Value in Health Care Act of 2023

Physician payment issues (MEI, E/M Budget Neutrality, APMs, MIPS) including SFC white paper: Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B; Prior authorization in Medicare Advantage; HR 1770/S. 2477 Equitable Community Access to Pharmacist Services Act HR 766/S 144 Preventive Health Savings Act HR 618/ S 131 Improving Access to Workers' Compensation for Injured Federal Workers Act of 2023. S.1512 - CONNECT for Health Act of 2021 Monitoring PBM legislation - S. 1967 and S. 1038 H.R. 4822, Health Care Price Transparency Act of 2023; H.R. 2474, Strengthening Medicare for Patients and Providers Act; H.R. 3284, Providers and Payers COMPETE Act; S. 3503, Value in Healthcare Act; H.R. 10545, American Relief Act, 2025

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Enacting an annual, permanent inflationary payment update for Medicare physician payment that is tied to the Medicare Economic Index (MEI) (H.R. 2474); Budget Neutrality reforms (H.R. 6371); Overhaul of MACRAs Merit-based Incentive Payment System (No specific legislation 4rd Q 2024). Modifications to Alternative Payment Models (APM) (S. 3503/H.R. 5013). Support generally mitigating or stopping impending cut to the Medicare physician fee schedule conversion factor for CY2025. Support the Improving Seniors Timely Access to Care Act (H.R. 8702/S. 4532)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medical Economic Index (MEI) in the 2023 Physician Fee Schedule Rule; H.R. 2474, Strengthening Medicare for Patients and Providers Act; H.R. 3561, PATIENT Act of 2023; H.R. 3284, Providers and Payers COMPETE Act; H.R. 4822, Health Care Price Transparency Act of 2023; S. 3503, Value in Healthcare Act; SFC white paper entitled, Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B; Issues related to physician payment cuts; H.R. 1770/S. 2477, Equitable Community Access to Pharmacist Services Act; H.R. 10545, American Relief Act, 2025

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for the Hospital Inpatient Services Modernization Act of 2024 (S. 4350/H.R. 8260) Support for the Value in Health Care Act (H.R. 5013/S. 3503) Issues related to Physician Fee Schedule cuts. Issues related to Medicare COVID-19 Telehealth Waivers/Flexibilities.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for the Hospital Inpatient Services Modernization Act of 2024 (S. 4350/H.R. 8260) Support for the Value in Health Care Act (H.R. 5013/S. 3503) Outreach in support of emergency and trauma service access. Issues related to Medicare Physician Fee Schedule cuts. Issues related to Medicare COVID-19 Telehealth Waivers/Flexibilities.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6445, Medicare Audiology Access Improvement Act, all provisions S. 2377, Medicare Audiology Access Improvement Act, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, GOLD CARD Act, all provisions H.R. 2713, Improving Care and Access to Nurses (I CAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act, all provisions H.R. 6487, No Fees for EFTs Act, all provisions S. 3805, No Fees for EFTs Act, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 2630, Safe Step Act, all provisions S. 652, Safe Step Act, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 6371, Provider Reimbursement Stability Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all provisions H.R. 8702, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4532, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4935, Physician Fee Stabilization Act, all provisions H.R. 10073, Medicare Patient Access and Practice Stabilization Act of 2024, all provisions H.R. 7856, PREVENT DIABETES Act, all provisions H.R. 3838, Preventing Maternal Deaths Reauthorization Act of 2023, all provisions S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023, all provisions H.R. 8532, Connected MOM Act, all provisions S. 712, Connected MOM Act, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 8404, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions S. 4330, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, all provisions H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act, all provisions H.R. 3730, Rural Health Clinic Burden Reduction Act, all provisions H.R. 7279, Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act, all provisions H.R. 6230, Doctor Knows Best Act of 2023, all provisions H.R. 9572, Enhanced Enforcement of Health Coverage Act, all provisions H.R. 9001, Physician Led and Rural Access to Quality Care Act, all provisions S. 5218, Health Infrastructure Security and Accountability Act of 2024, all provisions S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions H.R. 9572, Enhanced Enforcement of Health Coverage Act, all provisions Supporting Health Moms and Babies Act/draft Fewer Burdens for Better Healthcare Act/draft Medicaid Primary Care Improvement Act/Senate draft Opioid Workforce Act of 2021/Senate draft Electronic clinical quality measures (eCQM) reporting/draft Medicare program: Medicare physician payment/2.83% cut for FY2025 Medicare program: Payment reform/Medicare Part B cuts Medicare program: Medicare Economic Index (MEI) inflation update Medicare program: Budget neutrality reforms Medicare program: Merit-based Incentive Payment System (MIPS) reforms and penalties Medicare program: G2211 inherent complexity codes Medicare program: Protecting Access to Medicare Act (PAMA 2014)/clinical lab cut reforms Medicare Program: Medicare Access and CHIP Reauthorization Act (MACRA) physician burdens Medicare program: Alternative Payment Models (APMs) Medicare program: Advanced APMs reporting requirements Medicare program: APMs for rural physicians Medicare program: Graduate Medical Education (GME) cap flexibility Medicare program: Physician-owned hospitals Medicare program: Telehealth Medicare program: Prior Authorization Medicare program: Site neutral payment Medicare program: Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Medicare program: Sunsetting of web interface Medicare program: Access to claims data Medicare program: Coding Medicare program: Accountable Care Organization (ACO)/APM/Medicare Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Physician burden Medicare program: Promoting Interoperability (PI) program Medicare program: Quality Payment Program Medicare program: Certified electronic health record technology and PI Medicare program: Shared Savings program Medicare program: Public Health Reporting and Data Exchange Medicare program: Patient engagement Medicare program: Medicare Advantage plans/Prior Authorization Medicare program: Physician-owned hospitals Medicare program: Medigap/modified community rating Medicare and Medicaid programs: Artificial intelligence Medicare and Medicaid programs: Substance use disorder Medicare and Medicaid programs: Cybersecurity/health care clearinghouses Medicare and Medicaid programs: Health IT Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: Mandatory models Medicaid and Medicare programs: Quality programs/physician choice Medicaid program: Maternal health Medicaid program: Maternal mortality

Client expense: $6,590,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE

H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 H.R. 1202 / S. 704 - Resident Education Deferred Interest (REDI) Act H.R. 2389 - Resident Physician Shortage Reduction Act of 2023 H.R. 2400 / S. 1165 - Reentry Act of 2023 H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 3073 / S. 1452 - Community Mental Wellness and Resilience Act H.R. 3432 / S. 3651 - Telemental Health Care Access Act of 2023 H.R. 3946/S. 1800 - FASD Respect Act H.R. 4189 / S. 2016 - CONNECT for Health Act of 2023 H.R. 4892 / S. 3921 - Medicaid Bump Act H.R. 4933 / S. 462 - Mental Health Professionals Workforce Shortage Loan Repayment Act H.R. 4942 / S. 665 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5116 / S. 2688 - Behavioral Health Information Technology (BHIT) Coordination Act H.R. 5819 / S. 1378 - COMPLETE Care Act H.R. 6683 - Preserving Seniors Access to Physicians Act of 2023 H.R. 7153 / S. 3679 - Dr. Lorna Breen Health Care Provider Protections Reauthorization Act H.R. 3305 / S. 1606 - Black Maternal Health Momnibus Act H.R. 3226 / S. 1573 - Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act of 2023 H.R. 3312 / S. 1602 - Moms Matter Act H.R. 3838 / S. 2415 - Preventing Maternal Deaths Reauthorization Act of 2023 H.R. 7024 - Tax Relief for American Families and Workers Act of 2024 H.R. 8458 / S. 669- Increasing Mental Health Options Act of 2024 H.R. 8543 / S. 2993 - To amend the Social Security Act and the Public Health Service Act to permanently authorize certified community behavioral health clinics, and for other purposes H.R. 8680 - To authorize the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, to award grants to train community mental wellness workers H.R. 8702/ S .4532 - To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans H.R.8767 - To amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases S. 1339 - Pharmacy Benefit Reform Manager Act H.R. 7891 / S. 1409 - Kids Online Safety Act H.R. 7890 / S. 1418 - Children and Teens Online Privacy Protection Act (COPPA 2.0) H.R. 4531 / S. 3106 - SUPPORT for Patients and Communities Reauthorization Act H.R. 6663 / S. 3364 - Kid PROOF Act of 2023 S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Health Extenders Act S. 3157 - More Behavioral Health Providers Act of 2023 H.R. 7619 / S. 3158 - Expand the Behavioral Health Workforce Now Act H.R.6928 - CONNECT Act of 2024 H.R.6961 / S. 3010 - Nutrition CARE Act of 2024 H.R. 6982 / S. 3579 - Gambling Addiction, Recovery, Investment, and Treatment Act H.R. 7050 - Substance Use Disorder Workforce Act of 2024 H.Res. 1089 / S.Res.567 - Health Workforce Well-being Day of Awareness Resolution S. 2556 - Improving Coordination and Access to Resources Equitably (CARE) for Youth Act H.R. 5408 / S. 2767 - SSI Savings Penalty Elimination Act H.R.7301 - Certified Community Behavioral Health Clinic Expansion Act of 2024 H.R. 7808 - EARLY Minds Act H.R. 7265 / S. 3779 - Child Suicide Prevention and Lethal Means Act S. 3638 - Dependent Controlled Substance Transparency Act H.R. 7265 / S. 3379 Child Suicide Prevention & Lethal Means Safety Act H.R.7708 - To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes H.R.8575 - Michelle Alyssa Go Act H.R. 7258 / S. 3968 - A bill to amend the Public Health Service Act to provide community-based training opportunities for medical students in rural areas and medically under-served communities, and for other purposes S.4023 - Behavioral Health Network and Directory Improvement Act S.4358 - Preventing and Treating Substance Use Disorders Among Older Adults Act Sent letter to the FDA on reducing the scope of the Clozapine REMS in preparation for the Joint Committees Meeting Meeting with FDA on continued Stimulant Shortage APA met with DOL, HHS, and Treasury to Discuss Parity APA sent letter to ONC on Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule Signed onto AMA letter on Medicare physician payment reform S.4935- Physician Fee Stabilization Act H.R. 6371 - the Provider Reimbursement Stability Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5013 / S. 3503 - Value in Health Care (VALUE) Act H.R. 1770 / S. 2477 - Equitable Community Access to Pharmacist Services Act. Signed AMA letter in opposition H.R.6664 / S. 4905- Innovation in Pediatric Drugs Act of 2023 H.R.9133 / S. 4835- The Primary and Behavioral Health Care Access Act H.R. 2630 / S. 652 - the Safe Step Act H.R. 9581 - STAR Plus Scholarship Act H.R. 8715 - NEST Act H.R. 9577- Stabilization to Prevent (STOP) Suicide Act H.R. 9656 - Career and Technical Education (CTE) Student Mental Health and Wellness Act S. 5146- Medical Graduate Investment Act of 2024 H.R. 9688 - Keep Kids Covered Act H.R. 9886/S.5271 - Broadening Utilization of Proven and Effective Treatment for Recovery Act H.R. 7858 - Telehealth Enhancement for Mental Health Act of 2024 Cover Our Care Act H.R. 3503 - NIH Clinical Trial Diversity Act of 2023 H.R. 9422 - Recovery Act H.R. 10073 - Medicare Patient Access and Practice Stabilization Act of 2024 H.R. 9457 - Transparent Telehealth Bills Act of 2024 H.R. 3838/S. 2415 - Preventing Maternal Deaths Reauthorization Act of 2023 S.5524 - Parity Enforcement Act of 2024 H.R. 10085 - Saving Lives on Campuses Act of 2024 H.R. 10280 - Strengthening Pathways to Health Professions Act

