Expanded Telehealth Access Act

Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683); Medicare Payment Reform; Prevent Interruptions in Physical Therapy Act (H.R.1617/S. 793); Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act (H.R. 7279); Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459); Expanded Telehealth Act (H.R. 3875/S. 2880); Telehealth Modernization Act (H.R. 7623 / S. 3967); Stopping Addiction and Falls for the Elderly (SAFE) Act (H.R. 7618); Medicare Opt-Out; Improving Seniors Timely Access to Care Act (H.R. 8702 / S. 4532); Strengthening Medicare for Patients and Providers Act (H.R. 2474); The Provider Reimbursement Stability Act (H.R. 6371); Physician Fee Stabilization Act (S. 4935); Medicare Patient Access and Practice Stabilization Act of 2024 (H.R. 10073).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 6445/S. 2377) Issues related to the provision of audiology and speech-language pathology services through telepractice, including the Expanded Telehealth Access Act (H.R. 3875/S. 2880), the CONNECT for Health Act (H.R. 4189/S. 2016) and the Telehealth Modernization Act (H.R. 7623). Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 2474, the Strengthening Medicare for Patients and Providers Act, H.R. 2474, H.R. 6545, the Physician Fee Schedule Update and Improvements Act, and S. 4935, the Physician Fee Schedule Stabilization Act Various issues related to CMS Actions surrounding: Audits of medical records and claims for Part A and B services Procedure code development and valuation of audiology and speech-language pathology services Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems, including home health and skilled nursing facility policy and payment issues Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Various issues related to interoperable health information, including the post-acute care interoperability project (PACIO) Medicare telehealth coverage under Part A and B Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Issues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care The Long-Term Care Workforce Support Act (H.R. 7994/S. 4120) Issues related to the Medicaid program, including Medicaid and Medicaid managed care access, the Early and Periodic Screening, Diagnosis, and Treatment benefit, school-based billing, and block grants, per capita caps, and work requirements. Improving Seniors Timely Access to Care Act (H.R. 8702/S. 4532) The American Relief Act, 2025 (H.R. 10545)

H.R. 5378 - Lower Costs, More Transparency Act S. 3967/H.R. 7263 - Telehealth Modernization Act of 2024 S. 1001/H.R. 1843 - Telehealth Expansion Act of 2023 S. 2880/H.R. 3875 - Expanded Telehealth Access Act

Client expense: $330,000 · Firm income: Not reported

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

HR 4315/S3977 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. H.R.7623/S.3967 - Telehealth Modernization Act: Advocate for passage of bill that would among other things establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act: Advocate for passage of bill that would extend waivers allowing OTs to provide services via telehealth in Medicare. H.R.8151 - Telehealth Therapy Act: Advocate for passage of bill that would allow OTs to provide services via telehealth in Medicare on a permanent basis. H.R.7148 - Medicare Home Health Accessibility Act: Advocate for passage of legislation that would establish occupational therapy as a qualifying Medicare home health service and for introduction of similar bill in the Senate. S. 1592/H.R.8220 - Occupational Therapy in Mental Health Parity Act: Support passage. S. 2942 WELL Seniors Act - support passage H.R. 6371 Provider Reimbursement Stability Act - support passage H.R. 6545 Physician Fee Schedule Update and Improvements Act - support passage H.R. 6683 Preserving Seniors Access to Physicians Act - support passage S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act - support passage S. 2433/S. 3106/H.R. 4079 Substance-Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act - support passage H.R.7279 REDUCE Act: Supported introduction and passage. H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act: Supported introduction and passage. S. 5023 support Stand Strong Falls Prevention Act Support Congressional efforts to stop cuts to the Medicare Physician Fee Schedule Support inclusion of a repeal of the Multiple Procedure payment reduction in Medicare Fee Schedule Reform

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 4878/S. 2459 - EMPOWER Act (PTA/OTA Supervision) H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act H.R. 3875/S. 2880 Expanded Telehealth Access Act H.R. 4829 Physical Therapist Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 8151 to Expand eligible practitioners to furnish telehealth services H.R. 10073 Medicare Patient Access and Practice Stabilization Act

