Rural Physician Workforce Production Act of 2023

No Bill No. - Congressional Primary Care Caucus NO Bill No. - Teaching Health Centers GME; Community Health Centers, National Health Service Corps No Bill No. - COVID-19 Vaccines No Bill No. - PAHPA Reauthorization NO Bill No. - Medicare Physician Payment Reform No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Physician Workforce No Bill No. - Prior authorization/reducing administrative burden NO Bill No. - Health care affordability, including Medicare physician payments and site neutral payments, anti-competitive contracting, and the No Surprises Act No Bill No. - Black Maternal Health Momnibus Act No Bill No. - DATA in Public Health Act No Bill No. - Complete Care Act No Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Tobacco Users Quit Act(S.704/H.R. 1202) REDI Act No Bill No. - FY2024 NDAA No Bill No. - Vaccine commercialization No Bill No. - VA Standards of Practice No Bill No. - MATE Improvement Act No Bill No. - SPEAK Act of 2023 No Bill No. - Access to Donor Milk Act NO Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Primary and Virtual Care Affordability Act No Bill No. - Advancing Menopause Care and Mid-Life Women's Health Act No Bill No. - Change Cyberattack No Bill No. - Inpatient prospective Payment Rule No Bill No. - Healthcare Cybersecurity Act No Bill No. - Protecting Communities Through Immunizations Act No Bill No. - Mental Health and MAMA Act No Bill No. - SEEK HELP Act No Bill No. - Access to Workers' Compensation for Injured Federal Workers Act No Bill No. - Protecting Patients from Deceptive Drugs Ad Online Act No Bill No. - Innovation in Pediatric Drugs Act of 2023 No Bill No. - BLOCKING Act No. Bill No. - Strengthening the Vaccines for Children Act (S. 230/H.R. 834) Rural Physician Workforce Production Act (S. 862) Restoring America's Health Care Workforce and Readiness Act (H.R. 498) 988 Lifeline Cybersecurity Responsibility Act (H.R. 1114) Long-COVID Recovery Now Act (S. 114/H.R. 766) Preventive Health Savings Act (S. 923) Better Mental Health for Americans (H.R. 286) Healthcare Providers' Safety Act (H.R. 2569) DOC Act (H.R. 1770) Equitable Community Access to Pharmacist Services Act (H.R. 2630/S.652) Safe Step Act (H.R. 3800) Chronic Disease Flexible Coverage Act (H.R. 3029) Primary Care Enhancement Act (H.R. 5378) Lower Cost More Transparency Act (H.R. 2584) Safety from Violence for Healthcare Employees Act (H.R. 4392/S.2188) PrEP Access and Coverage Act (H.R. 6067) Early Childhood Nutrition Improvement Act (S. 3295/H.R. 5569) Child Care Nutrition Enhancement Act (H.R. 1117) Advancing Safe Medications for Moms and Babies Act (H.R. 5909) Care for Grieving Families Act (H.R. 1616/S.807) Comprehensive Access to Resources and Education (CARE) for Long COVID Act (H.R. 3258) Targeting Resources for Equitable Access to Treatment (TREAT) Long COVID Act (S. 2560) Long COVID Support Act (H.R. 6038/S.3108) Teen E-Cigarette and Tobacco Addition (PROTECT) Act (H.R. 6103/S.3137) Support Through Loss Act (S. 3070) Youth Prevention and Recovery Reauthorization Act (H.R. 7381) - Healthcare Enhancement and Learning Through Harnessing Artificial Intelligence Act (S. Res. 597) - A Resolution Creating a Health Workforce Well-Being Day of Awareness (S. 3740) STRONGER Act (H.R. 6965) - EPIPEN Act (S.3779) - Child Suicide Prevention and Lethal Means Safety Act (S. 3679/H.R. 7153) - Lorna Breen Reauthorization Act (H.R. 3752) Parity Enforcement Act (S. 8) - Improving Health Insurance Affordability Act (H.R. 1692) - Health care Affordability Act (H.R. 5010) - Recognizing Gun Violence as a Public Health Emergency Act (H.R. 7891) - Kids Online Safety Act (H.R. 8383) - Rural Obstetrics Readiness Act (H.R. 7153/S.3679) - Dr. Lorna Breen Health Care Provider Protection Act (S. 4429) - Reducing Drug Prices for Seniors Act (H.R. 7681) - Primary and Virtual Care Affordability Act (H.R. 7808) - EARLY Minds Act (H.R. 7855) - Rural Residency Planning and Development Act of 2024 (H.R. 6664) - Innovation in Pediatric Drugs Act (H.R. 6412) - Healthcare Cybersecurity Act (H.R. 3800) - Chronic Disease Flexible Coverage Act (H.R. 618/S. 131) - Improving Access to Workers Compensation for Injured Federal Workers Act (H.R. 8839/S.5203) - Maternal and Infant Syphilis Prevention Act (H.R. 10129/S. 5330) - Prenatal Care for Military Families Act (H.R. 10098) - Family Plus Health Care Act (H.R. 1359/S. 644) - Modernizing Opioid Treatment Access Act (H.R. 9774/S. 5194) - Health Care Affordability Act

