Promoting Effective and Empowering Recovery Services in Medicare Act of 2023

S. 2016 HR. 4189: Connect for Health Act: expand the use of telehealth and remote patient monitoring services in Medicare, toward the goal of cost savings and quality care improvement. HR 4056 Ensuring Medicaid Continuity of Children in Foster Care Act: Ensuring that Medicaid is available for foster children who are placed in qualified residential treatment programs maintaining beneficiary access to the full range of available medications under Medicare Part D by protecting consumer access to Medicare Part D's Six Protected Classes Supporting new quality measures in Medicare's FY 2024 Inpatient psychiatric facility prospective payment system Objecting to new potential work requirements for Medicare and other public assistance programs H.R. 5510: Helping our patients for emotional and mental well-being Act. Requires coverage of 3 primary care visits without cost-sharing each year under the Medicare S. 2129: Ensuring Access to Lower-Cost Medicines for Seniors Act: To amend the Social Security Act to require PDP sponsors of a prescription drug plan and Medicare Advantage organizations offering an MA-PD plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary H.R. 4771 The CHIPP Act: permanently extend the Childrens Health Insurance Program S.838/H.R.1638: Improving Access to Mental Health Act: Increases the Medicare reimbursement rate for clinical social worker services. H.R. 4892 & S. 3921: Medicaid Bump Act: Increase Medicaid payments to certain providers H.R. 6748 & S. 3498: Peers IN Medicaid Act: requiring Medicare to cover peer support services at certain facilities S. 3892: Community Health Workers Access Act: Increase access to community health workers under the Medicare and Medicaid H.R. 8575 Michelle Go Act: Increase the number of inpatient beds that can be reimbursed under the IMD provision. H.R. 8487/S.3018 Improving Seniors Timely Access to Care Act: Reform prior authorization process in Medicare advantage plans H.R. 6748/S.3498 Peers In Medicare Act: Allows for Medicare reimbursement for peer supourt specialist

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

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

Mental Health (mental health parity, mental health workforce, school-based behavioral services, H.R.7808 - Early Minds Act, S.4041 - CARE for Students Mental Health Act, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023, caregivers of individuals with mental illness and caregiver mental health including the Office of Caregiver Health, 988 suicide/crisis line georouting of calls), H.R.8702/S.4532 Improving Seniors Timely Access to Care Act)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Mental Health (mental health parity, mental health workforce, school-based behavioral services, caregivers of individuals with mental illness and caregiver mental health, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023), H.R.8702/S.4532 Improving Seniors Timely Access to Care Act)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare reimbursement for addiction counselors Medicare coverage for substance use disorder treatment services Consolidated Appropriations Act, 2023 implementation (S.923) Better Mental Health Care for Americans Act (H.R.2400/S.1165) Reentry Act (H.R. 1638/S. 838) Improving Access to Mental Health Act (S.3921/H.R. 4892) Medicaid Bump Act (H.R.6928) CONNECT Act of 2024 Gaps in substance use disorder services Issues surrounding peer support services (H.R. 6748/S. 3498) PEERS in Medicare Act Issues surrounding Medicare Part B (H.R. 9232/S. 4860) Residential Recovery for Seniors MHPAEA Application to Medicare (H.R.2400/S.1165) Reentry Act of 2023 (H.R.3074/S.971) Due Process Continuity of Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Ensuring Excellence in Mental Health Act (CCBHC 2.0) (S. 2993/H.R. 8543), all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. Mental Health Access Improvement Act (S. 828/H.R. 432), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 2400/S. 1165), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Due Process Continuity of Care Act (H.R. 3074/S. 971), all provisions related to the removal of the Medicaid coverage exclusion for inmates in custody pending disposition of charges. ADAPT Act (S.2511), all provisions related to allowing certain supervised psychology trainees to provide mental health services and bill Medicare, Medicaid and CHIP. PEERS in Medicare Act (H.R. 6748/S. 3498), all provisions related to creating a definition of peers in the Medicare program and making peer services reimbursable through Medicare in certain community-based settings. Residential Recovery for Seniors Act (S. 4860/H.R. 9232), all provisions related to establishing Medicare coverage for residential addiction treatment programs meeting nationally recognized standards. Language to expand NHSC allowable use of hours of service delivered outside clinic walls, all provisions related to expanding allowable use for hours of service.