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 1310 States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 7307 Health Care Workforce Innovation Act H.R. 8151 to Expand eligible practitioners to furnish telehealth services H.R. 9179/S. 4556 to establish the Office of Falls Prevention of the Department of Veterans Affairs H.R. 10073 Medicare Patient Access and Practice Stabilization Act

Client expense: $289,585 · Firm income: Not reported

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare and adds requirements for Part D plan contracts with PBMs including reporting and delinking provisions H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 7996 - Improving CARE for Youth Act - Rep. Dunn, Neal - allows for same-day billing for mental health services for youth Medicaid beneficiaries who are being seen for a primary care service H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 948 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - establishes programs and requirements to support maternal health services under Medicaid and CHIP S. 1002 - No UPCODE Act - Sen. Cassidy, Bill - modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Continued access to occupational therapy services including in the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of telehealth services in H.R. 3875, S.2880 - Expanded Telehealth Access Act H.R. 7623 - the Telehealth Modernization Act, H.R.8261 - Preserving Telehealth, Hospital, and Ambulance Access Act and S. 2016 - CONNECT for Health Act of 2023. Support of H.R.2474 - Strengthening Medicare for Patients and Providers Act. Issues related to MACRA reform. H.R. 4878, the EMPOWER Act, S.2459 - Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation Act H.R.7148 - Medicare Home Health Accessibility Act H.R.8261 - Preserving Telehealth, Hospital, and Ambulance Access Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act; S.3651/H.R.3432 - Telemental Health Care Access Act of 2023

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

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

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act; S.3651/H.R.3432 - Telemental Health Care Access Act of 2023

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

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

Minimum Staffing Standards for Long-Term Care Facilities Protecting Rural Seniors Access to Care Act (H.R. 5796/ S. 3490) Physician Fee Schedule Long-term Reform Strengthening Medicare for Patients and Providers Act (H.R. 2474) Ensuring Seniors' Access to Quality Care Act (H.R. 3227/S. 1749) Fee schedule conversion factor tied to inflation Eliminate the budget neutrality requirement Obtain an impact study of the 15% therapy assistant cut on rural and medically underserved areas; mitigate the 15% differential implemented in 2022 Follow and support efforts with respect to the CMS-identified potentially misvalued therapy CPT codes Elimination of Multiple Procedure Payment Reduction (MPPR) Reduced administrative burden through streamlined plan-of-care certifications Changes to the MIPS Quality Payment Program to allow all therapy providers to be eligible for the Quality Payments Program Skilled Nursing Facility Prospective Payment System Clinical Laboratory Fee Schedule Saving Access to Laboratory Services (SALSA) Act ( H.R. 2377 / S. 1000) Home Health Prospective Payment System Medicare Home Health Accessibility Act (H.R. 7148) Expanding Care in the Home Act (H.R. 2853) Medicare Advantage and Merit-based Incentive Payment System (MIPS) Reform Observation Stay Requirements Improving Access to Medicare Coverage Act of 2024 (H.R. 5138) Rehabilitation Therapy Outpatient Supervision Requirements Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459) Teletherapy/Telerehab Patient Access Expanded Telehealth Access Act (H.R. 3875/ S. 2880) Telehealth Modernization Act of 2024 (H.R. 7623/ S. 3967) Rehabilitation Therapy CPT Codes on Permanent Telehealth List Portable X-ray Transportation Payment Issues