Client expense: $1,072,997 · Firm income: Not reported

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

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for GME. Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. GME Data Transparency Act of 2024 Issue: Educate Congress on teaching health system and hospital GME data collection practices and concerns related to duplicative reporting requirements. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare DGME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate request for information on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 H.R. 10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 P.L. 118-158 American Relief Act, 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support elimination of two years of scheduled reductions to the Medicaid DSH program. H.R.9351 - The Save Our Safety-Net Hospitals (SOS) Act Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Client expense: $632,324 · Firm income: Not reported

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

HR 834/S 230 The Rural Physician Workforce Production Act; appropriations for AHRQ Center for Primary Care and HRSA Title VII; GME transparency; issues around rural reclassification

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for GME. Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare DGME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate RFI on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. H.R.9351 - The Save Our Safety-Net Hospitals (SOS) Act Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Client expense: $617,103 · Firm income: Not reported

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

General health care issues and Medicare graduate medical education; S.230/H.R.834, Rural Physician Workforce Production Act of 2023; H.R.2474, Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues and Medicare graduate medical education; S.230/H.R.834, Rural Physician Workforce Production Act of 2023; H.R.2474, Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for GME. Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare DGME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate RFI on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. H.R.9351 - The Save Our Safety-Net Hospitals (SOS) Act Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Client expense: $617,103 · Firm income: Not reported

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

Teaching Health Center permanent authorization THCGME S.230 Rural Physician Workforce Production Act of 2023 H.R 834 Rural Physician Workforce Production Act of 2023 CAA 2023 GME Slot Distribution CMS:IPPS Rule & Physician Fee Schedule re: Primary Care Exception Expansion

Client expense: $48,942 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Fair Access In Residency (FAIR) Act (H.R. 751) Rural Physician Workforce Production Act (S. 230/H.R. 834) Resident Physician Shortage Reduction Act of 2023 (S. 1302/H.R. 2389) Council on Graduate Medical Education Medicare Payment Advisory Commission Inpatient Prospective Payment System Consolidated Appropriations Act, 2021 (PL 116-260) Community Training, Education and Access for Medical Students (Community TEAMS) Act (S. 3968, H.R. 7258) National Health Service Corps Teaching Health Centers Graduate Medical Education NIH Osteopathic Funding and Representation 21st Century Cures Act and Cures 2.0 Substance Use Disorder Workforce Act of 2024 (H.R. 7050) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (S. 3679, H.R. 7153) Rural Physician Workforce Preservation Act (H.R. 8235) Rural Residency Planning and Development Act of 2024 (H.R. 7855) Physician Preceptor Tax Credit Pandemic and All-Hazards Preparedness Act (PL 109-417) Public Health Infrastructure Saves Lives Act (S. 1995) Physician Fee Stabilization Act (S.4935) Rural Health Preceptor Tax Fairness Act (H.R.8738) Telehealth Modernization Act of 2024 (H.R.7623/S.3967)

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

No Bill No. - Congressional Primary Care Caucus NO Bill No. - Teaching Health Centers GME; Community Health Centers, National Health Service Corps No Bill No. - COVID-19 Vaccines No Bill No. - PAHPA Reauthorization NO Bill No. - Medicare Physician Payment Reform No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Physician Workforce No Bill No. - Prior authorization/reducing administrative burden NO Bill No. - Health care affordability, including Medicare physician payments and site neutral payments, anti-competitive contracting, and the No Surprises Act No Bill No. - Black Maternal Health Momnibus Act No Bill No. - DATA in Public Health Act No Bill No. - Complete Care Act No Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Tobacco Users Quit Act(S.704/H.R. 1202) REDI Act No Bill No. - FY2024 NDAA No Bill No. - Vaccine commercialization No Bill No. - VA Standards of Practice No Bill No. - MATE Improvement Act No Bill No. - SPEAK Act of 2023 No Bill No. - Access to Donor Milk Act NO Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Primary and Virtual Care Affordability Act No Bill No. - Advancing Menopause Care and Mid-Life Women's Health Act No Bill No. - Change Cyberattack No Bill No. - Inpatient prospective Payment Rule No Bill No. - Healthcare Cybersecurity Act No Bill No. - Protecting Communities Through Immunizations Act No Bill No. - Mental Health and MAMA Act No Bill No. - SEEK HELP Act No Bill No. - Access to Workers' Compensation for Injured Federal Workers Act No Bill No. - Protecting Patients from Deceptive Drugs Ad Online Act No Bill No. - Innovation in Pediatric Drugs Act of 2023 (S. 230/H.R. 834) Rural Physician Workforce Production Act (S. 862) Restoring America's Health Care Workforce and Readiness Act (H.R. 498) 988 Lifeline Cybersecurity Responsibility Act (H.R. 1114) Long-COVID Recovery Now Act (S. 114/H.R. 766) Preventive Health Savings Act (S. 923) Better Mental Health for Americans (H.R. 286) Healthcare Providers' Safety Act (H.R. 2569) DOC Act (H.R. 1770) Equitable Community Access to Pharmacist Services Act (H.R. 2630/S.652) Safe Step Act (H.R. 3800) Chronic Disease Flexible Coverage Act (H.R. 3029) Primary Care Enhancement Act (H.R. 5378) Lower Cost More Transparency Act (H.R. 2584) Safety from Violence for Healthcare Employees Act (H.R. 4392/S.2188) PrEP Access and Coverage Act (H.R. 6067) Early Childhood Nutrition Improvement Act (S. 3295/H.R. 5569) Child Care Nutrition Enhancement Act (H.R. 1117) Advancing Safe Medications for Moms and Babies Act (H.R. 5909) Care for Grieving Families Act (H.R. 1616/S.807) Comprehensive Access to Resources and Education (CARE) for Long COVID Act (H.R. 3258) Targeting Resources for Equitable Access to Treatment (TREAT) Long COVID Act (S. 2560) Long COVID Support Act (H.R. 6038/S.3108) Teen E-Cigarette and Tobacco Addition (PROTECT) Act (H.R. 6103/S.3137) Support Through Loss Act (S. 3070) Youth Prevention and Recovery Reauthorization Act (H.R. 7381) - Healthcare Enhancement and Learning Through Harnessing Artificial Intelligence Act (S. Res. 597) - A Resolution Creating a Health Workforce Well-Being Day of Awareness (S. 3740) STRONGER Act (H.R. 6965) - EPIPEN Act (S.3779) - Child Suicide Prevention and Lethal Means Safety Act (S. 3679/H.R. 7153) - Lorna Breen Reauthorization Act (H.R. 3752) Parity Enforcement Act (S. 8) - Improving Health Insurance Affordability Act (H.R. 1692) - Health care Affordability Act (H.R. 5010) - Recognizing Gun Violence as a Public Health Emergency Act (H.R. 7891) - Kids Online Safety Act (H.R. 8383) - Rural Obstetrics Readiness Act (H.R. 7153/S.3679) - Dr. Lorna Breen Health Care Provider Protection Act (S. 4429) - Reducing Drug Prices for Seniors Act (H.R. 7681) - Primary and Virtual Care Affordability Act (H.R. 7808) - EARLY Minds Act (H.R. 7855) - Rural Residency Planning and Development Act of 2024 (H.R. 6664) - Innovation in Pediatric Drugs Act (H.R. 6412) - Healthcare Cybersecurity Act (H.R. 3800) - Chronic Disease Flexible Coverage Act (H.R. 618/S. 131) - Improving Access to Workers Compensation for Injured Federal Workers Act