Client expense: $112,806 · Firm income: Not reported

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

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531/S. 3393) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. CONNECT Act (H.R. 6928), all provisions related to awarding grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Mental Health Student Loan Forgiveness Act (H.R. 4933/S. 462), all provisions relating to expanding the Substance Use Disorder Treatment and Recovery Loan Repayment Program and expanding eligibility to include individuals who agree to work in mental health professional shortage areas for a period of time. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919), all provisions related to expanding access to fentanyl and xylazine test strips. H.R. 7545, all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. STAR Plus Scholarship Act (H.R. 9851), all provisions related to creating a scholarship program for substance use treatment providers. Community Mental Wellness Worker Training Act (H.R. 8680), all provisions related to creating a grant program for behavioral health organizations to train mental wellness workers in communities. Elementary and Secondary School Counseling Act (H.R. 8524/S. 4407), all provisions related to establishing five-year renewable grant programs to help elementary and secondary schools to hire additional school-based mental health providers such as counselors, psychologists and social workers. Kid PROOF Act of 2023 (H.R. 6663/S. 3364), all provisions related to allowing health care providers to purchase and distribute lethal means safety supplies for children at risk of overdose or suicide. Telehealth Access for Tribal Communities Act of 2024 (H.R. 9271), all sections related to expanding telehealth access for tribal communities. Campus Prevention and Recovery Services for Students Act of 2024 (H.R. 9214), all provisions related to helping higher education institutions implement programs to prevent alcohol and substance misuse on campus and support those with substance use disorders. Recognizing the Role of Direct Support Professionals Act (H.R. 2941/S. 1332), all provisions related to requiring the Office of Management and Budget to establish a separate category within the Standard Occupational Classification system for direct support professionals for data reporting purposes. American Relief Act (H.R. 10545), all provisions relating to extension of Medicare telehealth flexibilities. SAMHSA Notice of CCBHC-E Data Collection, submitted comment to SAMHSA regarding the request for clearance for eleven data collection instruments and forms related to the implementation and impact studies to be conducted as part of an evaluation of the 2022 CCBHC-Expansion grant cohorts. SAMHSA Notice of Patient-Level Data Collection, submitted comment SAMHSA regarding the proposed SAMHSA Unified Client-level Performance Reporting Tool (SUPRT) to modify the existing Center for Substance Abuse Treatment (CSAT) and Center for Mental Health Services (CMHS) Client-Level Performance Instruments into a streamlined, multi-component SAMHSA Client-Level Performance Tool. CMS Draft FAQ on Provider Enrollment and TPL for Dual Eligibles, submitted comment on CMSs draft FAQ related to providing services for dual eligible individuals. SAMHSA Crisis definitions and guidelines draft documents, submitted comments on SAMHSAs drafted coordinated crisis care services definitions and guidelines. SAMHSA Satellite Definition, submitted comment on SAMHSAs proposed update to Satellite Facility for purposes of CCBHC payment exclusion.

Client expense: $112,806 · Firm income: Not reported

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

- Telehealth, reforming barriers to access to services. Extending flexibilities and repealing the 6-month in person visit requirement. - Telemental Health Care Access Act, H.R. 3432/S. 3651 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act, S.3498/ H.R. 6748 - Coverage of peer support specialists services

Client expense: $84,902 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

Ensuring Excellence in Mental Health Act (CCBHC 2.0) (S. 2993/H.R. 8543), all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. Mental Health Access Improvement Act (S. 828/H.R. 432), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 2400/S. 1165), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Due Process Continuity of Care Act (H.R. 3074/S. 971), all provisions related to the removal of the Medicaid coverage exclusion for inmates in custody pending disposition of charges. ADAPT Act (S.2511), all provisions related to allowing certain supervised psychology trainees to provide mental health services and bill Medicare, Medicaid and CHIP. PEERS in Medicare Act (H.R. 6748/S. 3498), all provisions related to creating a definition of peers in the Medicare program and making peer services reimbursable through Medicare in certain community-based settings. Residential Recovery for Seniors Act (S. 4860/H.R. 9232), all provisions related to establishing Medicare coverage for residential addiction treatment programs meeting nationally recognized standards. Language to expand NHSC allowable use of hours of service delivered outside clinic walls, all provisions related to expanding allowable use for hours of service.

Client expense: $154,891 · Firm income: Not reported

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

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531/S. 3393) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. CONNECT Act (H.R. 6928), all provisions related to awarding grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Mental Health Student Loan Forgiveness Act (H.R. 4933/S. 462), all provisions relating to expanding the Substance Use Disorder Treatment and Recovery Loan Repayment Program and expanding eligibility to include individuals who agree to work in mental health professional shortage areas for a period of time. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919), all provisions related to expanding access to fentanyl and xylazine test strips. H.R. 7545, all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. STAR Plus Scholarship Act (H.R. 9851), all provisions related to creating a scholarship program for substance use treatment providers. Community Mental Wellness Worker Training Act (H.R. 8680), all provisions related to creating a grant program for behavioral health organizations to train mental wellness workers in communities. Elementary and Secondary School Counseling Act (H.R. 8524/S. 4407), all provisions related to establishing five-year renewable grant programs to help elementary and secondary schools to hire additional school-based mental health providers such as counselors, psychologists and social workers. Kid PROOF Act of 2023 (H.R. 6663/S. 3364), all provisions related to allowing health care providers to purchase and distribute lethal means safety supplies for children at risk of overdose or suicide. Telehealth Access for Tribal Communities Act of 2024 (H.R. 9271), all sections related to expanding telehealth access for tribal communities. Campus Prevention and Recovery Services for Students Act of 2024 (H.R. 9214), all provisions related to helping higher education institutions implement programs to prevent alcohol and substance misuse on campus and support those with substance use disorders. Recognizing the Role of Direct Support Professionals Act (H.R. 2941/S. 1332), all provisions related to requiring the Office of Management and Budget to establish a separate category within the Standard Occupational Classification system for direct support professionals for data reporting purposes. 2025 Medicare Physician Fee Schedule Proposed Rule, submitted comments to the administration regarding proposed provisions related to mental health and substance use services under Medicare. 2025 Outpatient Prospective Payment System Proposed Rule, submitted comments to the administration regarding proposed provisions related to mental health and substance use services. Congressional RFI on Pay PCP Act, submitted comment in response to request for comment from Senators Cassidy and Whitehouse regarding Medicare primary care provider payment and the importance of integration with behavioral health care. Marijuana Rescheduling Proposed Rule, submitted comment to the DEA in response to the proposed rule recognizing the importance of research, substance use prevention, and access to care. Standard Occupational Classification (SOC) 2028 Update, signed on to an organization sign-on letter regarding peer support specialists under the OMB SOC manual update.