Client expense: $269,642 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

H.R. 10545: American Relief Act, 2025 H.R. 10445: Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 H.R. 5612: Prior Authorization Relief Act H.R. 10073: Medicare Patient Access and Practice Stabilization Act of 2024 H.R. 5013 & S.3503 - The Value in Health Care Act of 2023 H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 7665 & S. 3939: The ACO Assignment Improvement Act of 2024 S. 4338, the Pay PCPs Act H.R. 7623 & S. 3967, the Telehealth Modernization Act of 2024 H.R.8702 & S. 4532, the Improving Seniors Timely Access to Care Act Issues related to Medicare & Medicaid payment and regulations, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, Centers for Medicare and Medicaid Innovation model evaluation, alternative payment model incentives, and telehealth.

Client expense: $185,402 · Firm income: Not reported

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

Issues related to value-based health care, including the Medicare Shared Savings Program (MSSP) and the ACO Reach Program; Issues related to reforming physician payments and the Medicare Access and CHIP Reauthorization Act (MACRA) (PL 114-10); Issues related to Medicare Advantage; Issues related to H.R.5013/S.3503 - Value in Health Care Act; Issues related to the extension of Alternative Payment Model bonus payments, telehealth flexibilities, and physician reimbursement in H.R.10545 - American Relief Act of 2025 (PL 118-158); Issues related to Medicare payment demonstration projects.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to value-based health care; Issues related to reforming physician payments and the Medicare Access and CHIP Reauthorization Act (MACRA) (PL 114-10); Issues related to H.R.5013/S.3503 - Value in Health Care Act; Issues related to the extension of Alternative Payment Model bonus payments in H.R.10545 - American Relief Act of 2025 (PL 118-158); Issues related to Medicare payment demonstration projects.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 10545 American Relief Act HR 9572 Enhanced Enforcement of Health Care Coverage Act. Surprise billing reform. S 4532/HR 8702 Seniors Timely Access to Care Act - prior authorization reform HR 6371 Provider Reimbursement Stability Act of 2023 (Bucshon, Kelly) budget neutrality reform S 4935 Physician Fee Stabilization Act of 2024 (Welch, Boozman) Medicare budget neutrality reform S 3503/HR 5013 The Value in Health Care Act of 2023 (Lahood, Wenstrup) Extends the ACO Bonus + HR 8261 Preserving Telehealth, Hospital, and Ambulance Access to Care Act (Ways and Means Committee adopted) HR 7623 Telehealth Modernization Act of 2024 (Energy and Commerce Health Subcommittee adopted) S 2016/HR 4189 CONNECT for Health Act of 2023 (Telehealth) (Menendez, Boozman, Schumer, Collins/Thompson, Matsui) HR 4941 (Schiff) Providing Access to Treatment and Housing Act of 2023 (PATH Act) HR 4974 (Cardenas) Local 988 Response Act of 2023 Mental Health Hotline S 1339 (Sanders, Cassidy) PBM Reform Act HR 3784 Providers and Payers Compete Act

Client expense: $55,000 · Firm income: Not reported

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

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill H.R. 4283, Gun Violence Prevention and Community Safety Act Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 9001, Physician Led and Rural Access to Quality Care Act Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R. 4942/ S. 665, the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317MAMAS First Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act S. 4935, Physician Fee Stabilization Act H.R.10073, Medicare Patient Access and Practice Stabilization Act of 2024 H.R. 8816, the American Medical Innovation and Investment Act of 2024 H.R. 2474, the Strengthening Medicare for Patients and Providers Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill Issues related to Medicare Advantage - no specific bill Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act H.R.4189, the CONNECT for Health Act of 2023 H.R.7623, the Telehealth Modernization Act of 2024 H.R.1843, the Telehealth Expansion Act of 2023 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill H.R. 4283, Gun Violence Prevention and Community Safety Act Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 9001, Physician Led and Rural Access to Quality Care Act Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R. 4942/ S. 665, the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317MAMAS First Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act S. 4935, Physician Fee Stabilization Act H.R.10073, Medicare Patient Access and Practice Stabilization Act of 2024 H.R. 8816, the American Medical Innovation and Investment Act of 2024 H.R. 2474, the Strengthening Medicare for Patients and Providers Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill Issues related to Medicare Advantage - no specific bill Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Publications Open access to information based on publicly funded research - no specific bill Request for Information for NIH Plan to Enhance Public Access to the Results of NIH-Supported Research Issues related to scholarly and scientific publishing and public access - no specific bill H.R. 9378, Sunshine Act of 2023 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act H.R.4189, the CONNECT for Health Act of 2023 H.R.7623, the Telehealth Modernization Act of 2024 H.R.1843, the Telehealth Expansion Act of 2023 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Advocate for improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Advocate to replace scheduled and anticipated cuts in Medicare payments with positive, inflationary-based updates, eliminate the anticipated conversion factor cut in the CMS proposed rule for the 2024 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes. Support H.R.2474, Strengthening Medicare for Patients and Providers Act. Support H.R. 3674, the Providing Relief and Stability for Medicare Patients Act of 2023. Support the Resident Physician Shortage Reduction Act (S. 1302/H.R. 2389). Advocate regarding matters related to Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), and Qualified Clinical Data Registries. H.R. 5213, the Reducing Medically Unnecessary Delays in Care Act of 2023. H.R. 6445/S.2377, the Medicare Audiology Access Improvement Act of 2023. H.R. 6487/S.3805, the No Fees for EFTs Act. H.R. 6545, the Physician Fee Schedule Update and Improvements Act. H.R. 6683, the Preserving Seniors' Access to Physicians Act of 2023; Draft legislation, To amend title XVIII of the Social Security Act to transform the Merit-based Incentive Payment System into the Data-Driven Performance Payment System under the Medicare physician fee schedule, and for other purposes; H.R. 8702/S. 4532, the Improving Seniors Timely Access to Care Act; S. 3503/H.R. 5013, Value in Health Care Act; S. 4935, Physician Fee Stability Act; S. 2477/H.R. 1770, Equitable Community Access to Pharmacist Services Act; H.R. 10073, the Medicare Patient Access and Practice Stabilization Act of 2024; H.R. 10545, the American Relief Act, 2025