Client expense: $928,743 · Firm income: Not reported

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

HR 834/S 230 The Rural Physician Workforce Production Act; appropriations for AHRQ Center for Primary Care and HRSA Title VII; GME transparency; issues around rural reclassification

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare program general; S.230 and H.R.834 Rural Physician Workforce Production Act; H.R.2665 Supporting Safety Net Hospitals Act; H.R.5378 Lower Costs, More Transparency Act; Site Neutrality issues;

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No Bill No. - Congressional Primary Care Caucus NO Bill No. - Teaching Health Centers GME; Community Health Centers, National Health Service Corps No Bill No. - COVID-19 Vaccines No Bill No. - PAHPA Reauthorization NO Bill No. - Medicare Physician Payment Reform No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Physician Workforce No Bill No. - Prior authorization/reducing administrative burden NO Bill No. - Health care affordability, including Medicare physician payments and site neutral payments, anti-competitive contracting, and the No Surprises Act No Bill No. - Black Maternal Health Momnibus Act No Bill No. - DATA in Public Health Act No Bill No. - Complete Care Act No Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Tobacco Users Quit Act(S.704/H.R. 1202) REDI Act No Bill No. - FY2024 NDAA No Bill No. - Vaccine commercialization No Bill No. - VA Standards of Practice No Bill No. - MATE Improvement Act No Bill No. - SPEAK Act of 2023 No Bill No. - Access to Donor Milk Act NO Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Primary and Virtual Care Affordability Act No Bill No. - Advancing Menopause Care and Mid-Life Women's Health Act No Bill No. - Change Cyberattack No Bill No. - Inpatient prospective Payment Rule No Bill No. - Healthcare Cybersecurity Act No Bill No. - Protecting Communities Through Immunizations Act No Bill No. - Mental Health and MAMA Act No Bill No. - SEEK HELP Act No Bill No. - Access to Workers' Compensation for Injured Federal Workers Act (S. 230/H.R. 834) Rural Physician Workforce Production Act (S. 862) Restoring America's Health Care Workforce and Readiness Act (H.R. 498) 988 Lifeline Cybersecurity Responsibility Act (H.R. 1114) Long-COVID Recovery Now Act (S. 114/H.R. 766) Preventive Health Savings Act (S. 923) Better Mental Health for Americans (H.R. 286) Healthcare Providers' Safety Act (H.R. 2569) DOC Act (H.R. 1770) Equitable Community Access to Pharmacist Services Act (H.R. 2630/S.652) Safe Step Act (H.R. 3800) Chronic Disease Flexible Coverage Act (H.R. 3029) Primary Care Enhancement Act (H.R. 5378) Lower Cost More Transparency Act (H.R. 2584) Safety from Violence for Healthcare Employees Act (H.R. 4392/S.2188) PrEP Access and Coverage Act (H.R. 6067) Early Childhood Nutrition Improvement Act (S. 3295/H.R. 5569) Child Care Nutrition Enhancement Act (H.R. 1117) Advancing Safe Medications for Moms and Babies Act (H.R. 5909) Care for Grieving Families Act (H.R. 1616/S.807) Comprehensive Access to Resources and Education (CARE) for Long COVID Act (H.R. 3258) Targeting Resources for Equitable Access to Treatment (TREAT) Long COVID Act (S. 2560) Long COVID Support Act (H.R. 6038/S.3108) Teen E-Cigarette and Tobacco Addition (PROTECT) Act (H.R. 6103/S.3137) Support Through Loss Act (S. 3070) Youth Prevention and Recovery Reauthorization Act (H.R. 7381) - Healthcare Enhancement and Learning Through Harnessing Artificial Intelligence Act (S. Res. 597) - A Resolution Creating a Health Workforce Well-Being Day of Awareness (S. 3740) STRONGER Act (H.R. 6965) - EPIPEN Act (S.3779) - Child Suicide Prevention and Lethal Means Safety Act (S. 3679/H.R. 7153) - Lorna Breen Reauthorization Act (H.R. 3752) Parity Enforcement Act (S. 8) - Improving Health Insurance Affordability Act (H.R. 1692) - Health care Affordability Act (H.R. 5010) - Recognizing Gun Violence as a Public Health Emergency Act (H.R. 7891) - Kids Online Safety Act (H.R. 8383) - Rural Obstetrics Readiness Act (H.R. 7153/S.3679) - Dr. Lorna Breen Health Care Provider Protection Act (S. 4429) - Reducing Drug Prices for Seniors Act (H.R. 7681) - Primary and Virtual Care Affordability Act (H.R. 7808) - EARLY Minds Act (H.R. 7855) - Rural Residency Planning and Development Act of 2024 (H.R. 6664) - Innovation in Pediatric Drugs Act