Client expense: $154,891 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

S. 3059 & H.R. 7708 - REAL Health Providers Act - MHA has lobbied in support of this bill, which would require Medicare Advantage plans to regularly verify their provider directories and would require CMS to establish an accuracy score for each MA plan's provider directory. S. 1378 & H.R. 5819 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care - MHA has lobbied in support of this bill, which would increase the reimbursement rates in Medicare for the behavioral health integration billing codes. S. 3498 & H.R. 6748 - Promoting Effective and Empowering Recovery Services in Medicare Act of 2023 - MHA has lobbied in support of this bill, which would establish reimbursement for peer support services at community mental health centers, rural health centers, federally qualified health centers, and certified community behavioral health clinics. S. 4338 - Pay PCPs Act - MHA has lobbied for modifications to this bill, which would establish a hybrid per-member-per-month payment structure in Medicare for primary care providers contingent upon them incorporating several treatment areas into their core practice function, including behavioral health integration. MHA has specifically lobbied for the hybrid payment structure to feature multiple tiers of payment, with the higher payment tiers corresponding with greater levels of behavioral health integration.

Client expense: $22,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Womens Health Protection Act Mental Health Workforce Shortages Meeting with various administrative agencies on expanding access to mental health care in rural areas Forthcoming House bill on capital investments in rural mental health Federal policies affecting access to contingency management services for substance use disorders H. R. 498 / S.1493, 9-8-8 Lifeline Cybersecurity Responsibility Act H.R. 501 Block, Report, And Suspend Suspicious Shipments Act H.R. 773/S. 3165, Homelessness and Behavioral Health Care Coordination Act of 2023 H.R. 1359/S. 644 Modernizing Opioid Treatment Access Act H.R. 1423 911 Community Crisis Responders Act of 2023 H.R. 1502 Comprehensive Opioid Recovery Centers Reauthorization Act of 2023 H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.2577/S.1137,DHS Suicide Prevention and Resiliency for Law Enforcement Act H.R. 3074/S. 971 The Due Process Continuity of Care Act HR 3305 Black Maternal Health Momnibus Act H.R. 3375 STOP Fentanyl Overdoses Act H.R. 3752 Parity Enforcement Act of 2023 H.R.4310/S.2233, Youth Poisoning Protection Act H.R. 4531 / S. 2433, SUPPORT for Patients and Communities Reauthorization Act of 2023 H.R. 4851, 9-8-8 Implementation Act of 2023 H.R. 4884 /S. 2476 Mental Health for Latinos Act of 2023 H.R.4974, Local 988 Response Act H.R. 5866, Substance Use Disorder and Family Engagement (SAFE) in Recovery Act H.R. 6284/S. 3260 Improving Measurements for Loneliness and Isolation Act of 2023 H.R. 6475 Health Disparity Zones Act of 2023 H.R.6928 CONNECT Act of 2024 H.R. 7301 Certified Community Behavioral Health Clinic Expansion Act of 2024 H.R. 8390 Mental Health and MAMA Act of 2024 H.R. 8503 Integrated Care for Dual Eligibles H.R. 9577 STOP Suicide Act S.669/H.R. 8458 Increasing Mental Health Options Act of 2023 S. 923 Better Mental Health Care for Americans Act S. 1378/ H.R 5819 COMPLETE Care Act S.2350, National Strategy for Social Connection Act Reintroduction of The Behavioral Health Coverage Transparency Act Reintroduction of The Parity Enforcement Act of 2023 H.R. 5804, The Mental Health Infrastructure Improvement Act Reintroduction of The Comprehensive Addiction Resources Emergency Act Reintroduction of The Stop Online Suicide Assistance Forums Act S.2511, the ADAPT Act S. 2688 / H.R. 5116, the Behavioral Health IT Coordination Act S. 2733, PEER Support Act H.R. 7808, EARLY Minds Act H.R. 6407 / S. 3297, Medical Nutrition Therapy Act S.3364, Kids Providing Resources for Optimal Outcomes Against Fatalities Act of 2024 (KID Proof Act) S.3085, Preventing Adverse Childhood Experiences Act (PACE Act) S. 3393 SUPPORT for Patients and Communities Reauthorization Act S.3498 Promoting Effective and Empowering Recovery Services in Medicare Act of 2023S. 3557 Public Health Impact of Opioid Drugs S. 3769, Alternative Pathways to Child Abuse Prevention Act S. 4312 United States Senate Commission on Mental Health Act of 2024 S. 4338 Pay PCPs Act of 2024 Dear Colleague letter to CMS re: coverage of digital therapeutics Reauthorization of the Older Americans Act Caregiving for older adults Title IV-B of the Social Security Act H.R. 3432/S. 3651, Telemental Health Care Access Act Mental Health Parity Final Rule Meeting with the Tri-Departments (DOL, HHS and Treasury) H.R 3312, S. 1602, Moms Matter Act S.4811, Prevention Services for Youth Act S.4812, Strengthening Supports for Youth Act H.R.9875, Child Safety and Well-Being Act Response to RFI re: 21st Century Cures 2.0 Response to RFI regarding regulation of cannabis and hemp products Research regarding the safety and efficacy of psychedelic-assisted therapy   Flexibility to prescribe certain controlled medications via telehealth for the treatment of mental health and substance use disorders Support of the proposed rule on georouting solutions for the 988 Suicide & Crisis Lifeline (988 Lifeline) Medicare coverage policies regarding mental health and substance use disorder services