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

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

S 765/HR 1526: Reducing Hereditary Cancer Act of 2023- provide hereditary cancer genetic testing Increasing access to telehealth S 2016/HR 4189: CONNECT for Health Act- expands access to telehealth services Medicare physician payment reforms HR 2474: Strengthening Medicare for Patients and Providers Act- physician reimbursement HR 5013: Value in Health Care Act of 2023 - provides a multi-year commitment to reforming care delivery by extending MACRA's 5 percent advanced APM incentives for an additional two years. S 3503: Value in Health Care Act of 2023 - A bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other alternative payment arrangements to encourage participation in such program, and for other purposes HR 6371: Provider Reimbursement Stability Act of 2023 - To provide for certain adjustments to the physician fee schedule under the Medicare program. H.R. 6369: To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models - Extend incentive payments for participation in alternative payment models HR 3674: Providing Relief and Stability for Medicare Patients Act of 2023 - increase the nonfacility practice expense relative value units for specified services furnished under the Medicare program Reducing burdens caused by prior authorization requirements HR 4968: GOLD CARD Act of 2023 - exempt qualifying providers from prior authorization requirements under Medicare Advantage plans S 2372/HR 4758: Accelerating Kids' Access to Care Act - improve childrens access to needed out-of-state health care by streamlining Medicaid provider screening and enrollment processes. HR 6364: Medicare Telehealth Privacy Act of 2023 - To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program S 2764/HR 5391: Protecting Patient Access to Cancer and Complex Therapies Act of 2023 - ensures patients will be able to access critical medications and providers will be reimbursed fairly, unaffected by drug pricing negotiations between Medicare and drug manufacturers. S 2345/HR 4714: Pediatricians Accelerate Childhood Therapies Act of 2023 - requires the National Institutes of Health (NIH) to make awards to support early-career pediatric researchers. It also provides statutory authority for the NIH Pediatric Research Consortium to coordinate pediatric research across national health research institutions. S 3967/HR 7623: Telehealth Modernization Act of 2024 - permanently extends telehealth flexibilities for Medicare beneficiaries. S 4518/HR 8702: To Amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans - prior authorization HR 7384: Creating Hope Reauthorization Act of 2024 - This bill extends until FY2029 a Food and Drug Administration program that awards priority review vouchers to manufacturers of drugs that treat rare pediatric diseases. HR 8412: Clinical Trial Modernization Act - To modernize clinical trials and remove barriers for participation in clinical trials, and for other purposes. S 2407/HR 4818: Treat and Reduce Obesity Act of 2023 - Expands Medicare coverage of intensive behavioral therapy for obesity. HR 6545: Physician Fee Schedule Update and Improvements Act - To amend title XVIII of the Social Security Act to make improvements to the physician fee schedule under the Medicare program. HR 6683: Preserving Seniors' Access to Physicians Act of 2023 - This bill increases payments under the Medicare physician fee schedule for 2024. S 4935: Physician Fee Stabilization Act - A bill to amend title XVIII of the Social Security Act to update the budget neutrality threshold under the Medicare physician fee schedule. S. 4905: Innovation in Pediatric Drugs Act of 2024 - Ensure that children with rare diseases can benefit from new and innovative treatments. H.R. 6664: Innovation in Pediatric Drugs Act of 2023 - To encourage innovation in the development of pediatric drugs, and for other purposes. S. 4349: Electronic Prior Authorization for Prescription Drugs Act - A bill to require private health plans to provide for secure electronic transmission of prior authorization requests for prescription drugs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Incentivizing domestic manufacturing of critical medical supplies Issues related to health care costs and transparency Electronic prior authorization and administrative simplification Health care supply chain resiliency 340B Drug discount program Reauthorization of Pandemic and All Hazards Preparedness Act Hospital finance issues Healthcare workforce issues (graduate medical education, health professional training, recruitment and retention, minimum staffing requirements) Medicare payment policies Alternative payment models and related policies Medicare home infusion policy Reauthorization of Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act Expanding access to interoperable health tech in long term and post-acute care settings Maternal and infant health Health care workplace violence and worker safety S. 148 Stop STALLING Act S. 150 Affordable Prescriptions for Patients Act Medicaid Disproportionate Hospital Share cuts S. 2115, H.R. 4307 Medical Supply Chain Resiliency Act H.R. 4104, S. 1976 Preseving Patients Access to Home Infusion Act H.R. 2584, S. 2768 SAVE Act H.R. 3577 Medical and Health Stockpile Accountability Act H.R. 2665 Supporting Safety Net Hospitals Act H.R. 2389, S. 1302 Resident Physician Shortage Reduction Act H.R. 3346 IMPACT to Save Moms Act H.R. 5378 Lower Costs, More Transparency Act S. 2840 Bipartisan Primary Care and Health Workforce Act H.R. 5013, S. 3503 Value in Health Care Act H.R. 4942, S. 665 Conrad State 30 and Physician Access Reauthorization Act Artificial intelligence in healthcare H.R.766, S. 114 Preventive Health Savings Act H.R. 6205, S. 3211 Healthcare Workforce Resilience Act H.R. 7050 Substance Use Disorder Workforce Act H.R. 8702, S. 4532 Improving Seniors' Timely Access to Care Act H.R. 7855 Rural Residency Planning and Development Act

Client expense: $180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to value-based health care, including the Medicare Shared Savings Program (MSSP) and the ACO Reach Program; Issues related to reforming physician payments and the Medicare Access and CHIP Reauthorization Act (MACRA) (PL 114-1 0); Issues related to Medicare Advantage; Issues related to H.R.5013/S.3503 - Value in Health Care Act; Issues related to the extension of Alternative Payment Model bonus payments, telehealth flexibilities, and physician reimbursement in H.R.10545 - American Relief Act of 2025 (PL 118-158); issues related to Medicare payment demonstration projects.

Client expense: $110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment issues (MEI, E/M Budget Neutrality, APMs, MIPS) including SFC white paper: Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B; Prior authorization in Medicare Advantage; HR 1770/S. 2477 Equitable Community Access to Pharmacist Services Act HR 766/S 144 Preventive Health Savings Act HR 618/ S 131 Improving Access to Workers' Compensation for Injured Federal Workers Act of 2023. S.1512 - CONNECT for Health Act of 2021 Monitoring PBM legislation - S. 1967 and S. 1038 H.R. 4822, Health Care Price Transparency Act of 2023; H.R. 2474, Strengthening Medicare for Patients and Providers Act; H.R. 3561, PATIENT Act of 2023; H.R. 3284, Providers and Payers COMPETE Act; S. 3503, Value in Healthcare Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Enacting an annual, permanent inflationary payment update for Medicare physician payment that is tied to the Medicare Economic Index (MEI) (H.R. 2474); Budget Neutrality reforms (H.R. 6371); Overhaul of MACRAs Merit-based Incentive Payment System (No specific legislation 3rd Q 2024). Modifications to Alternative Payment Models (APM) (S. 3503/H.R. 5013). Support generally mitigating or stopping impending cut to the Medicare physician fee schedule conversion factor for CY2025.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Incentivizing domestic manufacturing of critical medical supplies Issues related to health care costs and transparency Electronic prior authorization and administrative simplification Health care supply chain resiliency 340B Drug discount program Reauthorization of Pandemic and All Hazards Preparedness Act Hospital finance issues Healthcare workforce issues (graduate medical education, health professional training, recruitment and retention, minimum staffing requirements) Medicare payment policies Alternative payment models and related policies Medicare home infusion policy Reauthorization of Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act Expanding access to interoperable health tech in long term and post-acute care settings Maternal and infant health Health care workplace violence and worker safety S. 148 Stop STALLING Act S. 150 Affordable Prescriptions for Patients Act Medicaid Disproportionate Hospital Share cuts S. 2115, H.R. 4307 Medical Supply Chain Resiliency Act H.R. 4104, S. 1976 Preseving Patients Access to Home Infusion Act H.R. 2584, S. 2768 SAVE Act H.R. 3577 Medical and Health Stockpile Accountability Act H.R. 2665 Supporting Safety Net Hospitals Act H.R. 2389, S. 1302 Resident Physician Shortage Reduction Act H.R. 3346 IMPACT to Save Moms Act H.R. 5378 Lower Costs, More Transparency Act S. 2840 Bipartisan Primary Care and Health Workforce Act H.R. 5013, S. 3503 Value in Health Care Act H.R. 4942, S. 665 Conrad State 30 and Physician Access Reauthorization Act Artificial intelligence in healthcare H.R.766, S. 114 Preventive Health Savings Act H.R. 6205, S. 3211 Healthcare Workforce Resilience Act H.R. 7050 Substance Use Disorder Workforce Act H.R. 8702, S. 4532 Improving Seniors' Timely Access to Care Act H.R. 7855 Rural Residency Planning and Development Act