Client expense: $1,045,426 · Firm income: Not reported

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

Support the Community Training, Education, and Access for Medical Students Act (Community TEAMS Act) (H.R. 7528 / S. 3968). Support the Fair Access In Residency Act (H.R. 751) which would provide transparency by reporting annually on the number of DO and MD applicants and accepted residents; and affirm that DO applications and the COMLEX-USA are accepted for consideration. Support the Rural Physician Workforce Production Act (H.R. 834/S.230) which would increase the physician workforce in rural areas by improving Medicare reimbursement for rural residency training. Support a five-year reauthorization at $300 million per year to provide sustainable funding for existing Teaching Health Center programs and support the development of new programs.

Client expense: Not reported · Firm income: $21,600

Government targets: HOUSE OF REPRESENTATIVES

H.R. 834 and S. 230 Rural Physician Workforce Production Act of 2023 S. 940 Rural America Health Corps Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate RFI on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Client expense: $742,323 · Firm income: Not reported

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

H.R. 834 and S. 230 Rural Physician Workforce Production Act of 2023 S. 940 Rural America Health Corps Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues and Medicare graduate medical education; S.230/H.R.834, Rural Physician Workforce Production Act of 2023; H.R.2474, Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues and Medicare graduate medical education; S.230/H.R.834, Rural Physician Workforce Production Act of 2023; H.R.2474, Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare program general; S.230 and H.R.834 Rural Physician Workforce Production Act; H.R.2665 Supporting Safety Net Hospitals Act; H.R.5378 Lower Costs, More Transparency Act; Site Neutrality issues;

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Abortion access (general); Access to mifepristone (general); Contraception (general); Maternal mortality and morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; Obstetric and gynecologic care in rural and underserved areas (general); impact of closures of ob-gyn units in rural hospitals on patient access to care and maternal morbidity and mortality; Impact of abortion restrictions on patient outcomes and the ob-gyn workforce (general); H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; Inclusion of pregnant and lactating individuals in research (general); Telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; H.R. 7056/S. 3612, Access to Family Building Act; H.R. 7153/S. 3679, Dr. Lorna Breen Health Care Provider Protection Act; S.___, Supporting Healthy Moms and Babies Act; S. 712/H.R. 8532, Connected MOM Act; S. 4079/H.R. 8383, Rural Obstetrics Readiness Act; H.R.___, PRAMS for Dads Act; S. 4223, Access to Birth Control Act; H.Res.1248, National Menstrual Health Awareness Month Resolution; Diversity, Equity, and Inclusion in medicine (general); H.R 8715, NEST Act; S.___, Keep Obstetrics Local Act; H.R. 7855, Rural Residency Planning and Development Act; H.R.___, Diane Powis Ovarian Cancer Testing Access Act; H.R. 8247, Uterine Fibroids Intervention and Gynecological Health Treatment Act (UFIGHT); H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act; H.R. 7432, Sickle Cell Disease Comprehensive Care Act of 2024; S. 4445, Right to IVF Act; Implementation of P.L. 117-328, Pregnant Workers Fairness Act; H.R. 834/S. 230, Rural Physician Workforce Production Act; Rural Residency Planning and Development Program (general); National Health Service Corps (general); H.R. 3523/S. 1710, Perinatal Workforce Act; H.R. 3086, Find it Early Act; H.R. 8796/S. 4619, Stop Comstock Act; Health Insurance Portability and Accountability Act (general); Patient-physician relationship (general); Menopause research, training, and education (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); Abortion training in obstetrics and gynecology residency programs (general); Obstetrician-gynecologist workforce (general); Reproductive health data privacy (general); Substance use disorder during pregnancy (general); Physician burnout (general); Maternal mental health (general); Artificial intelligence in health care (general); Coverage for infertility (general); Protections for in vitro fertilization (general); Restrictions on menthol cigarettes and flavored cigars (general); Nicotine limits in cigarettes (general); White House Initiative on Womens Health Research (general); Pediatric Subspecialty Loan Repayment Program; Over-the-counter contraception (general); HPV vaccination (general); Cancer Moonshot Initiative; Remote patient monitoring (general); Fertility preservation services for sickle cell patients treated with cell and gene therapies; Prenatal screening (general);Prenatal supplements (general); Crisis pregnancy centers (general); Care for pregnant and postpartum incarcerated individuals (general); Congenital syphilis (general); Gun violence as a public health issue (general); Obstetric hemorrhage managements at the Indian Health Service (general); H.Res. 1180, Recognizing the importance of diversity, equity, and inclusion efforts in medical education.