Minimum Staffing Standards for Long-Term Care Facilities Protecting Rural Seniors Access to Care Act (H.R. 5796/ S. 3490) Physician Fee Schedule Long-term Reform Strengthening Medicare for Patients and Providers Act (H.R. 2474) Ensuring Seniors' Access to Quality Care Act (H.R. 3227/S. 1749) Fee schedule conversion factor tied to inflation Eliminate the budget neutrality requirement Obtain an impact study of the 15% therapy assistant cut on rural and medically underserved areas; mitigate the 15% differential implemented in 2022 Follow and support efforts with respect to the CMS-identified potentially misvalued therapy CPT codes Elimination of Multiple Procedure Payment Reduction (MPPR) Reduced administrative burden through streamlined plan-of-care certifications Changes to the MIPS Quality Payment Program to allow all therapy providers to be eligible for the Quality Payments Program Skilled Nursing Facility Prospective Payment System Clinical Laboratory Fee Schedule Saving Access to Laboratory Services (SALSA) Act ( H.R. 2377 / S. 1000) Home Health Prospective Payment System Medicare Home Health Accessibility Act (H.R. 7148) Expanding Care in the Home Act (H.R. 2853) Medicare Advantage and Merit-based Incentive Payment System (MIPS) Reform Observation Stay Requirements Improving Access to Medicare Coverage Act of 2024 (H.R. 5138) Rehabilitation Therapy Outpatient Supervision Requirements Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459) Teletherapy/Telerehab Patient Access Expanded Telehealth Access Act (H.R. 3875/ S. 2880) Telehealth Modernization Act of 2024 (H.R. 7623/ S. 3967) Rehabilitation Therapy CPT Codes on Permanent Telehealth List Portable X-ray Transportation Payment Issues

Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 6445/S. 2377) Issues related to the provision of audiology and speech-language pathology services through telepractice, including the Expanded Telehealth Access Act (H.R. 3875/S. 2880), the CONNECT for Health Act (H.R. 4189/S. 2016) and the Telehealth Modernization Act (H.R. 7623). Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 2474, the Strengthening Medicare for Patients and Providers Act, H.R. 2474, H.R. 6545, the Physician Fee Schedule Update and Improvements Act, and S. 4935, the Physician Fee Schedule Stabilization Act Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems, including home health and skilled nursing facility policy and payment issues oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oVarious issues related to interoperable health information, including the post-acute care interoperability project (PACIO) oMedicare telehealth coverage under Part A and B oImplementation of CARES Act (P.L. 116-136) oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care The Long-Term Care Workforce Support Act (H.R. 7994/S. 4120) Issues related to the Medicaid program, including Medicaid and Medicaid managed care access, the Early and Periodic Screening, Diagnosis, and Treatment benefit, and school-based billing. Improving Seniors Timely Access to Care Act (H.R. 8702/S. 4532)

Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683); Medicare Payment Reform; Prevent Interruptions in Physical Therapy Act (H.R.1617/S. 793); Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act (H.R. 7279); Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459); Expanded Telehealth Act (H.R. 3875/S. 2880); Telehealth Modernization Act (H.R. 7623 / S. 3967); Stopping Addiction and Falls for the Elderly (SAFE) Act (H.R. 7618); Medicare Opt-Out; Improving Seniors Timely Access to Care Act (H.R. 8702 / S. 4532); Strengthening Medicare for Patients and Providers Act (H.R. 2474); The Provider Reimbursement Stability Act (H.R. 6371); Physician Fee Stabilization Act (S. 4935).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 1310 States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 7307 Health Care Workforce Innovation Act H.R. 8151 to Expand eligible practitioners to furnish telehealth services H.R. 9179/S. 4556 to establish the Office of Falls Prevention of the Department of Veterans Affairs

Client expense: $240,412 · Firm income: Not reported

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 4878/S. 2459 - EMPOWER Act (PTA/OTA Supervision) H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act H.R. 3875/S. 2880 Expanded Telehealth Access Act H.R. 4829 Physical Therapist Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 8151 to Expand eligible practitioners to furnish telehealth services

H.R. 5378 - Lower Costs, More Transparency Act S. 3967/H.R. 7263 - Telehealth Modernization Act of 2024 S. 1001/H.R. 1843 - Telehealth Expansion Act of 2023 S. 2880/H.R. 3875 - Expanded Telehealth Access Act