Client expense: $173,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medical Economic Index (MEI) in the 2023 Physician Fee Schedule Rule; H.R. 2474, Strengthening Medicare for Patients and Providers Act; H.R. 3561, PATIENT Act of 2023; H.R. 3284, Providers and Payers COMPETE Act; H.R. 4822, Health Care Price Transparency Act of 2023; S. 3503, Value in Healthcare Act; SFC white paper entitled, Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B; Issues related to physician payment cuts; H.R. 1770/S. 2477, Equitable Community Access to Pharmacist Services Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6645, Medicare Audiology Access Improvement Act of 2023, all provisions S. 2377, Medicare Audiology Access Improvement Act of 2023, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions H.R. 8532, Connected MOM Act, all provisions S. 712, Connected MOM Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2023, all provisions H.R. 2713, Improving Care and Access to Nurses (I CAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023, all provisions H.R. 6487, No Fees for EFTs Act, all provisions S. 3805, No Fees for EFTs Act, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 830, Help Ensure Lower Patient (HELP) Copays Act, all provisions S. 1375, Help Ensure Lower Patient (HELP) Copays Act, all provisions H.R. 6371, Provider Reimbursement Stability Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all provisions H.R. 8702, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4532, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4518, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4935, Physician Fee Stabilization Act, all provisions H.R. 6366, To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program, all provisions H.R. 7463, Extension of Continuing Appropriations and Other Matters Act, 2024, provisions relating to Medicare payments H.R. 7931, Preserving Emergency Access in Key Sites (PEAKS) Act, all provisions S. 4338, Pay PCPs Act of 2024, all provisions H.R. 8563, Preserving Access To Care in Hawaii (PATCH) Act, all provisions S. 4395, Protecting Access To Care in Hawaii (PATCH) Act, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 7665, ACO Assignment Improvement Act of 2024, all provisions S. 3939, ACO Assignment Improvement Act of 2024, all provisions H.R. 8404, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions S. 4330, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions H.R. 4829, Physical Therapist Workforce and Patient Access Act of 2023, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, all provisions H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act, all provisions H.R. 3730, Rural Health Clinic Burden Reduction Act, all provisions H.R. 7279, Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act, all provisions H.R. 7708, Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act, all provisions S. 3508, Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act, all provisions H.R. 9001, Physician Led and Rural Access to Quality Care Act, all provisions S. 5218, A bill to amend titles XI and XVIII of the Social Security Act to strengthen, increase oversight of, and compliance with, security standards for health information, and for other purposes, all provisions S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions H.R. 8588, Linking Seniors to Needed Legal Services Act of 2024, all provisions H.R. 5526, Seniors Access to Critical Medications Act of 2024, all provisions H.R. 9129, Patient Debt Relief Act, all provisions Fewer Burdens for Better Care Act/draft MACRA/MIPS program reform legislation/draft FY 2025 Medicare physician payment increase/draft Medical Chaperones in Medicare/draft Medicare program: No Surprises Act implementation Medicare program: 21st Century Cures Act implementation Medicare program: FY 2025 Physician payment cut Medicare program: Information Blocking Disincentives Medicare program: Merit-based Incentive Payment System (MIPS) reform Medicare program: Medicare Economic Index (MEI) Medicare program: Medicare Access and CHIP Reauthorization Act (MACRA) reform Medicare program: Budget neutrality reforms/Inflationary update Medicare program: G2211 Inherent complexity code Medicare program: Protecting Access to Medicare Act (PAMA 2014) lab cut reform Medicare program: High-cost disposable services payment Medicare program: Medicare Administrative Contractor/local-coverage determinations Medicare program: Making Care Primary alternative payment models (APM) Medicare program: Rural physicians APM Medicare program: Site neutral payment Medicare program: Physician-owned hospitals Medicare program: Graduate Medical Education (GME) funding Medicare program: Audio-visual supervision of residents/permanent expansion Medicare program: Conditions of Participation (COP)/Obstetrical service Medicare program: MACRA/physician burdens Medicare program: Health Information Technology/physician burdens Medicare program: Prior authorization/Medicare Advantage plans Medicare program: Interoperability/data sharing/information blocking/provider disincentives Medicare program: Promoting interoperability reporting Medicare program: Trusted exchange framework/common agreement Medicare program: Data segmentation Medicare program: Quality payment program Medicare program: Medicare Shared Savings Program/Advanced APM Medicare program: Public health reporting and data exchange Medicare program: Accountable Care Organizations/APM flexibilities Medicare program: Certified Electronic Health Record (EHR) Technology Medicare program: Physician Practice Information (PPI) survey/practice expense Medicare program: MIPS Value Pathways (MVPs)/APMs Medicare program: Telehealth flexibilities Medicare and Medicaid programs: Data Privacy and Cybersecurity Medicare and Medicaid programs: Health Insurance Portability and Accountability Act (HIPAA)/electronic records

Client expense: $5,330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)

H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 H.R. 1202 / S. 704 - Resident Education Deferred Interest (REDI) Act H.R. 2389 - Resident Physician Shortage Reduction Act of 2023 H.R. 2400 / S. 1165 - Reentry Act of 2023 H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 3073 / S. 1452 - Community Mental Wellness and Resilience Act H.R. 3432 / S. 3651 - Telemental Health Care Access Act of 2023 H.R. 3946/S. 1800 - FASD Respect Act H.R. 4189 / S. 2016 - CONNECT for Health Act of 2023 H.R. 4892 / S. 3921 - Medicaid Bump Act H.R. 4933 / S. 462 - Mental Health Professionals Workforce Shortage Loan Repayment Act H.R. 4942 / S. 665 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5116 / S. 2688 - Behavioral Health Information Technology (BHIT) Coordination Act H.R. 5819 / S. 1378 - COMPLETE Care Act H.R. 6683 - Preserving Seniors Access to Physicians Act of 2023 H.R. 7153 / S. 3679 - Dr. Lorna Breen Health Care Provider Protections Reauthorization Act H.R. 3305 / S. 1606 - Black Maternal Health Momnibus Act H.R. 3226 / S. 1573 - Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act of 2023 H.R. 3312 / S. 1602 - Moms Matter Act H.R. 3838 / S. 2415 - Preventing Maternal Deaths Reauthorization Act of 2023 H.R. 7024 - Tax Relief for American Families and Workers Act of 2024 H.R. 8458 / S. 669- Increasing Mental Health Options Act of 2024 H.R. 8543 / S. 2993 - To amend the Social Security Act and the Public Health Service Act to permanently authorize certified community behavioral health clinics, and for other purposes H.R. 8680 - To authorize the Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use, to award grants to train community mental wellness workers H.R. 8702/ S .4532 - To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans H.R.8767 - To amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases S. 1339 - Pharmacy Benefit Reform Manager Act H.R. 7891 / S. 1409 - Kids Online Safety Act H.R. 7890 / S. 1418 - Children and Teens Online Privacy Protection Act (COPPA 2.0) H.R. 4531 / S. 3106 - SUPPORT for Patients and Communities Reauthorization Act H.R. 6663 / S. 3364 - Kid PROOF Act of 2023 S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Health Extenders Act S. 3157 - More Behavioral Health Providers Act of 2023 H.R. 7619 / S. 3158 - Expand the Behavioral Health Workforce Now Act H.R.6928 - CONNECT Act of 2024 H.R.6961 / S. 3010 - Nutrition CARE Act of 2024 H.R. 6982 / S. 3579 - Gambling Addiction, Recovery, Investment, and Treatment Act H.R. 7050 - Substance Use Disorder Workforce Act of 2024 H.Res. 1089 / S.Res.567 - Health Workforce Well-being Day of Awareness Resolution S. 2556 - Improving Coordination and Access to Resources Equitably (CARE) for Youth Act H.R. 5408 / S. 2767 - SSI Savings Penalty Elimination Act H.R.7301 - Certified Community Behavioral Health Clinic Expansion Act of 2024 H.R. 7808 - EARLY Minds Act H.R. 7265 / S. 3779 - Child Suicide Prevention and Lethal Means Act S. 3638 - Dependent Controlled Substance Transparency Act H.R. 7265 / S. 3379 Child Suicide Prevention & Lethal Means Safety Act H.R.7708 - To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes H.R.8575 - Michelle Alyssa Go Act H.R. 7258 / S. 3968 - A bill to amend the Public Health Service Act to provide community-based training opportunities for medical students in rural areas and medically under-served communities, and for other purposes S.4023 - Behavioral Health Network and Directory Improvement Act S.4358 - Preventing and Treating Substance Use Disorders Among Older Adults Act APA engaged with SAMHSA on Harm Reduction strategies and agency framework Sent letter to the FDA on the planning of the Clozapine REMS re-evaluation meeting FDA engagement through APAs involvement with the FDA Total Product Life Cycle Advisory Program Meeting with SAMHSA and FDA on continued Stimulant Shortage APA met with DOL, HHS, and Treasury to Discuss Parity APA meeting with ONC on priorities impacting Mental Health Integration and AI APA meeting with CDC on workplace mental health and wellness Signed onto AMA letter on Medicare physician payment reform S.4935- Physician Fee Stabilization Act H.R. 6371 - the Provider Reimbursement Stability Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5013 / S. 3503 - Value in Health Care (VALUE) Act H.R. 1770 / S. 2477 - Equitable Community Access to Pharmacist Services Act. Signed AMA letter in opposition H.R.6664 / S. 4905- Innovation in Pediatric Drugs Act of 2023 H.R.9133 / S. 4835- The Primary and Behavioral Health Care Access Act H.R. 2630 / S. 652 - the Safe Step Act H.R. 9581 - STAR Plus Scholarship Act H.R. 8715 - NEST Act H.R. 9577- Stabilization to Prevent (STOP) Suicide Act H.R. 9656 - Career and Technical Education (CTE) Student Mental Health and Wellness Act S. 5146- Medical Graduate Investment Act of 2024 H.R. 9688 - Keep Kids Covered Act