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Faith-Based & Community Initiatives, Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Mental Health (mental health parity, mental health workforce, school-based behavioral services, caregivers of individuals with mental illness and caregiver mental health, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023), H.R.8702/S.4532 Improving Seniors Timely Access to Care Act)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Mental Health (mental health parity, mental health workforce, school-based behavioral services, H.R.7808 - Early Minds Act, S.4041 - CARE for Students Mental Health Act, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023, caregivers of individuals with mental illness and caregiver mental health including the Office of Caregiver Health, 988 suicide/crisis line georouting of calls), H.R.8702/S.4532 Improving Seniors Timely Access to Care Act)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Chronic Care Management Improvement Act of 2023 (H.R.2829) Removes cost-sharing responsibilities for CCM services under the Medicare program. Rural Health Innovation Act of 2023 (S.953 and H.R.1712) Creates grant programs under HRSA to expand urgent/triage care in rural communities (RHCs and FQHCs eligible); $500,000 for existing facilities and $750,000 for new facilities. Rural America Health Corps Act (S.940) Creates a loan repayment program called NHSC Rural Provider Loan Repayment Program; includes NPs and PAs as providers eligible for the program; specifically aimed at rotating graduates through underserved areas. Save Americas Rural Hospitals (H.R.833) Primarily hospital related but Sec.113 makes permanent Medicare telehealth in RHCs/FQHCs and allows for telehealth visits to be reimbursed at parity with in-person visits. Home-Based Telemental Health Care Act of 2023 (S.1077) Grant demonstration program through USDA for increasing mental health and substance abuse services in rural, medically underserved populations. Patients' Right to Know Their Medication Act of 2023 (H.R.1173) RPM Cost Sharing Elimination Study Act of 2023 (H.R.6801) Primary Care Team Education Centers Act Creates further investment in the establishment of clinical training sites for primary care providers. RHCs would be eligible entities for this funding. Improving Seniors Timely Access to Care Act Modernize Medicare Advantage prior authorization processes. Rural Residency Planning and Development Act of 2024 Officially authorizes the RRPD program that has been around since 2019. RHCs are eligible entities for participation in RRPD programs. Improving Measurements for Loneliness and Isolation Act of 2023 (H.R.6284) Create a working group within the Department of Health and Human Services tasked with developing standards to measure loneliness and isolation, with the goal of tackling this growing issue. Promoting Effective and Empowering Recovery Services Under the Medicare Program (H.R.6748/S.3498) Provides for Medicare coverage of peer support services as RHC services. Physical Therapist Workforce and Patient Access Act of 2023 (H.R.4829) Establishes physical therapy services as RHC services (reimbursable at RHC AIR) Rural Health Preceptor Tax Fairness Act (H.R.8738) Creates a $1,000 tax credit for health preceptors of various health professionals in rural areas.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare reimbursement for addiction counselors Medicare coverage for substance use disorder treatment services Consolidated Appropriations Act, 2023 implementation (S.923) Better Mental Health Care for Americans Act (H.R.2400/S.1165) Reentry Act (H.R. 1638/S. 838) Improving Access to Mental Health Act (S.3921/H.R. 4892) Medicaid Bump Act (H.R.6928) CONNECT Act of 2024 Gaps in substance use disorder services Issues surrounding peer support services (H.R. 6748/S. 3498) PEERS in Medicare Act Issues surrounding Medicare Part B (H.R. 9232/S. 4860) Residential Recovery for Seniors

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2016 HR. 4189: Connect for Health Act: expand the use of telehealth and remote patient monitoring services in Medicare, toward the goal of cost savings and quality care improvement. HR 4056 Ensuring Medicaid Continuity of Children in Foster Care Act: Ensuring that Medicaid is available for foster children who are placed in qualified residential treatment programs maintaining beneficiary access to the full range of available medications under Medicare Part D by protecting consumer access to Medicare Part D's Six Protected Classes Supporting new quality measures in Medicare's FY 2024 Inpatient psychiatric facility prospective payment system Objecting to new potential work requirements for Medicare and other public assistance programs H.R. 5510: Helping our patients for emotional and mental well-being Act. Requires coverage of 3 primary care visits without cost-sharing each year under the Medicare S. 2129: Ensuring Access to Lower-Cost Medicines for Seniors Act: To amend the Social Security Act to require PDP sponsors of a prescription drug plan and Medicare Advantage organizations offering an MA-PD plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary H.R. 4771 The CHIPP Act: permanently extend the Childrens Health Insurance Program S.838/H.R.1638: Improving Access to Mental Health Act: Increases the Medicare reimbursement rate for clinical social worker services. H.R. 4892 & S. 3921: Medicaid Bump Act: Increase Medicaid payments to certain providers H.R. 6748 & S. 3498: Peers IN Medicaid Act: requiring Medicare to cover peer support services at certain facilities S. 3892: Community Health Workers Access Act: Increase access to community health workers under the Medicare and Medicaid H.R. 8575 Michelle Go Act: Increase the number of inpatient beds that can be reimbursed under the IMD provision. H.R. 8487/S.3018 Improving Seniors Timely Access to Care Act: Reform prior authorization process in Medicare advantage plans H.R. 6748/S.3498 Peers In Medicare Act: Allows for Medicare reimbursement for peer supourt specialist

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

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

- Telehealth, reforming barriers to access to services. - Telemental Health Care Access Act, H.R. 3432/S. 3651 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act, S.3498/ H.R. 6748 - Coverage of peer support specialists services

Client expense: $82,011 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Extension of Medicare and Medicaid waivers beyond the COVID-19 public health emergency Medicare and Medicaid restrictions related to telehealth services Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures H.R. 704/S.260, Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 H.R. 3432/S. 3651, Telemental Health Care Access Act H.R. 6748/S. 3498, Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023 H.R. 7623/S. 3967, Telehealth Modernization Act H.R. 7711, Advancing Access to Telehealth Act S. 198, Rural Health Clinic Burden Reduction Act S. 2016/H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 S. 1586/H.R. 3623, Educating Future Nurses Act

Client expense: Not reported · Firm income: $27,400

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

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Extension of Medicare and Medicaid waivers beyond the COVID-19 public health emergency Medicare and Medicaid restrictions related to telehealth services Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures H.R. 704/S.260, Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 H.R. 3432/S. 3651, Telemental Health Care Access Act H.R. 3836, Medicaid Primary Care Improvement Act H.R. 5434/S. 3138, Stabilize Medicaid and CHIP Coverage Act H.R. 6683, Preserving Seniors Access to Physicians Act of 2023 H.R. 6748/S. 3498, Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023 H.R. 7623/S. 3967, Telehealth Modernization Act H.R. 7711, Advancing Access to Telehealth Act S. 198, Rural Health Clinic Burden Reduction Act S. 2016/H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 S. 1586/H.R. 3623, Educating Future Nurses Act