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

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

HR 4315/S3977 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. H.R.7623/S.3967 - Telehealth Modernization Act: Advocated for passage of bill that would among other things establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act: Advocate for passage of bill that would extend waivers allowing OTs to provide services via telehealth in Medicare. H.R.8151 - Telehealth Therapy Act: Advocate for passage of bill that would allow OTs to provide services via telehealth in Medicare on a permanent basis. H.R.7148 - Medicare Home Health Accessibility Act: Advocate for passage of legislation that would establish occupational therapy as a qualifying Medicare home health service and for introduction of similar bill in the Senate. S. 1592/H.R.8220 - Occupational Therapy in Mental Health Parity Act: Support passage. S. 2942 WELL Seniors Act - support passage H.R. 6371 Provider Reimbursement Stability Act - support passage H.R. 6545 Physician Fee Schedule Update and Improvements Act - support passage H.R. 6683 Preserving Seniors Access to Physicians Act - support passage S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act - support passage S. 2433/S. 3106/H.R. 4079 Substance-Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act - support passage H.R.7279 REDUCE Act: Supported introduction and passage. H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act: Supported introduction and passage. S. 5023 support Stand Strong Falls Prevention Act Support Congressional efforts to stop cuts to the Medicare Physician Fee Schedule Support inclusion of a repeal of the Multiple Procedure payment reduction in Medicare Fee Schedule Reform

Minimum Staffing Standards for Long-Term Care Facilities Protecting Rural Seniors Access to Care Act (H.R. 5796/ S. 3490) Physician Fee Schedule Long-term Reform Strengthening Medicare for Patients and Providers Act (H.R. 2474) Ensuring Seniors' Access to Quality Care Act (H.R. 3227/S. 1749) Fee schedule conversion factor tied to inflation Eliminate the budget neutrality requirement Obtain an impact study of the 15% therapy assistant cut on rural and medically underserved areas; mitigate the 15% differential implemented in 2022 Follow and support efforts with respect to the CMS-identified potentially misvalued therapy CPT codes Elimination of Multiple Procedure Payment Reduction (MPPR) Reduced administrative burden through streamlined plan-of-care certifications Changes to the MIPS Quality Payment Program to allow all therapy providers to be eligible for the Quality Payments Program Skilled Nursing Facility Prospective Payment System Clinical Laboratory Fee Schedule Saving Access to Laboratory Services (SALSA) Act ( H.R. 2377 / S. 1000) Home Health Prospective Payment System Medicare Home Health Accessibility Act (H.R. 7148) Expanding Care in the Home Act (H.R. 2853) Medicare Advantage and Merit-based Incentive Payment System (MIPS) Reform Observation Stay Requirements Improving Access to Medicare Coverage Act of 2024 (H.R. 5138) Rehabilitation Therapy Outpatient Supervision Requirements Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459) Teletherapy/Telerehab Patient Access Expanded Telehealth Access Act (H.R. 3875/ S. 2880) Telehealth Modernization Act of 2024 (H.R. 7623/ S. 3967) Rehabilitation Therapy CPT Codes on Permanent Telehealth List Portable X-ray Transportation Payment Issues

Draft, Broker Accountability Act (no bill number) - ACA Agent/Broker accountability H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment; coverage of weight loss drugs; and Inflation Reduction Act implementation.

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act; S.3651/H.R.3432 - Telemental Health Care Access Act of 2023

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

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

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act; S.3651/H.R.3432 - Telemental Health Care Access Act of 2023

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

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

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 1310 States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 7307 Health Care Workforce Innovation Act H.R. 8151 to Expand eligible practitioners to furnish telehealth services S. 4556 to establish the Office of Falls Prevention of the Department of Veterans Affairs

Client expense: $238,054 · Firm income: Not reported

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 4878/S. 2459 - EMPOWER Act (PTA/OTA Supervision) H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act H.R. 3875/S. 2880 Expanded Telehealth Access Act H.R. 4829 Physical Therapist Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 8151 to Expand eligible practitioners to furnish telehealth services

Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683); Medicare Payment Reform; Prevent Interruptions in Physical Therapy Act (H.R.1617/S. 793); Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act (H.R. 7279); Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459); Expanded Telehealth Act (H.R. 3875/S. 2880); Telehealth Modernization Act (H.R. 7623 / S. 3967); Stopping Addiction and Falls for the Elderly (SAFE) Act (H.R. 7618); Medicare Opt-Out; Improving Seniors Timely Access to Care Act (H.R. 8702 / S. 4532); Strengthening Medicare for Patients and Providers Act (H.R. 2474).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Continued access to occupational therapy services including in the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of telehealth services in H.R. 3875, S.2880 - Expanded Telehealth Access Act and the Telehealth Modernization Act, H.R.8261 - Preserving Telehealth, Hospital, and Ambulance Access Act and S. 2016 - CONNECT for Health Act of 2023. Support of H.R.2474 - Strengthening Medicare for Patients and Providers Act. Issues related to MACRA reform. H.R. 4878, the EMPOWER Act, S.2459 - Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation Act H.R.7148 - Medicare Home Health Accessibility Act H.R.8261 - Preserving Telehealth, Hospital, and Ambulance Access Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 6445/S. 2377) Issues related to the provision of audiology and speech-language pathology services through telepractice, including the Expanded Telehealth Access Act (H.R. 3875/S. 2880), the CONNECT for Health Act (H.R. 4189/S. 2016) and the Telehealth Modernization Act (H.R. 7623). Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 2474, the Strengthening Medicare for Patients and Providers Act, H.R. 2474 Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems, including home health and skilled nursing facility policy and payment issues oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oVarious issues related to interoperable health information, including the post-acute care interoperability project (PACIO) oMedicare telehealth coverage under Part A and B oImplementation of CARES Act (P.L. 116-136) oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care Issues related to Medicaid work requirements, including H.R. 2811, the Limit, Save, Grow Act of 2023 The Long-Term Care Workforce Support Act (H.R. 7994/S. 4120) Issues related to the Medicaid program, including Medicaid and Medicaid managed care access, the Early and Periodic Screening, Diagnosis, and Treatment benefit, and school-based billing. Improving Seniors Timely Access to Care Act (H.R. 8702/S. 4532)

No bill number - Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. HR 4315/S3977 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. H.R.7623/S.3967 - Telehealth Modernization Act: Advocated for passage of bill that would among other things establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act: Advocate for passage of bill that would extend waivers allowing OTs to provide services via telehealth in Medicare. H.R.8151 - Telehealth Therapy Act: Advocate for passage of bill that would allow OTs to provide services via telehealth in Medicare on a permanent basis. H.R.7148 - Medicare Home Health Accessibility Act: Advocate for passage of legislation that would establish occupational therapy as a qualifying Medicare home health service and for introduction of similar bill in the Senate. S. 1592/H.R.8220 - Occupational Therapy in Mental Health Parity Act: Support passage. S. 2942 WELL Seniors Act - support passage H.R. 6371 Provider Reimbursement Stability Act - support passage H.R. 6545 Physician Fee Schedule Update and Improvements Act - support passage H.R. 6683 Preserving Seniors Access to Physicians Act - support passage S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act - support passage S. 2433/S. 3106/H.R. 4079 Substance-Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act - support passage H.R.7279 REDUCE Act: Supported introduction and passage. H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act: Supported introduction and passage.

Continued access to occupational therapy services including in the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of telehealth services in H.R. 3875, S.2880 - Expanded Telehealth Access Act and the Telehealth Modernization Act, H.R.4189/S. 2016 - CONNECT for Health Act of 2023. Support of H.R.2474 - Strengthening Medicare for Patients and Providers Act. Issues related to MACRA reform. H.R. 4878, the EMPOWER Act, S.2459 - Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation Act H.R.7148 - Medicare Home Health Accessibility Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. - makes certain telehealth flexibilities permanent under Medicare S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573- Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578- Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630- Medicare Transaction Fraud Prevention Act- Sen. Braun. Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651- Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766- Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882- Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934- Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; issues related to Medicare Advantage payment, including Medicare Payment Advisory Commission analyses and the 2025 Advance Rate Notice for MA and Part D; MedPAC analysis of MA payments, MA CY 2025 rate notice; MA risk adjustment; prior authorization in Medicare and Medicaid; MA coverage in rural areas; and issues related to implementation of the Inflation Reduction Act, including reform of the Medicare Part D program. Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2024 Rate Notice; issues related to the expiration of Medicaid continuous eligibility and transitions in coverage; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to specialty infant formula; issues related to the Inflation Reduction Act implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency, including the Medicaid unwinding; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to artificial intelligence; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; issues related to private equity ownership transparency; and other issues relating to health care reform implementation.