Client expense: $244,222 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill S. 1655/H.R. 3421, Medicare for All Act of 2023 H.R. 9001, Physician Led and Rural Access to Quality Care Act Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act H.R. 2389 The Resident Physician Shortage Reduction Act H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R. 4942/ S. 665, the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign H.R. 2389 The Resident Physician Shortage Reduction Act Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317MAMAS First Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act S. 4935, Physician Fee Stabilization Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill Issues related to Medicare Advantage - no specific bill Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Issues related to scholarly and scientific publishing and public access - no specific bill H.R. 9378, Sunshine Act of 2023 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act H.R. 4189/S.2016 the CONNECT for Health Act and H.R.7623/S.3967 the Telehealth Modernization Act Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident File Code CMS-1807-P. Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health Program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill H.R. 4283, Gun Violence Prevention and Community Safety Act Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill S. 1655/H.R. 3421, Medicare for All Act of 2023 H.R. 9001, Physician Led and Rural Access to Quality Care Act Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act H.R. 2389 The Resident Physician Shortage Reduction Act H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R. 4942/ S. 665, the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign H.R. 2389 The Resident Physician Shortage Reduction Act Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317MAMAS First Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act S. 4935, Physician Fee Stabilization Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill Issues related to Medicare Advantage - no specific bill Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Publications Open access to information based on publicly funded research - no specific bill Request for Information for NIH Plan to Enhance Public Access to the Results of NIH-Supported Research Issues related to scholarly and scientific publishing and public access - no specific bill H.R. 9378, Sunshine Act of 2023 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act H.R. 4189/S.2016 the CONNECT for Health Act and H.R.7623/S.3967 the Telehealth Modernization Act Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident File Code CMS-1807-P. Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health Program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)

7/10/2024: Sign-on letter to Chair and Ranking Member of Senate Committee on Appropriations, Subcommittee on State, Foreign Operations, and Related Programs in support on $10 million for Neglected Surgical Conditions for FY2025. Outlines health and longevity benefits of supporting surgical interventions through low-and-middle-income counties (LMICs). 7/23/2024: Sign-on letter to House Speaker, House Minority Leader, Senate Majority Leader, and Senate Minority Leader in opposition to the Equitable Community Access to Pharmacist Services Act (H.R. 1770/S. 2477); includes issues related to scope of practice, patient care, physician education and training, and the CBO scoring system. 7/24/2024:Sign-on letter to House Speaker, House Minority Leader, Senate Majority Leader, and Senate Minority Leader in support of the Strengthening Medicare for Patients and Providers Act (H.R. 2474), the Provider Reimbursement Stability Act (H.R. 6371), and the Value in Health Care (VALUE) Act (H.R. 5013/S.3503); issues related to the Medicare Access and CHIP Reauthorization Act (MACRA), inflationary updates to the Medicare Physician Fee Schedule, reforms to budget neutrality laws, reforms to MACRA's Merit-based Incentive Payment System (MIPS), and changes to Alternative Payment Models (APMs). 9/4/2024: Letter to Sens. Boozman, Welch, Tillis, King, Marshall, and Shaheen in support of the Physician Fee Stabilization Act (S. 4935); issues related to the Medicare Physician Fee Schedule and the Medicare Economic Index. 9/10/2024: Sign-on letter to House Speaker, House Minority Leader, Senate Majority Leader, and Senate Minority Leader in support of the Strengthening Medicare for Patients and Providers Act (H.R. 2474), the Provider Reimbursement Stability Act (H.R. 6371), and the Physician Fee Stabilization Act (S. 4935); issues related to the Medicare physician payment system and inflationary impacts on the Medicare Physician Fee Schedule. Issues pertaining to Medicare allergy verification, the Penicillin Allergy Verification and Evaluation Act of 2024 (H.R. 9778), and in general. Issues pertaining to the budget and appropriations, in general.

Client expense: $280,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

7/24/2024: Sign-on letter to House Speaker, House Minority Leader, Senate Majority Leader, and Senate Minority Leader in support of the Strengthening Medicare for Patients and Providers Act (H.R. 2474), the Provider Reimbursement Stability Act (H.R. 6371), and the Value in Health Care (VALUE) Act (H.R. 5013/S.3503); issues related to the Medicare Access and CHIP Reauthorization Act (MACRA), inflationary updates to the Medicare Physician Fee Schedule, reforms to budget neutrality laws, reforms to MACRA's Merit-based Incentive Payment System (MIPS), and changes to Alternative Payment Models (APMs). 9/4/2024: Letter to Sens. Boozman, Welch, Tillis, King, Marshall, and Shaheen in support of the Physician Fee Stabilization Act (S. 4935); issues related to the Medicare Physician Fee Schedule and the Medicare Economic Index. 9/10/2024: Sign-on letter to House Speaker, House Minority Leader, Senate Majority Leader, and Senate Minority Leader in support of the Strengthening Medicare for Patients and Providers Act (H.R. 2474), the Provider Reimbursement Stability Act (H.R. 6371), and the Physician Fee Stabilization Act (S. 4935); issues related to the Medicare physician payment system and inflationary impacts on the Medicare Physician Fee Schedule. Issues pertaining to Medicare allergy verification, the Penicillin Allergy Verification and Evaluation Act of 2024 (H.R. 9778), and in general. Issues related to hearing healthcare, in general. Issues pertaining to step therapy, in general. Issues pertaining to health information technology and electronic health records, in general. Issues pertaining to Graduate Medical Education, in general. Issues pertaining to healthcare liability reform, in general

Client expense: $280,000 · Firm income: Not reported

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

7/10/2024: Sign-on letter to Chair and Ranking Member of Senate Committee on Appropriations, Subcommittee on State, Foreign Operations, and Related Programs in support on $10 million for Neglected Surgical Conditions for FY2025. Outlines health and longevity benefits of supporting surgical interventions through low-and-middle-income counties (LMICs). 7/23/2024: Sign-on letter to House Speaker, House Minority Leader, Senate Majority Leader, and Senate Minority Leader in opposition to the Equitable Community Access to Pharmacist Services Act (H.R. 1770/S. 2477); includes issues related to scope of practice, patient care, physician education and training, and the CBO scoring system. 7/24/2024: Sign-on letter to House Speaker, House Minority Leader, Senate Majority Leader, and Senate Minority Leader in support of the Strengthening Medicare for Patients and Providers Act (H.R. 2474), the Provider Reimbursement Stability Act (H.R. 6371), and the Value in Health Care (VALUE) Act (H.R. 5013/S.3503); issues related to the Medicare Access and CHIP Reauthorization Act (MACRA), inflationary updates to the Medicare Physician Fee Schedule, reforms to budget neutrality laws, reforms to MACRA's Merit-based Incentive Payment System (MIPS), and changes to Alternative Payment Models (APMs). 7/29/2024: Letter to Reps. Burgess, Cardenas, Griffith, and Gonzalez in support of the Physician Led and Rural Access to Quality Care Act (H.R. 9001); issues related to patient access to care, healthcare innovation and competition, and physician ownership of healthcare facilities. 8/21/2024: Coalition letter to Director of the Division of Services for Children with Special Health Needs at the Maternal and Child Health Bureau of the HRSA regarding changes to the funding structure of state Early Hearing Detection Intervention (EHDI) programs. Letter urges Director to ensure new structure ensures continued excellence and supports stated aims to improve children lost to follow-up (LTF) in these programs, screen three-year-olds, utilize new gene therapies, meet existing benchmark for referrals, and other quality metrics. 9/4/2024: Letter to Sens. Boozman, Welch, Tillis, King, Marshall, and Shaheen in support of the Physician Fee Stabilization Act (S. 4935); issues related to the Medicare Physician Fee Schedule and the Medicare Economic Index. 9/10/2024: Sign-on letter to House Speaker, House Minority Leader, Senate Majority Leader, and Senate Minority Leader in support of the Strengthening Medicare for Patients and Providers Act (H.R. 2474), the Provider Reimbursement Stability Act (H.R. 6371), and the Physician Fee Stabilization Act (S. 4935); issues related to the Medicare physician payment system and inflationary impacts on the Medicare Physician Fee Schedule. 9/13/2024: Sign-on letter to Congress in support of the Physician Led and Rural Access to Quality Care Act (H.R. 9001); issues related to physician ownership of hospitals in needy areas and rural access to quality healthcare services. Issues related to hearing healthcare, in general. Issues pertaining to health information technology and electronic health records, in general. Issues pertaining to Graduate Medical Education, in general. Issues pertaining to healthcare liability reform, in general. Issues pertaining to prior authorization, the Improving Seniors Timely Access to Care Act (S. 4532 /H.R. 8702), and in general. Issues pertaining to Medicare physician reimbursement, related to the Strengthening Medicare for Patients and Providers Act (H.R. 2474) and the Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683), and in general. Issues pertaining to Medicare allergy verification, the Penicillin Allergy Verification and Evaluation Act of 2024 (H.R. 9778), and in general.