Client expense: $350,000 · Firm income: Not reported

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

Fair Access In Residency (FAIR) Act (H.R. 751) Rural Physician Workforce Production Act (S. 230/H.R. 834) Resident Physician Shortage Reduction Act of 2023 (S. 1302/H.R. 2389) Council on Graduate Medical Education Medicare Payment Advisory Commission Inpatient Prospective Payment System (SCH/MDH Issue) Consolidated Appropriations Act, 2021 (PL 116-260) Community Training, Education and Access for Medical Students (Community TEAMS) Act (S. 3968, H.R. 7258) National Health Service Corps Teaching Health Centers Graduate Medical Education NIH Osteopathic Funding and Representation Substance Use Disorder Workforce Act of 2024 (H.R. 7050) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (S. 3679, H.R. 7153) Medically Tailored Home-Delivered Meals Demonstration Pilot Act (S. 2133, H.R. 6780) Rural Physician Workforce Preservation Act (H.R. 8235) Rural Residency Planning and Development Act of 2024 (H.R. 7855) Physician Preceptor Tax Credit Pandemic and All-Hazards Preparedness Act (PL 109-417) Public Health Infrastructure Saves Lives Act (S. 1995)

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

No Bill No. - Congressional Primary Care Caucus NO Bill No. - Teaching Health Centers GME; Community Health Centers, National Health Service Corps No Bill No. - COVID-19 Vaccines No Bill No. - PAHPA Reauthorization NO Bill No. - Medicare Physician Payment Reform No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Physician Workforce No Bill No. - Prior authorization/reducing administrative burden NO Bill No. - Health care affordability, including Medicare physician payments and site neutral payments, anti-competitive contracting, and the No Surprises Act No Bill No. - Black Maternal Health Momnibus Act No Bill No. - DATA in Public Health Act No Bill No. - Complete Care Act No Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Tobacco Users Quit Act(S.704/H.R. 1202) REDI Act No Bill No. - FY2024 NDAA No Bill No. - Vaccine commercialization No Bill No. - VA Standards of Practice No Bill No. - MATE Improvement Act No Bill No. - SPEAK Act of 2023 No Bill No. - Access to Donor Milk Act NO Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Primary and Virtual Care Affordability Act No Bill No. - Advancing Menopause Care and Mid-Life Women's Health Act No Bill No. - Change Cyberattack No Bill No. - Inpatient prospective Payment Rule No Bill No. - Healthcare Cybersecurity Act No Bill No. - Protecting Communities Through Immunizations Act No Bill No. - Mental Health and MAMA Act No Bill No. - SEEK HELP Act No Bill No. - Access to Workers' Compensation for Injured Federal Workers Act (S. 230/H.R. 834) Rural Physician Workforce Production Act (S. 862) Restoring America's Health Care Workforce and Readiness Act (H.R. 498) 988 Lifeline Cybersecurity Responsibility Act (H.R. 1114) Long-COVID Recovery Now Act (S. 114/H.R. 766) Preventive Health Savings Act (S. 923) Better Mental Health for Americans (H.R. 286) Healthcare Providers' Safety Act (H.R. 2569) DOC Act (H.R. 1770) Equitable Community Access to Pharmacist Services Act (H.R. 2630/S.652) Safe Step Act (H.R. 3800) Chronic Disease Flexible Coverage Act (H.R. 3029) Primary Care Enhancement Act (H.R. 5378) Lower Cost More Transparency Act (H.R. 2584) Safety from Violence for Healthcare Employees Act (H.R. 4392/S.2188) PrEP Access and Coverage Act (H.R. 6067) Early Childhood Nutrition Improvement Act (S. 3295/H.R. 5569) Child Care Nutrition Enhancement Act (H.R. 1117) Advancing Safe Medications for Moms and Babies Act (H.R. 5909) Care for Grieving Families Act (H.R. 1616/S.807) Comprehensive Access to Resources and Education (CARE) for Long COVID Act (H.R. 3258) Targeting Resources for Equitable Access to Treatment (TREAT) Long COVID Act (S. 2560) Long COVID Support Act (H.R. 6038/S.3108) Teen E-Cigarette and Tobacco Addition (PROTECT) Act (H.R. 6103/S.3137) Support Through Loss Act (S. 3070) Youth Prevention and Recovery Reauthorization Act (H.R. 7381) - Healthcare Enhancement and Learning Through Harnessing Artificial Intelligence Act (S. Res. 597) - A Resolution Creating a Health Workforce Well-Being Day of Awareness (S. 3740) STRONGER Act (H.R. 6965) - EPIPEN Act (S.3779) - Child Suicide Prevention and Lethal Means Safety Act (S. 3679/H.R. 7153) - Lorna Breen Reauthorization Act (H.R. 3752) Parity Enforcement Act (S. 8) - Improving Health Insurance Affordability Act (H.R. 1692) - Health care Affordability Act (H.R. 5010) - Recognizing Gun Violence as a Public Health Emergency Act (H.R. 7891) - Kids Online Safety Act (H.R. 8383) - Rural Obstetrics Readiness Act (H.R. 7153/S.3679) - Dr. Lorna Breen Health Care Provider Protection Act (S. 4429) - Reducing Drug Prices for Seniors Act (H.R. 7681) - Primary and Virtual Care Affordability Act (H.R. 7808) - EARLY Minds Act (H.R. 7855) - Rural Residency Planning and Development Act of 2024 (H.R. 6664) - Innovation in Pediatric Drugs Act