Minimum Staffing Standards for Long-Term Care Facilities Protecting Rural Seniors Access to Care Act (H.R. 5796/ S. 3490) Physician Fee Schedule Long-term Reform Strengthening Medicare for Patients and Providers Act (H.R. 2474) Ensuring Seniors' Access to Quality Care Act (H.R. 3227/S. 1749) Fee schedule conversion factor tied to inflation Eliminate the budget neutrality requirement Obtain an impact study of the 15% therapy assistant cut on rural and medically underserved areas; mitigate the 15% differential implemented in 2022 Follow and support efforts with respect to the CMS-identified potentially misvalued therapy CPT codes Elimination of Multiple Procedure Payment Reduction (MPPR) Reduced administrative burden through streamlined plan-of-care certifications Changes to the MIPS Quality Payment Program to allow all therapy providers to be eligible for the Quality Payments Program Skilled Nursing Facility Prospective Payment System Clinical Laboratory Fee Schedule Saving Access to Laboratory Services (SALSA) Act ( H.R. 2377 / S. 1000) Home Health Prospective Payment System Medicare Home Health Accessibility Act (H.R. 7148) Expanding Care in the Home Act (H.R. 2853) Medicare Advantage and Merit-based Incentive Payment System (MIPS) Reform Observation Stay Requirements Improving Access to Medicare Coverage Act of 2024 (H.R. 5138) Rehabilitation Therapy Outpatient Supervision Requirements Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459) Teletherapy/Telerehab Patient Access Expanded Telehealth Access Act (H.R. 3875/ S. 2880) Telehealth Modernization Act of 2024 (H.R. 7623/ S. 3967) Rehabilitation Therapy CPT Codes on Permanent Telehealth List Portable X-ray Transportation Payment Issues

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act

Client expense: Not reported · Firm income: $135,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act

Client expense: Not reported · Firm income: $135,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683); Medicare Payment Reform; Prevent Interruptions in Physical Therapy Act (H.R.1617/S. 793); Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act (H.R. 7279); Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459); Expanded Telehealth Act (H.R. 3875/S. 2880); Telehealth Modernization Act (H.R. 7623); Stopping Addiction and Falls for the Elderly (SAFE) Act (H.R. 7618); Medicare Opt-Out.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No bill number - Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. HR 4315 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. Advocate for introduction in the Senate. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. H.R.7623/S.3967 - Telehealth Modernization Act: Advocated for introduction and passage of bill that would among other things establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. H.R.7148 - Medicare Home Health Accessibility Act: Advocated for introduction and passage of legislation that would establish occupational therapy as a qualifying Medicare home health service. S. 1592 - Occupational Therapy in Mental Health Parity Act: Support passage and advocate for introduction in the House of Representatives. S. 2942 WELL Seniors Act - support passage H.R. 6371 Provider Reimbursement Stability Act - support passage H.R. 6545 Physician Fee Schedule Update and Improvements Act - support passage H.R. 6683 Preserving Seniors Access to Physicians Act - support passage S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act - support passage S. 2433/S. 3106/H.R. 4079 Substance-Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act - support passage H.R.7279 REDUCE Act: Supported introduction and passage. H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act: Supported introduction and passage.

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 1310 States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 - Telehealth Modernization Act (TMA)

Client expense: $277,054 · Firm income: Not reported

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 4878/S. 2459 - EMPOWER Act (PTA/OTA Supervision) H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act H.R. 3875/S. 2880 Expanded Telehealth Access Act H.R. 4829 Physical Therapist Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA)

Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 6445/S. 2377) Issues related to the provision of audiology and speech-language pathology services through telepractice, including the Expanded Telehealth Access Act (H.R. 3875/S. 2880), the CONNECT for Health Act (H.R. 4189/S. 2016) and the Telehealth Modernization Act (H.R. 7623). Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 2474, the Strengthening Medicare for Patients and Providers Act, H.R. 2474,the Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683), and H.R. 4366, the Consolidated Appropriations Act, 2024 Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oVarious issues related to interoperable health information, including the post-acute care interoperability project (PACIO) oMedicare telehealth coverage under Part A and B oImplementation of CARES Act (P.L. 116-136) oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to Medicaid work requirements, including H.R. 2811, the Limit, Save, Grow Act of 2023 S. 4120, the Long-Term Care Workforce Support Act Issues related to the Medicaid program, including Medicaid and Medicaid managed care access, the Early and Periodic Screening, Diagnosis, and Treatment benefit, and school-based billing.