Client expense: $280,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

S 765/HR 1526: Reducing Hereditary Cancer Act of 2023- provide hereditary cancer genetic testing Increasing access to telehealth S 2016/HR 4189: CONNECT for Health Act- expands access to telehealth services Medicare physician payment reforms HR 2474: Strengthening Medicare for Patients and Providers Act- physician reimbursement HR 5013: Value in Health Care Act of 2023 - provides a multi-year commitment to reforming care delivery by extending MACRA's 5 percent advanced APM incentives for an additional two years. S 3503: Value in Health Care Act of 2023 - A bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other alternative payment arrangements to encourage participation in such program, and for other purposes HR 6371: Provider Reimbursement Stability Act of 2023 - To provide for certain adjustments to the physician fee schedule under the Medicare program. H.R. 6369: To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models - Extend incentive payments for participation in alternative payment models HR 3674: Providing Relief and Stability for Medicare Patients Act of 2023 - increase the nonfacility practice expense relative value units for specified services furnished under the Medicare program Reducing burdens caused by prior authorization requirements HR 4968: GOLD CARD Act of 2023 - exempt qualifying providers from prior authorization requirements under Medicare Advantage plans S 2372/HR 4758: Accelerating Kids' Access to Care Act - improve childrens access to needed out-of-state health care by streamlining Medicaid provider screening and enrollment processes. HR 6364: Medicare Telehealth Privacy Act of 2023 - To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program S 2764/HR 5391: Protecting Patient Access to Cancer and Complex Therapies Act of 2023 - ensures patients will be able to access critical medications and providers will be reimbursed fairly, unaffected by drug pricing negotiations between Medicare and drug manufacturers. S 2345/HR 4714: Pediatricians Accelerate Childhood Therapies Act of 2023 - requires the National Institutes of Health (NIH) to make awards to support early-career pediatric researchers. It also provides statutory authority for the NIH Pediatric Research Consortium to coordinate pediatric research across national health research institutions. S 3967/HR 7623: Telehealth Modernization Act of 2024 - permanently extends telehealth flexibilities for Medicare beneficiaries. S 4518/HR 8702: To Amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans - prior authorization HR 7384: Creating Hope Reauthorization Act of 2024 - This bill extends until FY2029 a Food and Drug Administration program that awards priority review vouchers to manufacturers of drugs that treat rare pediatric diseases. HR 8412: Clinical Trial Modernization Act - To modernize clinical trials and remove barriers for participation in clinical trials, and for other purposes. S 2407/HR 4818: Treat and Reduce Obesity Act of 2023 - Expands Medicare coverage of intensive behavioral therapy for obesity. HR 6545: Physician Fee Schedule Update and Improvements Act - To amend title XVIII of the Social Security Act to make improvements to the physician fee schedule under the Medicare program. HR 6683: Preserving Seniors' Access to Physicians Act of 2023 - This bill increases payments under the Medicare physician fee schedule for 2024. S 4935: Physician Fee Stabilization Act - A bill to amend title XVIII of the Social Security Act to update the budget neutrality threshold under the Medicare physician fee schedule.

Client expense: $120,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Advocate for improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Advocate to replace scheduled and anticipated cuts in Medicare payments with positive, inflationary-based updates, eliminate the anticipated conversion factor cut in the CMS proposed rule for the 2024 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes. Support H.R.2474, Strengthening Medicare for Patients and Providers Act. Support H.R. 3674, the Providing Relief and Stability for Medicare Patients Act of 2023. Support the Resident Physician Shortage Reduction Act (S. 1302/H.R. 2389). Advocate regarding matters related to Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), and Qualified Clinical Data Registries. H.R. 5213, the Reducing Medically Unnecessary Delays in Care Act of 2023. H.R. 6445/S.2377, the Medicare Audiology Access Improvement Act of 2023. H.R. 6487/S.3805, the No Fees for EFTs Act. H.R. 6545, the Physician Fee Schedule Update and Improvements Act. H.R. 6683, the Preserving Seniors' Access to Physicians Act of 2023; Draft legislation, To amend title XVIII of the Social Security Act to transform the Merit-based Incentive Payment System into the Data-Driven Performance Payment System under the Medicare physician fee schedule, and for other purposes; H.R. 8702/S. 4532, the Improving Seniors Timely Access to Care Act; S. 3503/H.R. 5013, Value in Health Care Act; S. 4935, Physician Fee Stability Act; S. 2477/H.R. 1770, Equitable Community Access to Pharmacist Services Act

Client expense: $1,060,000 · Firm income: Not reported

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

- Urging the House Ways and Means Committee to support immediate passage of the bipartisan No Fees for EFTs Act HR 6487 that would prohibit payers from imposing fees on electronic funds transfers. - Urging Senate to seek legislation that provides a positive, stable, and predictable Medicare physician payment system. - Opposition to H.R. 1770/S. 2477, the Equitable Community Access to Pharmacist Services Act. This bill would inappropriately allow pharmacists to perform services that would otherwise be covered if they had been furnished by a physician, test and treat patients for certain illnesses and expand Medicare payment for pharmacists in limited but significant ways. - Congress should pass H.R. 6371 to achieve greater stability and predictability to the MPFS. - Congress should consider enacting S.3503/H.R. 5013, the Value in Health Care (VALUE) Act, bipartisan legislation that extends the original five percent APM incentive payments and freezes the 50 percent revenue threshold for an additional two years. - Support the Strengthening Medicare for Patients and Providers Act (HR 2474) which would be significant and needed progress toward a more viable Medicare payment system as it provides independent physician practices with greater financial stability and predictability.

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

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

Issues related to value-based health care, including the Medicare Shared Savings Program (MSSP) and the ACO Reach Program; Issues related to reforming physician payments and the Medicare Access and CHIP Reauthorization Act (MACRA) (PL 114-1 0); Issues related to Medicare Advantage; Issues related to H.R.5013/S.3503 - Value in Health Care Act. Issues related to the extension of Alternative Payment Model bonus payments; issues related to telehealth Medicare flexibilities; issues related to the Pay PCPs Act S. 4338.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5013 & S.3503 - The Value in Health Care Act of 2023 H.R. 2829 - Chronic Care Management Improvement Act of 2023 H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 7665 & S. 3939: The ACO Assignment Improvement Act of 2024 S. 4338, the Pay PCPs Act H.R. 7623 & S. 3967, the Telehealth Modernization Act of 2024 H.R.8702 & S. 4532, the Improving Seniors Timely Access to Care Act Issues related to Medicare & Medicaid payment and regulations, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, Centers for Medicare and Medicaid Innovation model evaluation, alternative payment model incentives, and telehealth.

Client expense: $129,480 · Firm income: Not reported

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

Issues related to value-based health care, including the Medicare Shared Savings Program (MSSP) and the ACO Reach Program; Issues related to reforming physician payments and the Medicare Access and CHIP Reauthorization Act (MACRA) (PL 114-10); Issues related to Medicare Advantage; Issues related to H.R.5013/S.3503 - Value in Health Care Act. Issues related to the extension of Alternative Payment Model bonus payments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to value-based health care; Issues related to reforming physician payments and the Medicare Access and CHIP Reauthorization Act (MACRA) (PL 114-10); Issues related to H.R.5013/S.3503 - Value in Health Care Act; Issues related to the extension of Alternative Payment Model bonus payments. Issues related to Medicare payment demonstration projects.

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

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

Issues related to value-based health care; Issues related to reforming physician payments and the Medicare Access and CHIP Reauthorization Act (MACRA) (PL 114-10); Issues related to H.R.5013/S.3503 - Value in Health Care Act; Issues related to the extension of Alternative Payment Model bonus payments. Issues related to Medicare payment demonstration projects.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

CMA/ACEP Letter to California Congressional Delegation regarding Aetnas Claim and Code Review program S 4532/HR 8702 Seniors Timely Access to Care Act - prior authorization reform S 3503/HR 5013 The Value in Health Care Act of 2023 (Lahood, Wenstrup) Extends the ACO Bonus + HR 8261 Preserving Telehealth, Hospital, and Ambulance Access to Care Act (Ways and Means Committee adopted) HR 7623 Telehealth Modernization Act of 2024 (Energy and Commerce Health Subcommittee adopted) S 2016/HR 4189 CONNECT for Health Act of 2023 (Telehealth) (Menendez, Boozman, Schumer, Collins/Thompson, Matsui) HR 6371 No Fees for EFT Act (EFT=Electronic Funds Transfer) S 1302/HR 2389 The Resident Physician Shortage Reduction Act of 2023 (Schatz, Wicker, Cardin, Thune/Sewell, Fitzpatrick) S 704/HR 1202 The Resident Education Deferred Interest (REDI) Act (Rosen, Boozman/Babin, Houlahan) HR 4941 (Schiff) Providing Access to Treatment and Housing Act of 2023 (PATH Act) HR 4974 (Cardenas) Local 988 Response Act of 2023 Mental Health Hotline S 1339 (Sanders, Cassidy) PBM Reform Act Drug Enforcement Administration 21 CFR Part 1308 [Docket No. DEA-1362; A.G. Order No. 5931-2024] Schedules of Controlled Substances: Rescheduling of Marijuana AGENCY: Drug Enforcement Administration, Department of Justice.

Client expense: $62,000 · Firm income: Not reported

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

H.R. 5013 & S.3503 - The Value in Health Care Act of 2023 H.R. 2829 - Chronic Care Management Improvement Act of 2023 H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 7665 & S. 3939: The ACO Assignment Improvement Act of 2024 S. 4338, the Pay PCPs Act H.R. 7623 & S. 3967, the Telehealth Modernization Act of 2024 H.R.8702 & S. 4532, the Improving Seniors Timely Access to Care Act Issues related to Medicare & Medicaid payment and regulations, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, Centers for Medicare and Medicaid Innovation model evaluation, alternative payment model incentives, and telehealth.