Client expense: Not reported · Firm income: $24,000

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

Increasing access to mental health and substance use treatment Mental health & substance use disorder workforce Modernizing Opioid Treatment Access Act (H.R. 1359/S.644) Federal funding for mental health and substance use programs, research and training Make Medicare telehealth flexibilities permanent Medicaid Bump Act (H.R. 4892/S. 3921) PEERS in Medicare Act (H.R. 6748 / S.3498) SUPPORT RX Act ( S.4429) Streamline utilization management protocols in Medicare; Improving Senior's Timely Access to Care Act (S. 4578)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3059 & H.R. 7708 - REAL Health Providers Act - MHA has lobbied in support of this bill, which would require Medicare Advantage plans to regularly verify their provider directories and would require CMS to establish an accuracy score for each MA plan's provider directory. S. 1378 & H.R. 5819 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care - MHA has lobbied in support of this bill, which would increase the reimbursement rates in Medicare for the behavioral health integration billing codes. S. 3498 & H.R. 6748 - Promoting Effective and Empowering Recovery Services in Medicare Act of 2023 - MHA has lobbied in support of this bill, which would establish reimbursement for peer support services at community mental health centers, rural health centers, federally qualified health centers, and certified community behavioral health clinics. S. 4338 - Pay PCPs Act - MHA has lobbied for modifications to this bill, which would establish a hybrid per-member-per-month payment structure in Medicare for primary care providers contingent upon them incorporating several treatment areas into their core practice function, including behavioral health integration. MHA has specifically lobbied for the hybrid payment structure to feature multiple tiers of payment, with the higher payment tiers corresponding with greater levels of behavioral health integration.

Client expense: $18,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Mental Health (mental health parity, mental health workforce, school-based behavioral services, H.R.7808 - Early Minds Act, S.4041 - CARE for Students Mental Health Act, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023, caregivers of individuals with mental illness and caregiver mental health including the Office of Caregiver Health, 988 suicide/crisis line georouting of calls)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Mental Health (mental health parity, mental health workforce, school-based behavioral services, caregivers of individuals with mental illness and caregiver mental health, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2016 HR. 4189: Connect for Health Act: expand the use of telehealth and remote patient monitoring services in Medicare, toward the goal of cost savings and quality care improvement. HR 4056 Ensuring Medicaid Continuity of Children in Foster Care Act: Ensuring that Medicaid is available for foster children who are placed in qualified residential treatment programs maintaining beneficiary access to the full range of available medications under Medicare Part D by protecting consumer access to Medicare Part D's Six Protected Classes Supporting new quality measures in Medicare's FY 2024 Inpatient psychiatric facility prospective payment system Objecting to new potential work requirements for Medicare and other public assistance programs H.R. 5510: Helping our patients for emotional and mental well-being Act. Requires coverage of 3 primary care visits without cost-sharing each year under the Medicare S. 2129: Ensuring Access to Lower-Cost Medicines for Seniors Act: To amend the Social Security Act to require PDP sponsors of a prescription drug plan and Medicare Advantage organizations offering an MA-PD plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary H.R. 4771 The CHIPP Act: permanently extend the Childrens Health Insurance Program S.838/H.R.1638: Improving Access to Mental Health Act: Increases the Medicare reimbursement rate for clinical social worker services. H.R. 4892 & S. 3921: Medicaid Bump Act: Increase Medicaid payments to certain providers H.R. 6748 & S. 3498: Peers IN Medicaid Act: requiring Medicare to cover peer support services at certain facilities S. 3892: Community Health Workers Access Act: Increase access to community health workers under the Medicare and Medicaid H.R. 8575 Michelle Go Act: Increase the number of inpatient beds that can be reimbursed under the IMD provision. H.R. 8487/S.3018 Improving Seniors Timely Access to Care Act: Reform prior authorization process in Medicare advantage plans H.R. 6748/S.3498 Peers In Medicare Act: Allows for Medicare reimbursement for peer supourt specialist

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

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

Medicare reimbursement for addiction counselors Medicare coverage for substance use disorder treatment services Consolidated Appropriations Act, 2023 implementation (S.923) Better Mental Health Care for Americans Act (H.R.2400/S.1165) Reentry Act (H.R. 1638/S. 838) Improving Access to Mental Health Act (S.3921/H.R. 4892) Medicaid Bump Act (H.R.6928) CONNECT Act of 2024 Gaps in substance use disorder services Issues surrounding peer support services (H.R. 6748/S. 3498) PEERS in Medicare Act Issues surrounding Medicare Part B

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

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

Ensuring Excellence in Mental Health Act (CCBHC 2.0) (S. 2993), all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. Mental Health Access Improvement Act (S. 828/H.R. 432), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 2400/S. 1165), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Due Process Continuity of Care Act (H.R. 3074/S. 971), all provisions related to the removal of the Medicaid coverage exclusion for inmates in custody pending disposition of charges. ADAPT Act (S.2511), all provisions related to allowing certain supervised psychology trainees to provide mental health services and bill Medicare, Medicaid and CHIP. PEERS in Medicare Act (H.R. 6748/S. 3498), all provisions related to creating a definition of peers in the Medicare program and making peer services reimbursable through Medicare in certain community-based settings. Ensuring Medicaid Continuity for Children in Foster Care Act of 2023 (H.R. 4056), all provisions relating to the allowance of Medicaid payment for services provided to children in foster care in residential treatment programs Language to expand NHSC allowable use of hours of service delivered outside clinic walls, all provisions related to expanding allowable use for hours of service.