Client expense: $1,045,426 · Firm income: Not reported

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

Teaching Health Center permanent authorization THCGME S.230 Rural Physician Workforce Production Act of 2023 H.R 834 Rural Physician Workforce Production Act of 2023 CAA 2023 GME Slot Distribution

Client expense: $49,201 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

HR 834/S 230 The Rural Physician Workforce Production Act; appropriations for AHRQ Center for Primary Care and HRSA Title VII; GME transparency; issues around rural reclassification

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 834 and S. 230 Rural Physician Workforce Production Act of 2023 S. 940 Rural America Health Corps Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues and Medicare graduate medical education; S.230/H.R.834, Rural Physician Workforce Production Act of 2023; H.R.2474, Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues and Medicare graduate medical education; S.230/H.R.834, Rural Physician Workforce Production Act of 2023; H.R.2474, Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/ S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts if it is paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. P.L.118-42 - Consolidated Appropriations Act, 2024 Issue: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments Issue: Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Issue: Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Issue: Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Client expense: $660,005 · Firm income: Not reported

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

Teaching Health Center permanent authorization THC GME S.230 Rural Physician Workforce Production Act of 2023 H.R 834 Rural Physician Workforce Production Act of 2023 CAA 2023 GME Slot Distribution

Client expense: $49,593 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Medical Center related issues as follows: H.R.3633, PREVENT HPV Cancers Act of 2023 H.R.834/S.230, Rural Physician Workforce Production Act of 2023 H.R.1359/S.644, Modernizing Opioid Treatment Access Act H.R.4392/S.2188, PrEP Access and Coverage Act of 2023 H.R.5414/S.1346, Improving Mental Health Access from the Emergency Department Act of 2023 Psychedelic research related issues Monitor Medical Center related issues as follows: Community Health Centers Public Law 118-47, Further Consolidated Appropriations Act, 2024, Division D - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2024 340B Drug Pricing related issues Organ transplant issues Prescription drug pricing, generally Laboratory development test issues Medicare reimbursement issues, generally H.R.5378, Lower Costs, More Transparency Act, Hospital related issues

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Fair Access In Residency (FAIR) Act (H.R. 751) Rural Physician Workforce Production Act (S. 230/H.R. 834) Resident Physician Shortage Reduction Act of 2023 (S. 1302/H.R. 2389) Council on Graduate Medical Education Medicare Payment Advisory Commission Inpatient Prospective Payment System Consolidated Appropriations Act, 2021 (PL 116-260) Community Training, Education and Access for Medical Students (Community TEAMS) Act (S. 3968, H.R. 7258) National Health Service Corps Teaching Health Centers Graduate Medical Education NIH Osteopathic Funding and Representation Substance Use Disorder Workforce Act of 2024 (H.R. 7050) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (S. 3679, H.R. 7153) Medically Tailored Home-Delivered Meals Demonstration Pilot Act (S. 2133, H.R. 6780)

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

Medicare program general; S.230 and H.R.834 Rural Physician Workforce Production Act; H.R.2665 Supporting Safety Net Hospitals Act; H.R.5378 Lower Costs, More Transparency Act; Site Neutrality issues;