Client expense: $183,511 · Firm income: Not reported

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

H.R. 7513, Protecting America's Seniors Access to Care Act, all provisions; H.R. 468, Building Americas Health Care Workforce Act, all provisions; H.R. 8113, Transparency into State Directed Payments Act of 2024, all provisions; 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, all provisions; H.R. 1110, KEEP Telehealth Option Act, all provisions; H.R. 7711, Advancing Access to Telehealth Act, all provisions; H.R. 3432, Telemental Health Care Access Act, all provisions; H.R. 3875, the Expanded Telehealth Access Act, all provisions; H.R. 5611, Helping Ensure Access to Local Telehealth (HEALTH) Act of 2023, all provisions; H.R. 6033, Patient Education and Knowledge (SPEAK) Act of 2023, all provisions; H.R. 5541, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions; 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, all provisions; H.R. 134, To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services, all provisions; H.R. 8261, The Preserving Telehealth, Hospital, and Ambulance Access Act, Issues pertaining to Telehealth, Hospital at Home, and MDH-LVA; S.4350 / H.R. 8260, Hospital Inpatient Services, Modernization Act of 2024, all provisions; H.R. 8235, Rural Physician Workforce Preservation Act, all provisions; S. 2016/ H.R. 4189, The CONNECT for Health Act of 2023, Specifically telehealth waivers, geographic restrictions, originating site requirements, in person requirement behavioral health, RHCs and FQHCs access; S. 1110, the Rural Hospital Support Act, all provisions; S. 1673 / H.R. 1666, Protecting Access to Ground Ambulance Medical Services Act of 2023, all provisions; H.R. 6430, Assistance for Rural Community Hospitals (ARCH)Act, all provisions; S. 803, Save Rural Hospitals Act, all provisions; H.R. 4968, GOLD Card Act of 2023, all provisions; H.R. 3173 / S. 4532, Improving Seniors' Timely Access to Care, all provisions; H.R. 5013/S. 3503, Value in Health Care Act, all provisions; HR 2389/ S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions; Draft Bill, Graduate Medical Education Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; H.J.Res. 139 / S.J. Res 91, A joint resolution for congressional disapproval of a rule relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting", all provisions; HR 1565, Critical Access Hospital Relief Act of 2023, all provisions; H.R. 7623, Telehealth Modernization Act, Issues pertaining to Telehealth, Hospital at Home, Unique Health Identifier; H.R.1128, Rural Health Care Access Act of 2023, all provisions; S.1571, Rural Hospital Closure Relief Act of 2023, all provisions; S. 470 / H.R. 977, The Patient Access to Higher Quality Health Care Act, all provisions; Draft Bill, Keeping Obstetrics Local Act, all provisions;H.R.5378, Lower Costs, More Transparency Act, Issues related to site neutral payment cuts, hospital price transparency, unique health identifier, 340B Program; Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule for the inpatient psychiatric facility (IPF) prospective payment system (PPS), Issues pertaining to payment policy proposals for inpatient psychiatric facilities (IPFs); Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule for skilled nursing facility prospective payment system , Issues pertaining to payment policy proposals for skilled nursing facilities (SNFs); Centers for Medicare & Medicaid Services (CMS)FY25 proposed rule for inpatient rehabilitation facility prospective payment system, Issues pertaining to payment policy proposals for inpatient rehabilitation facilities (IRFs); Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule Hospital Inpatient Prospective Payment Systems , Issues pertaining to payment policy proposals for acute-care hospitals; Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule Long-Term Care Hospital Prospective Payment System, Issues pertaining to payment policy proposals for long term acute-care hospitals; Centers for Medicare & Medicaid Services (CMS), Transforming Episode Accountability Model (TEAM), Deadline expansion and proposed mandatory alternative payment model; Centers for Medicare & Medicaid Services (CMS), Medicare Advantage Data RFI, Issues pertaining to enforcement and accountability of MA plans, prompt payment, gold carding, Standarization, penalties, and plan oversight; Centers for Medicare & Medicaid Services (CMS); Anomalous DME Spending in MSSP, accountable care models; Centers for Medicare & Medicaid Services (CMS), Accrediting Organizations (AO's), Feedback to strengthen accrediting organizations oversight; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees; Site Neutral Payments, for Q2 2024, Issues related to site neutral payment cuts for drug administration; Valued Based Care, for Q2 2024, Specifically on alternative payment models, MACRA reform, feedback on proposed TEAM model; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, and REHs; Physician Payments, Issues pertaining to proposed solutions to improve MACRA, alternative payment models, mental health of workforce; LTCH High Cost Outlier Threshold, Issues concerning High Cost Outlier in LTCH payment policy; Organ Transplant Model, Issues pertaining to Value Based Care; Rural Health Clinic Payments, Issues related to increasing payments for rural health clinics; Chronic Care Management, Issues pertaining to chronic care management for Medicare beneficiaries.

Client expense: $6,080,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Natl Drug Control Policy (NDCP), SENATE, White House Office

Issues related to Medical Economic Index (MEI) in the 2023 Physician Fee Schedule Rule; H.R. 2474, Strengthening Medicare for Patients and Providers Act; H.R. 3561, PATIENT Act of 2023; H.R. 3284, Providers and Payers COMPETE Act; H.R. 4822, Health Care Price Transparency Act of 2023; S. 3503, Value in Healthcare Act; SFC white paper entitled, Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B; Issues related to physician payment cuts; Issues related to prior authorization in Medicare Advantage

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 765/HR 1526: Reducing Hereditary Cancer Act of 2023- provide hereditary cancer genetic testing Increasing access to telehealth S 2016/HR 4189: CONNECT for Health Act- expands access to telehealth services Medicare physician payment reforms HR 2474: Strengthening Medicare for Patients and Providers Act- physician reimbursement HR 5013: Value in Health Care Act of 2023 - provides a multi-year commitment to reforming care delivery by extending MACRA's 5 percent advanced APM incentives for an additional two years. S 3503: Value in Health Care Act of 2023 - A bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other alternative payment arrangements to encourage participation in such program, and for other purposes HR 6371: Provider Reimbursement Stability Act of 2023 - To provide for certain adjustments to the physician fee schedule under the Medicare program. H.R. 6369: To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models - Extend incentive payments for participation in alternative payment models HR 3674: Providing Relief and Stability for Medicare Patients Act of 2023 - increase the nonfacility practice expense relative value units for specified services furnished under the Medicare program Reducing burdens caused by prior authorization requirements HR 4968: GOLD CARD Act of 2023 - exempt qualifying providers from prior authorization requirements under Medicare Advantage plans S 2372/HR 4758: Accelerating Kids' Access to Care Act - improve childrens access to needed out-of-state health care by streamlining Medicaid provider screening and enrollment processes. HR 6364: Medicare Telehealth Privacy Act of 2023 - To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program S 2764/HR 5391: Protecting Patient Access to Cancer and Complex Therapies Act of 2023 - ensures patients will be able to access critical medications and providers will be reimbursed fairly, unaffected by drug pricing negotiations between Medicare and drug manufacturers. S 2345/HR 4714: Pediatricians Accelerate Childhood Therapies Act of 2023 - requires the National Institutes of Health (NIH) to make awards to support early-career pediatric researchers. It also provides statutory authority for the NIH Pediatric Research Consortium to coordinate pediatric research across national health research institutions. S 3967/HR 7623: Telehealth Modernization Act of 2024 - permanently extends telehealth flexibilities for Medicare beneficiaries. S 4518/HR 8702: To Amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans - prior authorization HR 7384: Creating Hope Reauthorization Act of 2024 - This bill extends until FY2029 a Food and Drug Administration program that awards priority review vouchers to manufacturers of drugs that treat rare pediatric diseases. HR 8412: Clinical Trial Modernization Act - To modernize clinical trials and remove barriers for participation in clinical trials, and for other purposes. S 2407/HR 4818: Treat and Reduce Obesity Act of 2023 - Expands Medicare coverage of intensive behavioral therapy for obesity.