Client expense: $149,440 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531/S. 3393) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. CONNECT Act (H.R. 6928), all provisions related to awarding grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Mental Health Student Loan Forgiveness Act (H.R. 4933/S. 462), all provisions relating to expanding the Substance Use Disorder Treatment and Recovery Loan Repayment Program and expanding eligibility to include individuals who agree to work in mental health professional shortage areas for a period of time. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919), all provisions related to expanding access to fentanyl and xylazine test strips. H.R. 7545, all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes.

Client expense: $149,440 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Womens Health Protection Act Mental Health Workforce Shortages Meeting with various administrative agencies on expanding access to mental health care in rural areas Forthcoming House bill on capital investments in rural mental health Federal policies affecting access to contingency management services for substance use disorders H. R. 498 / S.1493, 9-8-8 Lifeline Cybersecurity Responsibility Act H.R. 501 Block, Report, And Suspend Suspicious Shipments Act H.R. 773/S. 3165, Homelessness and Behavioral Health Care Coordination Act of 2023 H.R. 1359/S. 644 Modernizing Opioid Treatment Access Act H.R. 1423 911 Community Crisis Responders Act of 2023 H.R. 1502 Comprehensive Opioid Recovery Centers Reauthorization Act of 2023 H.R. 2400 The Reentry Act H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.2577/S.1137,DHS Suicide Prevention and Resiliency for Law Enforcement Act H.R. 3074/S. 971 The Due Process Continuity of Care Act HR 3305 Black Maternal Health Momnibus Act H.R. 3375 STOP Fentanyl Overdoses Act H.R. 3548 Pursuing Equity in Mental Health Act H.R. 3752 Parity Enforcement Act of 2023 H.R. 3759 Barriers to Suicide Act of 2023 H.R. 3850/S.3949 Pride in Mental Health Act H.R.4310/S.2233, Youth Poisoning Protection Act H.R. 4531 / S. 2433, SUPPORT for Patients and Communities Reauthorization Act of 2023 H.R. 4851, 9-8-8 Implementation Act of 2023 H.R. 4884 /S. 2476 Mental Health for Latinos Act of 2023 H.R.4974, Local 988 Response Act H.R. 5866, Substance Use Disorder and Family Engagement (SAFE) in Recovery Act H.R. 6284/S. 3260 Improving Measurements for Loneliness and Isolation Act of 2023 H.R. 6475 Health Disparity Zones Act of 2023 H.R.6928 CONNECT Act of 2024 H.R. 7301 Certified Community Behavioral Health Clinic Expansion Act of 2024 H.R. 8390 Mental Health and MAMA Act of 2024 H.R. 8503 Integrated Care for Dual Eligibles S.669/H.R. 8458 Increasing Mental Health Options Act of 2023 S. 923 Better Mental Health Care for Americans Act S. 1378/ H.R 5819 COMPLETE Care Act S. 1426/H.R. 4541 Rise from Trauma Act S.2350, National Strategy for Social Connection Act Reintroduction of The Behavioral Health Coverage Transparency Act Reintroduction of The Parity Enforcement Act of 2023 H.R. 5804, The Mental Health Infrastructure Improvement Act Reintroduction of The Comprehensive Addiction Resources Emergency Act Reintroduction of The Stop Online Suicide Assistance Forums Act S.2511, the ADAPT Act S. 2688 / H.R. 5116, the Behavioral Health IT Coordination Act S. 2733, PEER Support Act Response to Senator Bill Cassidy Request for Information re: patient data privacy Federal policies affecting the use of contingency management services for the treatment of stimulant use disorders H.R. 7808, EARLY Minds Act H.R. 6407 / S. 3297, Medical Nutrition Therapy Act S.3364, Kids Providing Resources for Optimal Outcomes Against Fatalities Act of 2024 (KID Proof Act) S.3085, Preventing Adverse Childhood Experiences Act (PACE Act) S. 3393 SUPPORT for Patients and Communities Reauthorization Act S.3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S.3498 Promoting Effective and Empowering Recovery Services in Medicare Act of 2023S. 3557 Public Health Impact of Opioid Drugs S. 3769, Alternative Pathways to Child Abuse Prevention Act S. 4312 United States Senate Commission on Mental Health Act of 2024 S. 4338 Pay PCPs Act of 2024 Dear Colleague letter to CMS re: coverage of digital therapeutics Reauthorization of the Older Americans Act Elder Justice Act Title IV-B of the Social Security Act H.R. 7432, Sickle Cell Comprehensive Care Act H.R. 3432/S. 3651, Telemental Health Care Access Act Congressional briefing on telehealth and H.R. 3432 Congressional briefing on caregiving and mental health Congressional Briefing on A Population Health Approach to Youth Substance Use Disorder Prevention Congressional Briefing on Caucus on the Commission on the Social Status of Black Men and Boys Mental Health Parity Final Rule Meeting with the Tri-Departments (DOL, HHS and Treasury) H.R. 2412, Helping Kids Cope Act H.R 3312, S. 1602, Moms Matter Act

Client expense: $500,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Faith-Based & Community Initiatives, Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of

- Telehealth, reforming barriers to Medicare reimbursement and access to services. CONNECT Act S. 2016/H.R. 4189 - Telemental Health Care Access Act, H.R. 3432/S. 3651 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act, S.3498/ H.R. 6748 - Coverage of peer support specialists services