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No Bill No. - Congressional Primary Care Caucus NO Bill No. - Teaching Health Centers GME; Community Health Centers, National Health Service Corps No Bill No. - COVID-19 Vaccines No Bill No. - PAHPA Reauthorization NO Bill No. - Medicare Physician Payment Reform No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Physician Workforce No Bill No. - Prior authorization/reducing administrative burden NO Bill No. - Health care affordability, including Medicare physician payments and site neutral payments, anti-competitive contracting, and the No Surprises Act No Bill No. - Black Maternal Health Momnibus Act No Bill No. - DATA in Public Health Act No Bill No. - Complete Care Act No Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Tobacco Users Quit Act(S.704/H.R. 1202) REDI Act No Bill No. - FY2024 NDAA No Bill No. - Vaccine commercialization No Bill No. - VA Standards of Practice No Bill No. - MATE Improvement Act No Bill No. - SPEAK Act of 2023 No Bill No. - Access to Donor Milk Act NO Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Primary and Virtual Care Affordability Act No Bill No. - Advancing Menopause Care and Mid-Life Women's Health Act (S. 230/H.R. 834) Rural Physician Workforce Production Act (S. 862) Restoring America's Health Care Workforce and Readiness Act (H.R. 498) 988 Lifeline Cybersecurity Responsibility Act (H.R. 1114) Long-COVID Recovery Now Act (S. 114/H.R. 766) Preventive Health Savings Act (S. 923) Better Mental Health for Americans (H.R. 286) Healthcare Providers' Safety Act (H.R. 2569) DOC Act (H.R. 1770) Equitable Community Access to Pharmacist Services Act (H.R. 2630/S.652) Safe Step Act (H.R. 3800) Chronic Disease Flexible Coverage Act (H.R. 3029) Primary Care Enhancement Act (H.R. 5378) Lower Cost More Transparency Act (H.R. 2584) Safety from Violence for Healthcare Employees Act (H.R. 4392/S.2188) PrEP Access and Coverage Act (H.R. 6067) Early Childhood Nutrition Improvement Act (S. 3295/H.R. 5569) Child Care Nutrition Enhancement Act (H.R. 1117) Advancing Safe Medications for Moms and Babies Act (H.R. 5909) Care for Grieving Families Act (H.R. 1616/S.807) Comprehensive Access to Resources and Education (CARE) for Long COVID Act (H.R. 3258) Targeting Resources for Equitable Access to Treatment (TREAT) Long COVID Act (S. 2560) Long COVID Support Act (H.R. 6038/S.3108) Teen E-Cigarette and Tobacco Addition (PROTECT) Act (H.R. 6103/S.3137) Support Through Loss Act (S. 3070) Youth Prevention and Recovery Reauthorization Act (H.R. 7381) - Healthcare Enhancement and Learning Through Harnessing Artificial Intelligence Act (S. Res. 597) - A Resolution Creating a Health Workforce Well-Being Day of Awareness (S. 3740) STRONGER Act (H.R. 6965) - EPIPEN Act (S.3779) - Child Suicide Prevention and Lethal Means Safety Act (S. 3679/H.R. 7153) - Lorna Breen Reauthorization Act (H.R. 3752) Parity Enforcement Act

Client expense: $825,016 · Firm income: Not reported

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

HR 834/S 230 The Rural Physician Workforce Production Act; appropriations for AHRQ Center for Primary Care and HRSA Title VII; GME transparency; issues around rural reclassification

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. S.230/H.R.834 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. Issue: Provide feedback to CMS and Congress on CMS distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 (P.L. 116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Oppose Medicare hospital, physician, and provider cuts. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support permanent extension of Medicare telehealth waivers. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities. Issue: Support efforts to expand patient access to telehealth. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support extension of alternative payment model (APM) bonus. Issue: Support providing funds for rural teaching hospitals to expand their residency programs. H.R.8188/S.4449 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments.

Client expense: $641,145 · Firm income: Not reported

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

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. S.230/H.R.834 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. S.2768/H.R.2584 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts if it is paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). Issue: Provide feedback to CMS and Congress on CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Oppose Medicare hospital, physician, and provider cuts. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support permanent extension of Medicare telehealth waivers. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities. Issue: Support efforts to expand patient access to telehealth. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support extension of alternative payment model (APM) bonus. H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments.

Client expense: $492,940 · Firm income: Not reported

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

General health care issues and Medicare graduate medical education; S.230/H.R.834, Rural Physician Workforce Production Act of 2023; H.R.2474, Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues and Medicare graduate medical education; S.230/H.R.834, Rural Physician Workforce Production Act of 2023; H.R.2474, Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare-funded Graduate Medical Education National Health Service Corps Public Health Infrastructure and Emergency Preparedness Mental and Behavioral Health Funding for Health Professions NIH Approaches to Diversity, Equity and Inclusion Rural Healthcare HRSA THCGME Initiative to Strengthen Primary Health Care NIH Osteopathic Funding and Representation Community-based Clinical Rotations for Medical Students Advisory Committee on Interdisciplinary Community-Based Linkages Council on Graduate Medical Education U.S. Preventive Services Task Force Fair Access in Residency Act (H.R. 751) Physicians for Underserved Areas Act (S. 703) Specialty Physicians Advancing Rural Care (SPARC) Act (S. 705, H.R. 2761) Rural Physician Workforce Production Act (H.R. 834, S. 230) Resident Physician Shortage Reduction Act (H.R. 2389, S. 1302) Restoring America's Health Care Workforce and Readiness Act (S. 862) Rural Health Innovation Act (S. 953, H.R. 1712) Rural America Health Corps Act (S. 940, H.R. 1711) Save Rural Hospitals Act (S. 803) Health Care Worker Retention Act (H.R. 1215) Care for Long COVID Act (H.R. 1616, S. 801) Indian Health Service Health Professions Tax Fairness Act of 2023 Doctors of Community (DOC) Act (H.R. 2569) Expanding Medical Education Act Medical Student Education Authorization Act (S. 1403, H.R. 3046) Advisory Committee on Training in Primary Care Medicine and Dentistry Ensuring Access to General Surgery Act of 2023 (S. 1140, H.R. 1781) Strengthening Community Care Act of 2023 (H.R. 2559) AACOM 125th Anniversary Resolution (H.Res. 498, S.Res. 283) Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561) Sole Community Provider Hospital IME Payments FY24 IPPS Proposed Rule Graduate Medical Education Provisions Primary Care and Health Workforce Expansion Act Bipartisan Primary Care and Health Workforce Act (S. 2840) Lower Costs More Transparency Act (H.R.5378) Community Health Care Reauthorization Act (S. 2308) Medical School Preceptor Tax Credit