Client expense: $540,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 7513, Protecting America's Seniors Access to Care Act, all provisions; H.R. 468, Building Americas Health Care Workforce Act, all provisions; H.R. 8113, Transparency into State Directed Payments Act of 2024, all provisions; 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, all provisions; H.R. 1110, KEEP Telehealth Option Act, all provisions; H.R. 7711, Advancing Access to Telehealth Act, all provisions; H.R. 3432, Telemental Health Care Access Act, all provisions; H.R. 3875, the Expanded Telehealth Access Act, all provisions; H.R. 5611, Helping Ensure Access to Local Telehealth (HEALTH) Act of 2023, all provisions; H.R. 6033, Patient Education and Knowledge (SPEAK) Act of 2023, all provisions; H.R. 5541, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions; 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, all provisions; H.R. 134, To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services, all provisions; H.R. 8261, The Preserving Telehealth, Hospital, and Ambulance Access Act, Issues pertaining to Telehealth, Hospital at Home, and MDH-LVA; S.4350 / H.R. 8260, Hospital Inpatient Services, Modernization Act of 2024, all provisions; H.R. 8235, Rural Physician Workforce Preservation Act, all provisions; S. 2016/ H.R. 4189, The CONNECT for Health Act of 2023, Specifically telehealth waivers, geographic restrictions, originating site requirements, in person requirement behavioral health, RHCs and FQHCs access; S. 1110, the Rural Hospital Support Act, all provisions; S. 1673 / H.R. 1666, Protecting Access to Ground Ambulance Medical Services Act of 2023, all provisions; H.R. 6430, Assistance for Rural Community Hospitals (ARCH)Act, all provisions; S. 803, Save Rural Hospitals Act, all provisions; H.R. 4968, GOLD Card Act of 2023, all provisions; H.R. 3173 / S. 4532, Improving Seniors' Timely Access to Care, all provisions; H.R. 5013/S. 3503, Value in Health Care Act, all provisions; HR 2389/ S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions; Draft Bill, Graduate Medical Education Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; H.J.Res. 139 / S.J. Res 91, A joint resolution for congressional disapproval of a rule relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting", all provisions; HR 1565, Critical Access Hospital Relief Act of 2023, all provisions; H.R. 7623, Telehealth Modernization Act, Issues pertaining to Telehealth, Hospital at Home, Unique Health Identifier; H.R.1128, Rural Health Care Access Act of 2023, all provisions; S.1571, Rural Hospital Closure Relief Act of 2023, all provisions; S. 470 / H.R. 977, The Patient Access to Higher Quality Health Care Act, all provisions; Draft Bill, Keeping Obstetrics Local Act, all provisions;H.R.5378, Lower Costs, More Transparency Act, Issues related to site neutral payment cuts, hospital price transparency, unique health identifier, 340B Program; Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule for the inpatient psychiatric facility (IPF) prospective payment system (PPS), Issues pertaining to payment policy proposals for inpatient psychiatric facilities (IPFs); Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule for skilled nursing facility prospective payment system , Issues pertaining to payment policy proposals for skilled nursing facilities (SNFs); Centers for Medicare & Medicaid Services (CMS)FY25 proposed rule for inpatient rehabilitation facility prospective payment system, Issues pertaining to payment policy proposals for inpatient rehabilitation facilities (IRFs); Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule Hospital Inpatient Prospective Payment Systems , Issues pertaining to payment policy proposals for acute-care hospitals; Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule Long-Term Care Hospital Prospective Payment System, Issues pertaining to payment policy proposals for long term acute-care hospitals; Centers for Medicare & Medicaid Services (CMS), Transforming Episode Accountability Model (TEAM), Deadline expansion and proposed mandatory alternative payment model; Centers for Medicare & Medicaid Services (CMS), Medicare Advantage Data RFI, Issues pertaining to enforcement and accountability of MA plans, prompt payment, gold carding, Standarization, penalties, and plan oversight; Centers for Medicare & Medicaid Services (CMS); Anomalous DME Spending in MSSP, accountable care models; Centers for Medicare & Medicaid Services (CMS), Accrediting Organizations (AO's), Feedback to strengthen accrediting organizations oversight; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees; Site Neutral Payments, for Q2 2024, Issues related to site neutral payment cuts for drug administration; Valued Based Care, for Q2 2024, Specifically on alternative payment models, MACRA reform, feedback on proposed TEAM model; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, and REHs; Physician Payments, Issues pertaining to proposed solutions to improve MACRA, alternative payment models, mental health of workforce; LTCH High Cost Outlier Threshold, Issues concerning High Cost Outlier in LTCH payment policy; Organ Transplant Model, Issues pertaining to Value Based Care; Rural Health Clinic Payments, Issues related to increasing payments for rural health clinics; Chronic Care Management, Issues pertaining to chronic care management for Medicare beneficiaries.

Client expense: $9,080,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Natl Drug Control Policy (NDCP), SENATE, White House Office

H.R. 6445, Medicare Audiology Access Improvement Act of 2023, all provisions S. 2377, Medicare Audiology Access Improvement Act of 2023, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 712, Connected MOM Act, all provisions H.R. 5066, Tech to Save Moms Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2023 H.R. 2713, Improving Care and Access to Nurses (ICAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (ICAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions S. 3967, Telehealth Modernization Act, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 6371, Provider Reimbursement Stability Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all 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 (PREVENT DIABETES) Act, all provisions S. 4094, Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies (PREVENT DIABETES) Act, all provisions H.R. 8702, To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, all provisions S. 4532, A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, all provisions H.R. 6366, To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program, all provisions S. 4338, Pay PCPs Act of 2024, all provisions H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act, all provisions H.R. 7254, Hearing Device Coverage Clarification Act, all provisions S. 3059, Requiring Enhanced & Accurate Lists of Health Providers Act, all provisions H.R. 7708, To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes, all provisions S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions H.R. 1691, Ensuring Patient Access to Critical Breakthrough Products Act of 2023, all provisions H.R. 2407, Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, all provisions H.R. 4818, Treat and Reduce Obesity Act of 2023, all provisions H.R. 8816, American Medical Innovation and Investment Act of 2024, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 7665, ACO Assignment Improvement Act of 2024, all provisions S. 3939, ACO Assignment Improvement Act of 2024, all provisions H.R. 8404, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions S. 4330, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, provisions related to telehealth H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 8532, To identify and address barriers to coverage of remote physiologic devices under State Medicaid programs to improve maternal and child health outcomes for pregnant and postpartum women, all provisions S. 4350, Hospital Inpatient Services Modernization Act, all provisions H.R. 134, To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services, all provisions H.R. 7279, Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act, all provisions S. 971, Due Process Continuity of Care Act, all provisions Data-Driven Performance Payment System/draft Fewer Burdens for Better Healthcare Act/draft Supporting Healthy Moms and Babies Act/draft Medicare program: Improving Seniors Timely Access to Care Act implementation Medicare program: No Surprises Act implementation Medicare program: 21st Century Cures Act implementation Medicare program: Medicare physician payment reform Medicare program: Medicare Access and CHIP Reauthorization Act (MACRA)/physician burdens Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: MIPS Value Pathways Medicare program: MIPS/timely, actionable data Medicare program: Site neutral payments Medicare program: Information blocking Medicare program: Alternative Payment Models (APMs) Medicare program: Physician payment/inflation/practice costs Medicare program: High-cost disposable services/payment Medicare program: Prior authorization Medicare program: Hospital-at-Home Extension Medicare program: Prescriber-facing real-time benefit tools Medicare program: Accountable Care Organizations (ACO) Medicare program: ACO/APM flexibilities Medicare program: Medicare Shared Savings Program/regulatory changes Medicare program: Shared Savings Program/Promoting Interoperability/Certified EHR Technology Medicare program: Primary care payment reform Medicare program: Chronic care Medicare program: Diabetes Prevention Program Medicare program: Graduate Medical Education Medicare program: Medicare Administrative Contractors (MACs)/Local Coverage Article (LCA)/Local Coverage Determination (LCD) Medicare program: Quality Payment Program/physician burdens Medicare program: Medicare Shared Savings Program/Advanced APM reporting requirements Medicare program: Patient engagement Medicare program: Health IT/physician burdens Medicare program: Provider feedback/quality and efficiency measures Medicare and Medicaid programs: CHANGE Healthcare cyberattack Medicare and Medicaid programs: Rural health care Medicare and Medicaid programs: Data privacy Medicare and Medicaid programs: Pharmacy Benefit Managers Medicaid program: Maternal mortality

Client expense: $5,120,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

Incentivizing domestic manufacturing of critical medical supplies Issues related to health care costs and transparency Electronic prior authorization and administrative simplification Health care supply chain resiliency 340B Drug discount program Reauthorization of Pandemic and All Hazards Preparedness Act Hospital finance issues Healthcare workforce issues (graduate medical education, health professional training, recruitment and retention, minimum staffing requirements) Medicare payment policies Alternative payment models and related policies Medicare home infusion policy Reauthorization of Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act Expanding access to interoperable health tech in long term and post-acute care settings Maternal and infant health Health care workplace violence and worker safety S. 148 Stop STALLING Act Medicaid Disproportionate Hospital Share cuts S. 2115, H.R. 4307 Medical Supply Chain Resiliency Act H.R. 4104, S. 1976 Preseving Patients Access to Home Infusion Act H.R. 2584, S. 2768 SAVE Act H.R. 3577 Medical and Health Stockpile Accountability Act H.R. 2665 Supporting Safety Net Hospitals Act H.R. 2389, S. 1302 Resident Physician Shortage Reduction Act H.R. 3346 IMPACT to Save Moms Act H.R. 5378 Lower Costs, More Transparency Act S. 2840 Bipartisan Primary Care and Health Workforce Act H.R. 5013, S. 3503 Value in Health Care Act H.R. 4942, S. 665 Conrad State 30 and Physician Access Reauthorization Act Artificial intelligence in healthcare H.R.766, S. 114 Preventive Health Savings Act H.R. 6205, S. 3211 Healthcare Workforce Resilience Act H.R. 7050 Substance Use Disorder Workforce Act H.R. 8702, S. 4532 Improving Seniors' Timely Access to Care Act H.R. 7855 Rural Residency Planning and Development Act

Client expense: $225,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill H.R. 4283, Gun Violence Prevention and Community Safety Act Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill S. 1655/H.R. 3421, Medicare for All Act of 2023 Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act H.R. 2389 The Resident Physician Shortage Reduction Act H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R. 4942/ S. 665, the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign H.R. 2389 The Resident Physician Shortage Reduction Act Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317MAMAS First Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 2474, the Strengthening Medicare for Patients and Providers Act H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill Issues related to Medicare Advantage - no specific bill Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Publications Open access to information based on publicly funded research - no specific bill Request for Information for NIH Plan to Enhance Public Access to the Results of NIH-Supported Research Issues related to scholarly and scientific publishing and public access - no specific bill H.R. 9378, Sunshine Act of 2023 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)