H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; and Medicaid FMAP. Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2024 Rate Notice; issues related to the expiration of Medicaid continuous eligibility and transitions in coverage; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to specialty infant formula; issues related to the Inflation Reduction Act implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency, including the Medicaid unwinding; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to artificial intelligence; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; issues related to private equity ownership transparency; and other issues relating to health care reform implementation.

No bill number - Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. HR 4315 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. Advocate for introduction in the Senate. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. No bill number - Telehealth Modernization Act: Advocate for reintroduction and inclusion of provision to establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. No bill number - Medicare Home Health Accessibility Act: Advocate for introduction of legislation that would establish occupational therapy as a qualifying Medicare home health service. S. 1592 - Occupational Therapy in Mental Health Parity Act: Support passage and advocate for introduction in the House of Representatives. No bill number - support introduction of legislation to streamline the certification of the plan of care under Medicare No bill number - support introduction of legislation in the House that would add falls prevention to the services included in the Medicare annual wellness visit and add occupational therapist to the list of eligible providers S. 2942 WELL Seniors Act - support passage H.R. 6371 Provider Reimbursement Stability Act - support passage H.R. 6545 Physician Fee Schedule Update and Improvements Act - support passage H.R. 6683 Preserving Seniors Access to Physicians Act - support passage S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act - support passage S. 2433/S. 3106/H.R. 4079 Substance-Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act - support passage

Continued access to occupational therapy services including in the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of telehealth services in H.R. 3875, S.2880 - Expanded Telehealth Access Act and the Telehealth Modernization Act, H.R.4189 - CONNECT for Health Act of 2023. Support of S. 1592 - Occupational Therapy Mental Health Parity Act. Support of H.R.2474 - Strengthening Medicare for Patients and Providers Act. Issues related to MACRA reform. Advocate for introduction of legislation that would establish occupational therapy as a qualifying Medicare home health service. H.R. 4878, the EMPOWER Act, S.2459 - Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Expanded Telehealth Access Act Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, andinformation blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 4878/S. 2459 - EMPOWER Act (PTA/OTA Supervision) H.R. 1617.S.793 Prevent Interruptions in Physical Therapy Act H.RR./S. 2880 Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act HR2217/S4519 - IDEA Act H.R.2480 Optimizing Postpartum Outcomes Act

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R.2217/S. 4519 - IDEA Act

Client expense: $266,282 · Firm income: Not reported

Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 6445/S. 2377) Issues related to the provision of audiology and speech-language pathology services through telepractice, including the Expanded Telehealth Access Act (H.R. 3875/S. 2880) and the CONNECT for Health Act (H.R. 4189/S. 2016) Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including the Strengthening Medicare for Patients and Providers Act (H.R. 2474) and the Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683). Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oMedicare telehealth coverage under Part A and B oImplementation of CARES Act (P.L. 116-136) oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to Medicaid work requirements, including H.R. 2811, the Limit, Save, Grow Act of 2023 Issues related to the Medicaid program, including Medicaid and Medicaid managed care access, the Early and Periodic Screening, Diagnosis, and Treatment benefit, and school-based billing.

Client expense: $290,720 · Firm income: Not reported

No bill number - Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. HR 4315 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. Advocate for introduction in the Senate. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. No bill number - Telehealth Modernization Act: Advocate for reintroduction and inclusion of provision to establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. No bill number - Medicare Home Health Accessibility Act: Advocate for introduction of legislation that would establish occupational therapy as a qualifying Medicare home health service. S. 1592 - Occupational Therapy in Mental Health Parity Act: Support passage and advocate for introduction in the House of Representatives.

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R.2217/S. 4519 - IDEA Act

Client expense: $266,282 · Firm income: Not reported