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE

Teaching Health Center permanent authorization THC GME GME Transparency The Lower Costs More Transparency Act H.R. 3561 PATIENT ACT S.230 Rural Physician Workforce Production Act of 2023 H.R 834 Rural Physician Workforce Production Act of 2023 CAA 2023 GME Slot Distribution

Client expense: $51,460 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Abortion access (general); Access to Mifepristone (general); Contraception (general); Maternal Mortality and Morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; obstetric and gynecologic care in rural areas (general; H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 952, Kids Access to Primary Care Act of 2023; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); physician workforce and training (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; inclusion of pregnant and lactating individuals in research (general); Implementation of P.L. 115-320, Improving Access to Maternity Care Act; telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; Rural Residency Planning and Development (RRPD) Program; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; Implementation of P.L. 117-328, Consolidated Appropriations Act, including the Pregnant Workers Fairness Act; Health Insurance Portability and Accountability Act (general); patient-physician relationship (general); H.R. 4605/S. 948, Healthy Moms and Babies Act; H.R. 4816/S. 2427, Convenient Contraception Act; Cost-sharing for maternity care (general); H.R. 4796/S. 2439, Reproductive Health Patient Navigator Act; H.R. 4731/S. 2386, Access to Infertility Treatment and Care Act; H.R. 5066, Tech to Save Moms Act; H.R. 4901/S. 2544, Reproductive Health Care Accessibility Act; Conscientious refusals in medicine (general); H.R. 834/S. 230, Rural Physician Workforce Production Act; menopause research (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); H.R. 5568/S. 2846, CARE for Moms Act; Value-based care models for obstetrics and gynecology (general); S. 3006, SAFE in Recovery Act; H.R. 4775, Helping Tobacco Users Quit Act; Treatment of reproductive health information under the Stored Communications Act (general); Congenital syphilis (general); Tax treatment of stillbirths (general); Substance use disorder during pregnancy (general); H.R. 117, NEWBORN Act; Physician burnout (general); Maternal mental health (general).

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office

Abortion access (general); Access to Mifepristone (general); Contraception (general); Maternal Mortality and Morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; obstetric and gynecologic care in rural areas (general; H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 952, Kids Access to Primary Care Act of 2023; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); physician workforce and training (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; inclusion of pregnant and lactating individuals in research (general); Implementation of P.L. 115-320, Improving Access to Maternity Care Act; telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; Rural Residency Planning and Development (RRPD) Program; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; Implementation of P.L. 117-328, Consolidated Appropriations Act, including the Pregnant Workers Fairness Act; Health Insurance Portability and Accountability Act (general); patient-physician relationship (general); H.R. 4605/S. 948, Healthy Moms and Babies Act; H.R. 4816/S. 2427, Convenient Contraception Act; Cost-sharing for maternity care (general); H.R. 4796/S. 2439, Reproductive Health Patient Navigator Act; H.R. 4731/S. 2386, Access to Infertility Treatment and Care Act; H.R. 5066, Tech to Save Moms Act; H.R. 4901/S. 2544, Reproductive Health Care Accessibility Act; Conscientious refusals in medicine (general); H.R. 834/S. 230, Rural Physician Workforce Production Act; menopause research (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); H.R. 5568/S. 2846, CARE for Moms Act; Value-based care models for obstetrics and gynecology (general); S. 3006, SAFE in Recovery Act; H.R. 4775, Helping Tobacco Users Quit Act; Treatment of reproductive health information under the Stored Communications Act (general); Congenital syphilis (general); Tax treatment of stillbirths (general); Substance use disorder during pregnancy (general); H.R. 117, NEWBORN Act; Physician burnout (general); Maternal mental health (general).

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office

Abortion access (general); Access to Mifepristone (general); Contraception (general); Maternal Mortality and Morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; obstetric and gynecologic care in rural areas (general; H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 952, Kids Access to Primary Care Act of 2023; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act of 2023; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); physician workforce and training (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; inclusion of pregnant and lactating individuals in research (general); Implementation of P.L. 115-320, Improving Access to Maternity Care Act; telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; Rural Residency Planning and Development (RRPD) Program; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; Implementation of P.L. 117-328, Consolidated Appropriations Act, including the Pregnant Workers Fairness Act; Health Insurance Portability and Accountability Act (general); patient-physician relationship (general); H.R. 4605/S. 948, Healthy Moms and Babies Act; H.R. 4816/S. 2427, Convenient Contraception Act; Cost-sharing for maternity care (general); H.R. 4796/S. 2439, Reproductive Health Patient Navigator Act; H.R. 4731/S. 2386, Access to Infertility Treatment and Care Act; H.R. 5066, Tech to Save Moms Act; H.R. 4901/S. 2544, Reproductive Health Care Accessibility Act; Conscientious refusals in medicine (general); H.R. 834/S. 230, Rural Physician Workforce Production Act; menopause research (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); H.R. 5568/S. 2846, CARE for Moms Act; Value-based care models for obstetrics and gynecology (general); S. 3006, SAFE in Recovery Act; H.R. 4775, Helping Tobacco Users Quit Act; Treatment of reproductive health information under the Stored Communications Act (general); Congenital syphilis (general); Tax treatment of stillbirths (general); Substance use disorder during pregnancy (general); H.R. 117, NEWBORN Act; Physician burnout (general); Maternal mental health (general).

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office