check Completion Act of 2023; H.R.660, S.173: Ethan's Law; S.14: Age 21 Act; H.R.569, S.117: Handgun Permit to Purchase Act; H.R.625, S.298: Keep Americans Safe Act; S.252: Protecting Kids from Gun Marketing Act; H.R.1302, S.598: Gun Records Restoration and Preservation Act; H.R.1699, S.951: Office of Gun Violence Prevention Act of 2023; and H.R.2418: Gun Trafficker Detection Act. Lobbied in opposition of concealed carry reciprocity and the removal of silencers from the definition of "firearm," specifically in H.R.38: Concealed Carry Reciprocity Act; and H.R.152, S.401: Hearing Protection Act.

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

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a March 2023 ruling by a federal judge in Texas that the ACAs requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Expand Patient Access: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVID and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Urged Congress to also: 1) provide a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced APM incentive payments for additional years to continue to recruit new providers into APMs. Additionally, to ensure that qualifying thresholds remain attainable to promote program growth, CMS should be given authority to adjust thresholds through rulemaking and to set varying thresholds for more targeted models where participants cannot meet the existing one-size-fits-all thresholds; 2) remove distinctions (i.e., the high-low revenue designation in the Medicare Shared Savings Program) that penalize safety net providers, improve financial methodologies so that APM participants are not penalized for their own success, reduce regulatory burdens by offering increased flexibilities and waivers for clinicians moving to risk, and provide technical assistance and an appropriate glidepath to financial risk for those newly transitioning to APMs; 3) work with the CMS Innovation Center to ensure that promising models have a more predictable pathway for being implemented and becoming permanent and are not cut short due to overly stringent criteria; and 4) should seek greater alignment between APMs and the MA program to ensure that both models provide attractive, sustainable options for innovating care delivery, and to ensure that APMs do not face a competitive disadvantage. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Preventions (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDCs programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Acts prescription drug negotiation provisions. Firearm Safety (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 21 and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: 1) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduce s H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs.

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a March 2023 ruling by a federal judge in Texas that the ACAs requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Expand Patient Access: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVID and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Urged Congress to also: 1) provide a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced APM incentive payments for additional years to continue to recruit new providers into APMs. Additionally, to ensure that qualifying thresholds remain attainable to promote program growth, CMS should be given authority to adjust thresholds through rulemaking and to set varying thresholds for more targeted models where participants cannot meet the existing one-size-fits-all thresholds; 2) remove distinctions (i.e., the high-low revenue designation in the Medicare Shared Savings Program) that penalize safety net providers, improve financial methodologies so that APM participants are not penalized for their own success, reduce regulatory burdens by offering increased flexibilities and waivers for clinicians moving to risk, and provide technical assistance and an appropriate glidepath to financial risk for those newly transitioning to APMs; 3) work with the CMS Innovation Center to ensure that promising models have a more predictable pathway for being implemented and becoming permanent and are not cut short due to overly stringent criteria; and 4) should seek greater alignment between APMs and the MA program to ensure that both models provide attractive, sustainable options for innovating care delivery, and to ensure that APMs do not face a competitive disadvantage. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Preventions (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDCs programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Acts prescription drug negotiation provisions. Firearm Safety (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 21 and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: 1) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduce s H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs.

Funding to support/sustain NICS Funding for and implementation of National Criminal History Improvement Program (NCHIP); Funding for and implementation of NICS Act Record Improvement Program (NARIP); Funding for FBIs NICS Section; Funding for the implementation of NIBRS; Funding for Crime Data Collection; Funding for Hate Crime Data Collection; ATF overall budget; ATF programmatic activities related to firearms; ATF programmatic activities related to gun industry oversight; ATF programmatic activities related to firearms trafficking; ATF programmatic activities related to forensic analysis in relation to firearms; Funding for and operations of National Integrated Ballistic Information Network (NIBIN); Funding for Children Exposed to Violence Initiative; Funding for Violent Gang and Gun Crime Reduction Program (Project Safe Neighborhoods); Funding for Community Policing Development Program; Funding for Office on Violence Against Women; Funding for Centers for Disease Control and Prevention Injury Prevention Work; Funding for National Institutes of Health Injury Prevention Work; Funding for and implementation of National Violent Death Reporting System (NVDRS); Funding for Hospital-based violence intervention programs; Funding for United States Crime Victims Fund; Firearm trafficking; National Firearms Act; Extreme risk protection orders; Permit-to-purchase grant programs; Safe storage of Firearms; Funding for and implementation of Edward Byrne Memorial Justice Assistance Grant (JAG) Program; Funding for and implementation of Criminal Justice Response Program/Grants to Encourage Arrest and Enforcement of Protection Orders Program; Funding for and implementation of STOP Grants; Funding for and implementation of programs administered by Community Oriented Policing Services (COPS); VOCA Assistance Grants; Funding for and implementation of programs administered by Office of Juvenile Justice and Delinquency Prevention (OJJDP); Funding for National Child Traumatic Stress Network; Funding for and implementation of National Survey on Drug Use and Health (NSDUH); Funding for National Strategy for Suicide Prevention; Funding for and implementation of Project AWARE and ReCAST grants; Funding for and implementation of Student Support and Academic Enrichment grants (SSAE); Funding for and implementation of Community violence intervention programs, including hospital-based intervention programs; Pub. L. 117-159 Bipartisan Safer Communities Act; S. 117, Handgun Permit to Purchase Act; H.R. 569, Handgun Permit to Purchase Act; H.R. 625, Keep Americans Safe Act; S. 173, Ethans Law; H.R. 660, Ethans Law; S. 247, Extreme Risk Protection Order Expansion Act; H.R. 768, Extreme Risk Protection Order Expansion Act; S. 118, AIM Act; H.R. 974, AIM Act; S. 203, Crime Gun Tracing Modernization Act.

Background checks; Improving the National Instant Criminal Background Check System; Intimate partner violence and violence against women, as related to firearms; Mental health, as related to firearms; Trafficking of firearms; National Firearms Act; Interstate transport of firearms; Federal firearm licensee break-ins; Semiautomatic firearms; Firearm accessories; Gun permitting; Firearm tracing; 3D printing of firearms; Lost and stolen firearms; Violence Against Women Act; Consumer product safety; Gun dealer regulation; Fugitives from justice; ATF leadership; Guns in the hands of law enforcement; Recordkeeping of firearms, including theft/loss; Data sharing of firearm tracing; Point of contact states for NICS; Community violence intervention; Autosears and conversion devices; Pub. L. 117-159 Bipartisan Safer Communities Act; S. 117, Handgun Permit to Purchase Act; H.R. 569, Handgun Permit to Purchase Act; H.R. 625, Keep Americans Safe Act; S. 173, Ethans Law; H.R. 660, Ethans Law; H.R. 715, Bipartisan Background Checks Act; H.R. 698, Assault Weapons Ban; S. 25, Assault Weapons Ban; S. 247, Extreme Risk Protection Order Expansion Act; H.R. 768, Extreme Risk Protection Order Expansion Act; S. 203, Crime Gun Tracing Modernization Act; S. 14, Age 21 Act; H.R. 1830, Closing the Loophole on Interstate Firearm Sales Act; S. 118, AIM Act; H.R. 974, AIM Act; S. 321, Strengthening Protections for Domestic Violence and Stalking Survivors Act; H.R. 905, Strengthening Protections for Domestic Violence and Stalking Survivors Act; H.R. 396, Closing the Bump Stock Loophole Act; H.R. 1478, Federal Firearm Licensee Act; H.R. 7904, Multiple Firearm Sales Reporting Modernization Act; S. 867, State Firearms Dealer Licensing Enhancement Act; H.R. 1595, State Firearms Dealer Licensing Enhancement Act; S. 246, SECURE Firearm Storage Act; H.R. 816, SECURE Firearm Storage Act; H.R. 52, Kimberly Vaughan Firearm Safe Storage Act; H.R. 1145, Safe Guns, Safe Kids Act; H.R. 817, Default Proceed Sale Transparency Act; H.R. 667, COOL OFF Act; S. 494, Background Check Expansion Act; H.R. 2403, Enhanced Background Checks Act; S. 598, Gun Records Restoration and Preservation Act; H.R. 1302, Gun Records Restoration and Preservation Act; H.R. 1699, To Establish the Office of Gun Violence Prevention; S. 951, To Establish the Office of Gun Violence Prevention; S. 1116, Background Check Completion Act; S. 214, Constitutional Concealed Carry Reciprocity Act of 2023; H.R. 28, Illegal Alien NICS Alert Act; H.Res. 250 Honoring the victims of the March 15, 2019, shootings at mosques in Christchurch, New Zealand; H.J. Res. 44 Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'"; S.J. Res. 20 Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'".

Background checks of Firearm sales/transfers; Improving the National Instant Criminal Background Check System; Intimate partner violence and violence against women, as related to firearms; Trafficking of firearms; National Firearms Act; Interstate transport of firearms; Semiautomatic firearms; Firearm tracing; Firearm permitting; Lost and stolen firearms; Violence Against Women Act; Gun dealer regulation; Essential operations of firearms dealers and manufacturers; An interagency task force on gun violence prevention; Guns in the hands of law enforcement; Recordkeeping; Data sharing; Safe storage; Point of contact states; Merchant category codes; Office of Victims of Crime; Autosears and conversion devices; Policing; Pub. L. 117-159 Bipartisan Safer Communities Act; S. 117, Handgun Permit to Purchase Act; H.R. 569, Handgun Permit to Purchase Act; H.R. 625, Keep Americans Safe Act; S. 173, Ethans Law; H.R. 660, Ethans Law; H.R. 715, Bipartisan Background Checks Act; H.R. 698, Assault Weapons Ban; S. 25, Assault Weapons Ban; S. 247, Extreme Risk Protection Order Expansion Act; H.R. 768, Extreme Risk Protection Order Expansion Act; S. 203, Crime Gun Tracing Modernization Act; S. 14, Age 21 Act; H.R. 1830, Closing the Loophole on Interstate Firearm Sales Act; S. 118, AIM Act; H.R. 974, AIM Act; S. 321, Strengthening Protections for Domestic Violence and Stalking Survivors Act; H.R. 905, Strengthening Protections for Domestic Violence and Stalking Survivors Act; H.R. 396, Closing the Bump Stock Loophole Act; H.R. 1478, Federal Firearm Licensee Act; H.R. 7904, Multiple Firearm Sales Reporting Modernization Act; S. 867, State Firearms Dealer Licensing Enhancement Act; H.R. 1595, State Firearms Dealer Licensing Enhancement Act; S. 246, SECURE Firearm Storage Act; H.R. 816, SECURE Firearm Storage Act; H.R. 52, Kimberly Vaughan Firearm Safe Storage Act; H.R. 1145, Safe Guns, Safe Kids Act; H.R. 817, Default Proceed Sale Transparency Act; H.R. 667, COOL OFF Act; S. 494, Background Check Expansion Act; H.R. 2403, Enhanced Background Checks Act; S. 598, Gun Records Restoration and Preservation Act; H.R. 1302, Gun Records Restoration and Preservation Act; H.R. 1699, To Establish the Office of Gun Violence Prevention; S. 951, To Establish the Office of Gun Violence Prevention; S. 1116, Background Check Completion Act; S. 214, Constitutional Concealed Carry Reciprocity Act of 2023; S. 252, Protecting Kids from Gun Marketing Act; H.R. 28, Illegal Alien NICS Alert Act; H.Res.250 Honoring the victims of the March 15, 2019, shootings at mosques in Christchurch, New Zealand; H.J. Res 44 Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'"; S.J. Res. 20 Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Bureau of Alcohol, Tobacco, Firearms, and Explosives relating to "Factoring Criteria for Firearms with Attached 'Stabilizing Braces'".

Lobbied on issues related to gun violence prevention, specifically: the Assault Weapons Ban of 2023 (S.25, banning high-capacity magazines); the Age 21 Act (S.14, increasing minimum age to purchase a large capacity ammunition feeding device or semiautomatic assault weapon); the Protecting Kids from Gun Marketing Act (S.252, requiring the FTC to promulgate a rule regarding gun marketing to children); Ethan's Law (S.173, safe storage requirements as it relates to firearm storage); ATF Improvement and Modernization Act (S. 118, improving ATF's enforcement of gun laws); the Handgun Permit to Purchase Act (S.117, a grant program for states, local governments, and Indian tribes to implement and evaluate handgun purchaser licensing requirements); Bipartisan Background Checks Act (H.R.715, establishing new background check requirements for firearm transfers between private parties); Keep Americans Safe Act (S.298, regulating large capacity ammunition feeding devices); Child Suicide Prevention and Lethal Means Safety Act (bill yet to be introduced); Gun Violence Research Prevention Act (H.R.2390, appropriating funds to the CDC for conducting or supporting research on firearms safety or gun violence prevention); Federal Firearm Licensee Act (H.R.1478, modernizing the business of selling firearms); FY24 Appropriations related to gun violence prevention; and President Biden's Executive Order on Reducing Gun Violence and Making Our Communities Safer.

Client expense: Not reported · Firm income: Not reported