Client expense: $49,451 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

S. 2016 HR. 4189: Connect for Health Act: expand the use of telehealth and remote patient monitoring services in Medicare, toward the goal of cost savings and quality care improvement. HR 4056 Ensuring Medicaid Continuity of Children in Foster Care Act: Ensuring that Medicaid is available for foster children who are placed in qualified residential treatment programs maintaining beneficiary access to the full range of available medications under Medicare Part D by protecting consumer access to Medicare Part D's Six Protected Classes Supporting new quality measures in Medicare's FY 2024 Inpatient psychiatric facility prospective payment system Objecting to new potential work requirements for Medicare and other public assistance programs H.R. 5510: Helping our patients for emotional and mental well-being Act. Requires coverage of 3 primary care visits without cost-sharing each year under the Medicare S. 2129: Ensuring Access to Lower-Cost Medicines for Seniors Act: To amend the Social Security Act to require PDP sponsors of a prescription drug plan and Medicare Advantage organizations offering an MA-PD plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary H.R. 4771 The CHIPP Act: permanently extend the Childrens Health Insurance Program S.838/H.R.1638: Improving Access to Mental Health Act: Increases the Medicare reimbursement rate for clinical social worker services. H.R. 4892 & S. 3921: Medicaid Bump Act: Increase Medicaid payments to certain providers H.R. 6748 & S. 3498: Peers IN Medicaid Act: requiring Medicare to cover peer support services at certain facilities S. 3892: Community Health Workers Access Act: Increase access to community health workers under the Medicare and Medicaid

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

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

Womens Health Protection Act Mental Health Workforce Shortages Coding and reimbursement for digital therapeutics devices (DTx) and services furnished via DTx Meeting with various administrative agencies on expanding access to mental health care in rural areas Forthcoming House bill on capital investments in rural mental health Federal policies affecting access to contingency management services for substance use disorders H. R. 498 / S.1493, 9-8-8 Lifeline Cybersecurity Responsibility Act H.R. 501 Block, Report, And Suspend Suspicious Shipments Act H.R. 773/S. 3165, Homelessness and Behavioral Health Care Coordination Act of 2023 H.R. 824, Telehealth Benefit Expansion for Workers Act H.R. 1359/S. 644 Modernizing Opioid Treatment Access Act H.R. 1423 911 Community Crisis Responders Act of 2023 H.R. 1502 Comprehensive Opioid Recovery Centers Reauthorization Act of 2023 H.R. 2400 The Reentry Act H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.2577/S.1137,DHS Suicide Prevention and Resiliency for Law Enforcement Act H.R. 3074/S. 971 The Due Process Continuity of Care Act HR 3305 Black Maternal Health Momnibus Act H.R. 3375 STOP Fentanyl Overdoses Act H.R. 3432/S. 3651 Telemental Health Care Access Act H.R. 3548 Pursuing Equity in Mental Health Act H.R. 3752 Parity Enforcement Act of 2023 H.R. 3759 Barriers to Suicide Act of 2023 H.R. 3850/S.3949 Pride in Mental Health Act H.R.4310/S.2233, Youth Poisoning Protection Act H.R. 4531 / S. 2433, SUPPORT for Patients and Communities Reauthorization Act of 2023 H.R. 4851, 9-8-8 Implementation Act of 2023 H.R. 4892, Medicaid Bump Act H.R. 4884 /S. 2476 Mental Health for Latinos Act of 2023 H.R.4974, Local 988 Response Act H.R. 5866, Substance Use Disorder and Family Engagement (SAFE) in Recovery Act H.R. 6284/S. 3260 Improving Measurements for Loneliness and Isolation Act of 2023 H.R. 6475 Health Disparity Zones Act of 2023 H.R.6928 CONNECT Act of 2024 S.669 Increasing Mental Health Options Act of 2023 S. 923 Better Mental Health Care for Americans Act S. 1378/ H.R 5819 COMPLETE Care Act S. 1426/H.R. 4541 Rise from Trauma Act S. 1736, Farmers First Act S. 2016 / H.R. 4189, CONNECT for Health Act S.2350, National Strategy for Social Connection Act Reintroduction of The Behavioral Health Coverage Transparency Act Reintroduction of The Parity Enforcement Act of 2023 H.R. 5804, The Mental Health Infrastructure Improvement Act Reintroduction of The Comprehensive Addiction Resources Emergency Act Reintroduction of The Stop Online Suicide Assistance Forums Act S.2511, the ADAPT Act S. 2688 / H.R. 5116, the Behavioral Health IT Coordination Act S. 2733, PEER Support Act H.R. 4736, the Investing in Rural America Act Response to Senator Bill Cassidy Request for Information re: patient data privacy Federal policies affecting the use of contingency management services for the treatment of stimulant use disorders H.R. 7808, EARLY Minds Act H.R. 6524 / S. 1077, Home-Based Telemental Health Care Act H.R. 6407 / S. 3297, Medical Nutrition Therapy Act S.3364, Kids Providing Resources for Optimal Outcomes Against Fatalities Act of 2024 (KID Proof Act) S.3085, Preventing Adverse Childhood Experiences Act (PACE Act) S. 3393 SUPPORT for Patients and Communities Reauthorization Act S.3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S.3498 Promoting Effective and Empowering Recovery Services in Medicare Act of 2023S. 3557 Public Health Impact of Opioid Drugs S. 3769, Alternative Pathways to Child Abuse Prevention Act H.R. 6487, No Fees for EFTs Act H.R. 3730/S. 198, Rural Health Clinic Burden Reduction Act H.R. 6407/S. 3297, Medical Nutrition Therapy Act Coalition letter to CMS opposing inclusion of HR 824 in funding package Meeting with CMS CIIO Office re: future rulemaking under the No Surprises Act Meeting with CMS and House/Senate offices re: coverage of digital therapeutics Reauthorization of the Older Americans Act Elder Justice Act Title IV-B of the Social Security Act H.R. 2762, the Tribal Family Fairness Act H.R. 3461, the Strengthening Tribal Families Act H.R. 2412, Helping Kids Cope Act H.R 3312, S. 1602, Moms Matter Act

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Faith-Based & Community Initiatives, Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of

Ensuring Excellence in Mental Health Act (CCBHC 2.0) (S. 2993), all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. Mental Health Access Improvement Act (S. 828/H.R. 432), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 2400/S. 1165), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Due Process Continuity of Care Act (H.R. 3074/S. 971), all provisions related to the removal of the Medicaid coverage exclusion for inmates in custody pending disposition of charges. ADAPT Act (S.2511), all provisions related to allowing certain supervised psychology trainees to provide mental health services and bill Medicare, Medicaid and CHIP. PEERS in Medicare Act (H.R. 6748/S. 3498), all provisions related to creating a definition of peers in the Medicare program and making peer services reimbursable through Medicare in certain community-based settings. Language to expand NHSC allowable use of hours of service delivered outside clinic walls, all provisions related to expanding allowable use for hours of service.

Client expense: $140,770 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531/S. 3393) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. CONNECT Act (H.R. 6928), all provisions related to awarding grants to certain crisis centers for providing follow-up care to individuals who receive suicide prevention and crisis intervention services. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Mental Health Student Loan Forgiveness Act (H.R. 4933/S. 462), all provisions relating to expanding the Substance Use Disorder Treatment and Recovery Loan Repayment Program and expanding eligibility to include individuals who agree to work in mental health professional shortage areas for a period of time. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919), all provisions related to expanding access to fentanyl and xylazine test strips. H.R. 7545, all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes.

Client expense: $140,770 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Federal Affairs lobbies for Teaching Health Centers; Nurse Corps; National Health Service Corps; 340B Drug Discount Program; Community Health Center Program Funding; Healthcare Workforce Programs; and Behavioral and mental health policies. This includes the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); the HEALTH Act of 2023 (H.R. 5611); the Promoting Effective and Empowering Recovery Services in Medicare Act (PEER Act) of 2023 (S. 3498); and the HEADS Up Act of 2023 (H.R. 3380).

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

CONNECT for Health Act of 2023 (H.R. 4189 / S. 2106), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2023 (H.R. 3432), all provisions related to ensuring coverage of mental health services furnished through telehealth. Modernizing Opioid Treatment Access Act of 2023 (H.R. 1359/S. 644), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 988 Implementation Act (H.R. 4851), all provisions related to authorizing and growing funding and support for the 988 suicide and crisis lifeline Protecting Kids on Social Media Act (H.R. 6149/S.1291), all provisions related to authorizing certain safeguards to protect mental health for children when using social media platforms Ryan Haight Act, all provisions related to the extension of COVID-19 telemedicine flexibilities for prescription of controlled medication The PEER Mental Health Act of 2023 (H.R. 2642 / S.3498), all provisions related to award grants to build capacity for peer support programs for individuals experiencing mental health and substance use challenges Helping Kids Cope Act of 2023 (H.R. 2412), all provisions related to awarding grants to build the capacity of the pediatric behavioral health services Strengthening Community Care Act of 2023 (H.R. 2559) all provisions related to reauthorization of the Community Health Center Fund for three years, ending in 2026. Improving Access to Mental Health Act (H.R.1638 / S.838), all provisions related to the incentivizing of mental health professionals to practice in Mental Health Professional Shortage areas. SUPPORT for Patients and Communities Reauthorization Act (H.R. 4531) all provisions relating to the continued bolstered funding for substance use disorder treatment and recovery. Local 9-8-8 Response Act (H.R. 4974 / S. 3444), all provisions relating to the continued bolstering of 9-8-8 crisis services and requiring that 9-8-8 calls be routed to their nearest call center as opposed to the call center matching the area code of the phone originating the call. Improving Mental Health and Wellness in Schools Act (H.R.3331/ S.754), all provisions related to expanding mental health education and health promotion in existing school education programs Kickstarting Innovative Demonstrations Supporting Health Act (H.R.3805/ S.1769), all provisions relating to improving the health and wellbeing of children by addressing nonmedical factors that determine health outcomes. Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act (S.1378), all provisions related to incentivizing primary care to implement integrated care models to improve access to behavioral health care treatments. Better Mental Health Care for Americans Act (S.923), all provisions relating to parity enforcement and improving access to mental health care for Medicare and Medicaid beneficiaries. Resident Physician Shortage Reduction Act (H.R.2389/ S.1302), all provisions relating to adding additional residency positions for improved access to behavioral health care in physician shortage areas as defined by SAMHSA Stop Overdose in Schools Act (H.R.5652), all provisions related to setting aside funds for opioid reversal agent administration training for schools and the expansion of opioid education programs in education. Mental Health Infrastructure Improvement Act of 2023 (H.R.5804), all provisions relating to authorizing the Secretary of Health and Human Services to make loans and loan guarantees for the betterment of pediatric and adult mental health and substance use treatment facilities. Advancing Lifesaving Efforts with Rapid Test strips for Communities Act ALERT Communities Act (S.2919) all provisions related to expanding access to fentanyl and xylazine test strips Regulatory Comments Submitted: o Requirements Related to the Mental Health Parity and Addiction Equity Act (RIN 1210-AC11) o Technical Release 2023-01P - Request for Comment on Proposed Relevant Data Requirements for Nonquantitative Treatment Limitations (NQTLs) Related to Network Composition and Enforcement Safe Harbor for Group Health Plans and Health Insurance Issuers Subject to the Mental Health Parity and Addiction Equity Act o Defining and Delimiting the Exemptions for Executive, Administrative, Professional, Outside Sales, and Computer Employees (RIN 1235-AA39) o Discrimination on the Basis of Disability in Health and Human Service Programs or Activities (RIN 0945-AA15) o Guidance for Grants and Agreements (Docket OMB-2023-0017)

Client expense: $107,704 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE