Pay PCPs Act of 2024

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

Client expense: $26,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare physician payment including H.R.10073, the Medicare Patient Access and Practice Stabilization Act of 2024 and H.R.10545, the American Relief Act; new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act of 2023 (HR 2389/S. 1302); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy including the Physician Led Rural Access to Quality Care Act (HR 9001); COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); implementation of the Consolidated Appropriations Act of 2022; Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 (H.R. 2583/S. 3481); Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 1406/S. 3021); Strengthening Medicare for Patients and Providers (H.R. 2474); site-neutrality; Providing Relief and Stability for Medicare Patients Act (H.R. 3674); Connected Maternal Online Monitoring Act (Connected Mom) (S. 712); Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699) Preserving Seniors Access to Physicians Act (H.R. 6683); Provider Reimbursement Stability Act (H.R. 6371); FY2024 Further Consolidated Appropriations Act (H.R. 2882); The Improving Seniors Timely Access to Care Act of 2024 (H.R. 8702/S. 4532); The Pay PCPs Act (S. 4338); the Electronic Prior Authorization for Prescription Drugs Act (S. 4349); FY 25 Labor-HHS Appropriations (H.R. 9029/S. 4942); The Physician Fee Stabilization Act (S. 4935); GOLD CARD Act (H.R. 4968); Access to Claims Data Act (H.R. 9805)

Client expense: $490,000 · 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), SENATE

Federal Affairs also lobbies for Medicaid and Medicare payment for health centers and Medicaid unwinding policies. This includes: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); DUALS Act of 2024 (S.3950).

Client expense: $152,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

Federal Affairs lobbies for Teaching Health Centers; Nurse Corps; National Health Service Corps; 340B Drug Discount Program; Community Health Center Program Funding; Behavioral Health; Telehealth policies. This includes the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); the Urban Indian Health Parity Act (H.R. 6533)

Client expense: $152,000 · Firm income: Not reported

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

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

Extension of COVID-19 public health emergency waivers Nurse staffing shortages Removing barriers to care (H.R.2713/S.2418) I CAN Act (S.1586/H.R.3623) Educating Future Nurses Act (S.1869) SITE Act (S.3860/H.R.7546) Nurse Overtime and Patient Safety Act (H.R.2530 / S.1113) Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (H.R. 7513) Protecting Americas Seniors Access to Care Act Issues surrounding Medicare Part B reform Issues surrounding CMS Long Term Care staffing final rule (H.J. Res. 139) Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting". (S.J. Res. 91) A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting". (S. 2016/H.R. 4189) CONNECT for Health Act (H.R.2583/S.3481) Increasing Access to Quality Cardiac Rehabilitation Care Act H.R.3227 - Ensuring Seniors Access to Quality Care Act H.R.468 - Building Americas Health Care Workforce Act (S.5236) Keeping Obstetrics Local Act S.4338 - Pay PCPs Act of 2024 Issues surrounding Medicare reimbursement (H.R. 8702/S. 4532) Improving Seniors Timely Access to Care Act of 2024 (H.R.10445) Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 (H.R.10545) American Relief Act, 2025 (H.R.10515) American Relief Act, 2025 Issues surrounding surgical smoke

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Federal Affairs also lobbies for Medicaid and Medicare payment for health centers and Medicaid unwinding policies. This includes: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); DUALS Act of 2024 (S.3950).

Client expense: $155,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

Federal Affairs lobbies for Teaching Health Centers; Nurse Corps; National Health Service Corps; 340B Drug Discount Program; Community Health Center Program Funding; Behavioral Health; Telehealth policies. This includes the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); and the DUALS Act of 2024 (S.3950).

Client expense: $155,000 · Firm income: Not reported

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

Federal Affairs lobbies for Teaching Health Centers; Nurse Corps; National Health Service Corps; 340B Drug Discount Program; Community Health Center Program Funding; Behavioral Health; Telehealth policies. This includes the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); and the DUALS Act of 2024 (S.3950).

Client expense: $152,000 · Firm income: Not reported

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

Federal Affairs also lobbies for Medicaid and Medicare payment for health centers and Medicaid unwinding policies. This includes: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); DUALS Act of 2024 (S.3950).

Client expense: $152,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

Medicare physician reimbursement issues; Medicare graduate medical education; S. 4338, Pay PCP's Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Physician Payment Reform, Medicare Telehealth Extension, S.4338, the Pay PCPs Act of 2024

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 4338, the Pay PCPs Act of 2024; S. 4349, A bill to require private health plans to provide for secure electronic transmission of prior authorization requests for prescription drugs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 260/H.R. 704 - Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 2713/S. 2418 - Improving Care and Access to Nurses (ICAN) Act S. 3939/H.R. 7665 - ACO Assignment Improvement Act of 2024 H.R. 7623/S. 3967 - Telehealth Modernization Act H.R. 5163/ S. 3193 - Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act S. 923 - Better Mental Health Care for Americans Act H.R. 3305/S. 1606 - Black Maternal Health Momnibus Act H.R. 2663/S. 1176 - Workplace Violence Prevention for Health Care and Social Service Workers Act S. 2085 - A bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening tests H.R. 2407 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act H.R. 4189/S. 2016 - CONNECT for Health Act S. 1869 - Site-based Invoicing and Transparency Enhancement Act (SITE) Act H.R. 3623/S. 1586 - Educating Future Nurses Act H.R. 2829 - Chronic Care Management Improvement Act of 2023 H.R. 2400/S. 1165 - Reentry Act of 2023 S.1378 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 4822 - Health Care Price Transparency Act of 2023 H.R. 4779 - Breast Cancer Patient Equity Act Primary Care and Health Workforce Expansion Act S. 2840 - Bipartisan Primary Care and Health Workforce Act S. 1976/H.R. 4104 - Preserving Patient Access to Home Infusion Act Support implementation of Medicare code G2211 S. 3297/H.R. 6407 - Medical Nutrition Therapy Act of 2023 S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S. 4338 - Pay PCPs Act of 2024 H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act Issues related to Medicare Part B reform Skilled nursing facility admitting examination and assessment requirements Health plan coverage and program requirements, including provider non-discrimination, network adequacy and prior authorization Nursing faculty and workforce shortage Include nurses, APRNs, and nursing students in all national public health plans Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Addressing health equity Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic COVID-19 Pandemic, including funding, personal protective equipment, testing and vaccines Extension of CMS waivers beyond the COVID-19 Public Health Emergency Telehealth, remote patient monitoring and other forms of health technology Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Documentation of medical records Use of clinician home address on Medicare claims when providing telehealth services

Client expense: $470,000 · Firm income: Not reported

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

S. 260/H.R. 704 - Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 2713/S. 2418 - Improving Care and Access to Nurses (ICAN) Act S. 3939/H.R. 7665 - ACO Assignment Improvement Act of 2024 H.R. 7266/S. 3770 - Future Advancement of Academic Nursing (FAAN) Act H.R. 7153/S. 3679 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 7623/S. 3967 - Telehealth Modernization Act H.R. 7002/S. 2815 - Nurse Faculty Shortage Reduction Act H.R. 5163/ S. 3193 - Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 4534/S. 2245 - the Women and Lung Cancer Research and Preventive Services Act H.R. 5829 - Health Care Practitioner Disaster Protection Act S. 923 - Better Mental Health Care for Americans Act H.R. 3768/S. 1851 - Midwives for MOMs Act H.R. 3305/S. 1606 - Black Maternal Health Momnibus Act H.R. 2411/S. 1150 - National Nursing Workforce Center Act of 2023 H.R. 2663/S. 1176 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 3523/S. 1710 - Perinatal Workforce Act S. 2085 - A bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening tests H.R 2407 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 2016 - CONNECT for Health Act S. 1869 - Site-based Invoicing and Transparency Enhancement Act (SITE) Act H.R. 3355 - Substance Use Disorder Treatment and Recovery Loan Repayment Program Reauthorization Act of 2023 S. 1627 - Providing Real-World Education and Clinical Experience by Precepting Tomorrows Nurses Act (PRECEPT) Nurses Act H.R. 3623/S. 1586 - Educating Future Nurses Act H.R. 3730/S. 198 - Rural Health Clinic Burden Reduction Act H.R. 2829 - Chronic Care Management Improvement Act of 2023 H.R. 2400/S. 1165 - Reentry Act of 2023 S. 1378 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.Con.Res.42 - Honoring Mary Eliza Mahoney, America's first professionally trained Black nurse. S.Res.201/H.Res.375 - A resolution supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2023. H.R. 4822 - Health Care Price Transparency Act of 2023 H.R. 4779 - Breast Cancer Patient Equity Act Primary Care and Health Workforce Expansion Act S. 2840 - Bipartisan Primary Care and Health Workforce Act S. 3297/H.R. 6407 - Medical Nutrition Therapy Act of 2023 Support funding for the National Health Service Corps S. 862 - Restoring Americas Health Care Workforce and Readiness Act S. 1976/H.R. 4104 - Preserving Patient Access to Home Infusion Act S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S.Res. 676/H.Res. 1208 - a resolution supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2024 S. 4338 - Pay PCPs Act of 2024 H.R. 9133/S. 4835 - Primary and Behavioral Health Care Access Act H.R. 6860/S. 5018 - the Restore Protections for Dialysis Patients Act H.R. 10280 - Strengthening Pathways to Health Professions Act Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Support for the creation of the Office of Caregiver Health Support a final rule prohibiting menthol cigarettes and cigars Support implementation of Medicare code G2211 Extending COVID-19 waivers related to nurse practitioners and critical access hospitals Skilled nursing facility admitting examination and assessment requirements Health plan coverage and program requirements, including provider non-discrimination, network adequacy and prior authorization Nursing faculty and workforce shortage Nursing education Include nurses, APRNs, and nursing students in all national public health plans Public health and nursing workforce infrastructure Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Addressing health equity Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic COVID-19 Pandemic, including funding, personal protective equipment, testing and vaccines Provide resources to support nurses, APRNs, and nursing students mental health needs, especially for those responding to the pandemic Extension of CMS waivers beyond the COVID-19 Public Health Emergency Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Site specific restrictions on providers under DEA controlled substances policy Implementation of the Medication Access and Training Expansion (MATE) Act Telehealth, remote patient monitoring and other forms of health technology Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Primary care payment reform Documentation of medical records Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Framework reform of the National Institutes of Health and the National Institute of Nursing Research Optimizing the Food and Drug Administration's Use of and Processes for Advisory Committees

Client expense: $470,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

Womens Health Protection Act Mental Health Workforce Shortages Federal policies affecting access to contingency management services for substance use disorders S. 4246 Advancing Menopause Care and Mid-Life Womens Health Act General Menopause health policy H. R. 498 / S.1493, 9-8-8 Lifeline Cybersecurity Responsibility Act H.R. 501 Block, Report, And Suspend Suspicious Shipments Act H.R. 773/S. 3165, Homelessness and Behavioral Health Care Coordination Act of 2023 H.R. 1359/S. 644 Modernizing Opioid Treatment Access Act H.R. 1423 911 Community Crisis Responders Act of 2023 H.R. 1502 Comprehensive Opioid Recovery Centers Reauthorization Act of 2023 H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.2577/S.1137,DHS Suicide Prevention and Resiliency for Law Enforcement Act H.R. 3074/S. 971 The Due Process Continuity of Care Act HR 3305 Black Maternal Health Momnibus Act H.R. 3375 STOP Fentanyl Overdoses Act H.R. 3752 Parity Enforcement Act of 2023 H.R.4310/S.2233, Youth Poisoning Protection Act H.R. 4531 / S. 2433, SUPPORT for Patients and Communities Reauthorization Act of 2023 H.R. 4851, 9-8-8 Implementation Act of 2023 H.R. 4884 /S. 2476 Mental Health for Latinos Act of 2023 H.R.4974, Local 988 Response Act H.R. 5866, Substance Use Disorder and Family Engagement (SAFE) in Recovery Act H.R. 6284/S. 3260 Improving Measurements for Loneliness and Isolation Act of 2023 H.R. 6475 Health Disparity Zones Act of 2023 H.R.6928 CONNECT Act of 2024 H.R. 7153/S. 3679 Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 7301 Certified Community Behavioral Health Clinic Expansion Act of 2024 H.R. 8390 Mental Health and MAMA Act of 2024 H.R. 8503 Integrated Care for Dual Eligibles H.R. 9577 STOP Suicide Act H.R. 10073 Medicare Patient Access and Practice Stabilization Act of 2024 S.669/H.R. 8458 Increasing Mental Health Options Act of 2023 S. 923 Better Mental Health Care for Americans Act S. 1378/ H.R 5819 COMPLETE Care Act S.2350, National Strategy for Social Connection Act Reintroduction of The Behavioral Health Coverage Transparency Act Reintroduction of The Parity Enforcement Act of 2023 H.R. 5804, The Mental Health Infrastructure Improvement Act Reintroduction of The Comprehensive Addiction Resources Emergency Act Reintroduction of The Stop Online Suicide Assistance Forums Act S.2511, the ADAPT Act S. 2733, PEER Support Act H.R. 7808, EARLY Minds Act S.3364, Kids Providing Resources for Optimal Outcomes Against Fatalities Act of 2024 (KID Proof Act) S.3085, Preventing Adverse Childhood Experiences Act (PACE Act) S. 3393 SUPPORT for Patients and Communities Reauthorization Act S.3498 Promoting Effective and Empowering Recovery Services in Medicare Act of 2023 S. 3557 Public Health Impact of Opioid Drugs S. 3769, Alternative Pathways to Child Abuse Prevention Act S. 4312 United States Senate Commission on Mental Health Act of 2024 S. 4338 Pay PCPs Act of 2024 Reauthorization of the Older Americans Act Caregiving for older adults Title IV-B of the Social Security Act Mental Health Parity Final Rule Meeting with the Tri-Departments (DOL, HHS and Treasury) H.R 3312, S. 1602, Moms Matter Act S.4811, Prevention Services for Youth Act S.4812, Strengthening Supports for Youth Act H.R.9875, Child Safety and Well-Being Act Response to RFI regarding regulation of cannabis and hemp products Research regarding the safety and efficacy of psychedelic-assisted therapy Meeting with CMS on eligibility of postdoctoral training programs for Nursing/Allied Health Reimbursement   Flexibility to prescribe certain controlled medications via telehealth for the treatment of mental health and substance use disorders Support of the proposed rule on georouting solutions for the 988 Suicide & Crisis Lifeline (988 Lifeline) Medicare coverage policies regarding mental health and substance use disorder services Sickle Cell Disease Comprehensive Care Act (H.R. 7432 / S. 5097)

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

Issues relating to surprise medical bills Pandemic and All-Hazards Preparedness Act (PAHPA) Reauthorization Advocating for relief from cuts to evaluation and management codes within Medicare Issues relating to the debt limit Issues relating to site-neutral payments Issue relating to artificial intelligence Issues relating to combatting fentanyl crisis Issues relating to Medicare coverage pathways Researching Long Covid Fees paid on electronically submitting to insurers Issues relating to the Clinical Laboratory Fee Schedule Issues relating to forensic pathologist loan repayment Funding for the CDC AMD program Funding for lab test harmonization Issues surrounding Health Data Privacy Issues surrounding the Change Healthcare Cyber Attack Medicare payment reform S.4338 - Pay PCPs Act of 2024 Challenges facing independent medicine PTAC Reform

Client expense: $126,566 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Extension of COVID-19 public health emergency waivers Nurse staffing shortages Removing barriers to care (H.R.2713/S.2418) I CAN Act (S.1586/H.R.3623) Educating Future Nurses Act (S.1869) SITE Act (S.3860/H.R.7546) Nurse Overtime and Patient Safety Act (H.R.2530 / S.1113) Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (H.R. 7513) Protecting Americas Seniors Access to Care Act Issues surrounding Medicare Part B reform Issues surrounding CMS Long Term Care staffing final rule (H.J. Res. 139) Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting". (S.J. Res. 91) A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting". (S. 2016/H.R. 4189) CONNECT for Health Act (H.R.2583/S.3481) Increasing Access to Quality Cardiac Rehabilitation Care Act H.R.3227 - Ensuring Seniors Access to Quality Care Act H.R.468 - Building Americas Health Care Workforce Act (S.5236) Keeping Obstetrics Local Act S.4338 - Pay PCPs Act of 2024 Issues surrounding Medicare reimbursement Issues surrounding surgical smoke (H.R. 8702/S. 4532) Improving Seniors Timely Access to Care Act of 2024 (H.R.10445) Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 (H.R.10545) American Relief Act, 2025 (H.R.10515) American Relief Act, 2025

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for policies that accelerate the move to effective accountable care and that transform primary care payments (S.4338 - PAY PCPs Act); advocated for reforms to the Medicare Access and CHIP Reauthorization Act of 2015; advocated for improvements to Medicare ACO programs; advocated for policies related to dual eligibles.

Client expense: $160,000 · Firm income: Not reported

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

Advocated for policies that accelerate the move to effective accountable care and that transform primary care payments (S.4338 - PAY PCPs Act); advocated for reforms to the Medicare Access and CHIP Reauthorization Act of 2015; advocated for improvements to Medicare ACO programs; advocated for policies related to dual eligibles.

Client expense: $160,000 · Firm income: Not reported

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

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

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

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

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

Client expense: $242,106 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

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

Client expense: $124,919 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Support for primary care physician payment reform, including S.4338, "Pay PCPs Act of 2024;" incentives to attract adequate workforce, including geriatrics professionals, to care for older adults; and shared decision-making and patient-centered care on treatment plans for older adults. Support for payment for advanced primary care management (APCM) services in Medicare CY 2025 proposed physician payment rule. Support for shared decision making, care planning and services, and primary care quality measures for Medicare beneficiaries with cognition concerns and their doctors, omitted in the CHANGE Act of 2023 (HR 4752/S 2379) and American Medical Innovation and Investment Act of 2024, HR 8816.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5378, Lower Costs, More Transparency Act, Issues related to site neutral payment cuts, hospital price transparency, unique health identifier, 340B Program; H.R. 3173 / S. 4532, Improving Seniors' Timely Access to Care, all provisions; S.4350 / H.R. 8260, Hospital Inpatient Services Modernization Act of 2024, all provisions; Draft Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; S.4338, the Pay PCPs Act , Feedback to improve physician reimbursement and value-based primary care; S. 1110, the Rural Hospital Support Act, all provisions; H.R. 6430, Assistance for Rural Community Hospitals (ARCH)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, Supporting Patient Education and Knowledge (SPEAK) Act of 2023, all provisions; Draft Bill, To amend title XVIII of the Social Security Act to adjust long-term care hospital payment rates under the Medicare program, Issues related to LTCH payment policy reforms; S. 5236, A bill to amend titles XIX and XXI of the Social Security Act to enhance financial support for rural and safety net hospitals providing maternity, labor, and delivery services to vulnerable populations, and for other purposes, Reimbursements to rural and safety net hospitals providing maternity, labor, and delivery services; H.R. 7623, Telehealth Modernization Act, Issues pertaining to Telehealth, Hospital at Home, Unique Health Identifier; H. Jes 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; 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; H.R. 1110, KEEP Telehealth Option Act, All provisions; H.R. 5541, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, All provisions; HR 2389/ S. 1302, Resident Physician Shortage Reduction Act of 2023, All provisions; H.R. 977/S. 470, Patient Access to Higher Quality Care Act, all provisions; Draft Bill, Obstetric care in Critical Access Hospitals (CAH); Centers for Medicare & Medicaid Services (CMS), Medicare Drug Price Negotiation Program Draft Guidance, Issues pertaining to the implementation of the Medicare drug price negotiation program; Centers for Medicare & Medicaid Services (CMS), Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model, Issues pertaining to Value Based Care and feedback on proposed IOTA model; Centers for Medicare & Medicaid Services (CMS), FY 2025 Inpatient Prospective Payment Systems for Acute Care Hospitals; Disproportionate Share Hospital Payments, Issues pertaining to the FY2025 Inpatient Prospective Payment Systems Rule and Disproportionate Share Hospital Payments Changes in FY25 IPPS Rule; Medicare Payment Advisory Commission (MedPAC), 2025 Priorities, Issues pertaining to 340B Drug Pricing Program, inpatient rehabilitation facility (IRF) payments, the physician fee schedule (PFS) and telehealth in the new cycle; Centers for Medicare & Medicaid Services (CMS), Calendar Year (CY) 2025 Home Health Prospective; Payment System (HH PPS) Rate Update, Issues pertaining to the CY25 Home Health Proposed Rule; Centers for Medicare & Medicaid Services (CMS), Physician fee schedule (PFS) proposed rule for calendar year (CY) 2025, Issues pertaining to physician fee schedule; Centers for Medicare & Medicaid Services (CMS), Outpatient Prospective Payment System (OPPS) Proposed rule for Calendar Year (CY2025), Issues pertaining to outpatient and ambulatory surgery center prospective payment system, conditions of participation for maternal health; Health & Human Services (HHS), Letter to HHS, Medicare Advantage Organizations' Use of Prior Authorization for Post-Acute Care; Centers for Medicare & Medicaid Services (CMS), Significant, Anomalous and Highly Suspect (SAHS) billing in Medicare Shared Savings Program (MSSP) in Calendar Year 2023, Issues pertaining to proposed rule to mitigate the impact of significant, anomalous and highly suspect (SAHS) billing activity within the Medicare Shared Savings Program (MSSP) in calendar year (CY) 2023; Site Neutral Payments, Issues related to site neutral payment cuts for drug administration; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees, DSH cuts; Medicaid Disproportionate Share Hospital (DSH) program, Medicaid DSH program; LTCH High Cost Outlier Threshold, SFC / W&M Meeting / CMS Meeting , Issues concerning High Cost Outlier in LTCH payment policy; National Provider Identifier (NPI), Included in E&C markup statement in September , Unique identifiers for off-campus Hospital Outpatient Departments (HOPDs); Access to inpatient rehabilitation care, Letter to CMS / Supported Hill Led Effort, Access to inpatient rehabilitation care for MA enrollees; 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; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay and cost-based reimbursement for critical access hospitals under Medicare Advantage.

Client expense: $5,450,000 · 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

H.R. 2474, Strengthening Medicare for Patients and Providers Act; Physician payment under Medicare (general); Graduate medical education (general); Prior authorization in Medicare (general); Medicaid free choice of provider requirement; Implementation of P.L. 117-328, Consolidated Appropriations Act, including permanent option for postpartum Medicaid extension; Physician reimbursements under Medicaid (general); S. 4532/H.R. 8702, Improving Seniors Timely Access to Care Act; S. 4338, Pay PCPs Act; telehealth under Medicare, Medicaid, and CHIP (general); H.R. 4189/S. 2016, CONNECT for Health Act; CY 2025 Medicare Hospital Outpatient Prospective Payment System rule (general)

Client expense: $155,000 · Firm income: Not reported

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

Medicare physician payment; new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act of 2023 (HR 2389/S. 1302); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy including the Physician Led Rural Access to Quality Care Act (HR 9001); COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); implementation of the Consolidated Appropriations Act of 2022; Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 (H.R. 2583/S. 3481); Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 1406/S. 3021); Strengthening Medicare for Patients and Providers (H.R. 2474); site-neutrality; Providing Relief and Stability for Medicare Patients Act (H.R. 3674); Connected Maternal Online Monitoring Act (Connected Mom) (S. 712); Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699) Preserving Seniors Access to Physicians Act (H.R. 6683); Provider Reimbursement Stability Act (H.R. 6371); FY2024 Further Consolidated Appropriations Act (H.R. 2882); The Improving Seniors Timely Access to Care Act of 2024 (H.R. 8702/S. 4532); The Pay PCPs Act (S. 4338); the Electronic Prior Authorization for Prescription Drugs Act (S. 4349); FY 25 Labor-HHS Appropriations (H.R. 9029/S. 4942); The Physician Fee Stabilization Act (S. 4935); GOLD CARD Act (H.R. 4968); Access to Claims Data Act (H.R. 9805)

Client expense: $410,000 · 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), SENATE

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

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

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

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

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

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

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

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

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

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)

Extension of COVID-19 public health emergency waivers Nurse staffing shortages Removing barriers to care (H.R.2713/S.2418) I CAN Act (S.1586/H.R.3623) Educating Future Nurses Act (S.1869) SITE Act (S.3860/H.R.7546) Nurse Overtime and Patient Safety Act (H.R.2530 / S.1113) Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (H.R. 7513) Protecting Americas Seniors Access to Care Act Issues surrounding Medicare Part B reform Issues surrounding CMS Long Term Care staffing final rule (H.J. Res. 139) Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting". (S.J. Res. 91) A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting". (S. 2016/H.R. 4189) CONNECT for Health Act (H.R.2583/S.3481) Increasing Access to Quality Cardiac Rehabilitation Care Act H.R.3227 - Ensuring Seniors Access to Quality Care Act H.R.468 - Building Americas Health Care Workforce Act (S.5236) Keeping Obstetrics Local Act S.4338 - Pay PCPs Act of 2024

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Physician Payment Reform; S4338, Pay PCP's Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare physician reimbursement issues; Medicare graduate medical education; S. 4338, Pay PCP's Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Physician Payment Reform, Medicare Telehealth Extension, S.4338, the Pay PCPs Act of 2024

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 4338, the Pay PCPs Act of 2024; S. 4349, A bill to require private health plans to provide for secure electronic transmission of prior authorization requests for prescription drugs

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

Government targets: SENATE

S. 260/H.R. 704 - Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 2713/S. 2418 - Improving Care and Access to Nurses (ICAN) Act S. 3939/H.R. 7665 - ACO Assignment Improvement Act of 2024 H.R. 7266/S. 3770 - Future Advancement of Academic Nursing (FAAN) Act H.R. 7153/S. 3679 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 7623/S. 3967 - Telehealth Modernization Act H.R. 7002/S. 2815 - Nurse Faculty Shortage Reduction Act H.R. 5163/ S. 3193 - Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 4534/S. 2245 - the Women and Lung Cancer Research and Preventive Services Act H.R. 5829 - Health Care Practitioner Disaster Protection ActS. 923 - Better Mental Health Care for Americans Act H.R. 3768/S. 1851 - Midwives for MOMs Act H.R. 3305/S. 1606 - Black Maternal Health Momnibus Act H.R. 2411/S. 1150 - National Nursing Workforce Center Act of 2023 H.R. 2663/S. 1176 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 3523/S. 1710 - Perinatal Workforce Act S. 2085 - A bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening tests H.R 2407 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 2016 - CONNECT for Health Act S. 1869 - Site-based Invoicing and Transparency Enhancement Act (SITE) Act H.R. 3355 - Substance Use Disorder Treatment and Recovery Loan Repayment Program Reauthorization Act of 2023 S. 1627 - Providing Real-World Education and Clinical Experience by Precepting Tomorrows Nurses Act (PRECEPT) Nurses Act H.R. 3623/S. 1586 - Educating Future Nurses Act H.R. 3730/S. 198 - Rural Health Clinic Burden Reduction Act H.R. 2829 - Chronic Care Management Improvement Act of 2023 H.R. 2400/S. 1165 - Reentry Act of 2023 S. 1378 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.Con.Res.42 - Honoring Mary Eliza Mahoney, America's first professionally trained Black nurse. S.Res.201/H.Res.375 - A resolution supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2023. H.R. 4822 - Health Care Price Transparency Act of 2023 H.R. 4779 - Breast Cancer Patient Equity Act Primary Care and Health Workforce Expansion Act S. 2840 - Bipartisan Primary Care and Health Workforce Act S. 3297/H.R. 6407 - Medical Nutrition Therapy Act of 2023 Support funding for the National Health Service Corps S. 862 - Restoring Americas Health Care Workforce and Readiness Act S. 1976/H.R. 4104 - Preserving Patient Access to Home Infusion Act S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S.Res. 676/H.Res. 1208 - a resolution supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2024 S. 4338 - Pay PCPs Act of 2024 H.R. 9133/S. 4835 - Primary and Behavioral Health Care Access Act H.R. 6860/S. 5018 - the Restore Protections for Dialysis Patients Act Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Support for the creation of the Office of Caregiver Health Support a final rule prohibiting menthol cigarettes and cigars Support implementation of Medicare code G2211 Extending COVID-19 waivers related to nurse practitioners and critical access hospitals Skilled nursing facility admitting examination and assessment requirements Health plan coverage and program requirements, including provider non-discrimination, network adequacy and prior authorization Nursing faculty and workforce shortage Nursing education Include nurses, APRNs, and nursing students in all national public health plans Public health and nursing workforce infrastructure Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Addressing health equity Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic COVID-19 Pandemic, including funding, personal protective equipment, testing and vaccines Provide resources to support nurses, APRNs, and nursing students mental health needs, especially for those responding to the pandemic Extension of CMS waivers beyond the COVID-19 Public Health Emergency Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Site specific restrictions on providers under DEA controlled substances policy Implementation of the Medication Access and Training Expansion (MATE) Act Telehealth, remote patient monitoring and other forms of health technology Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Primary care payment reform Documentation of medical records Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Framework reform of the National Institutes of Health and the National Institute of Nursing Research Optimizing the Food and Drug Administration's Use of and Processes for Advisory Committees

Client expense: $360,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

S. 260/H.R. 704 - Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 2713/S. 2418 - Improving Care and Access to Nurses (ICAN) Act S. 3939/H.R. 7665 - ACO Assignment Improvement Act of 2024 H.R. 7623/S. 3967 - Telehealth Modernization Act H.R. 5163/ S. 3193 - Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act S. 923 - Better Mental Health Care for Americans Act H.R. 3305/S. 1606 - Black Maternal Health Momnibus Act H.R. 2663/S. 1176 - Workplace Violence Prevention for Health Care and Social Service Workers Act S. 2085 - A bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening tests H.R 2407 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act H.R. 4189/S. 2016 - CONNECT for Health Act S. 1869 - Site-based Invoicing and Transparency Enhancement Act (SITE) Act H.R. 3623/S. 1586 - Educating Future Nurses Act H.R. 2829 - Chronic Care Management Improvement Act of 2023 H.R. 2400/S. 1165 - Reentry Act of 2023 S.1378 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 4822 - Health Care Price Transparency Act of 2023 H.R. 4779 - Breast Cancer Patient Equity Act Primary Care and Health Workforce Expansion Act S. 2840 - Bipartisan Primary Care and Health Workforce Act S. 1976/H.R. 4104 - Preserving Patient Access to Home Infusion Act Support implementation of Medicare code G2211 S. 3297/H.R. 6407 - Medical Nutrition Therapy Act of 2023 S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S. 4338 - Pay PCPs Act of 2024 H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act Issues related to Medicare Part B reform Skilled nursing facility admitting examination and assessment requirements Health plan coverage and program requirements, including provider non-discrimination, network adequacy and prior authorization Nursing faculty and workforce shortage Include nurses, APRNs, and nursing students in all national public health plans Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Addressing health equity Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic COVID-19 Pandemic, including funding, personal protective equipment, testing and vaccines Extension of CMS waivers beyond the COVID-19 Public Health Emergency Telehealth, remote patient monitoring and other forms of health technology Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Documentation of medical records Use of clinician home address on Medicare claims when providing telehealth services

Client expense: $360,000 · Firm income: Not reported

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

Federal Affairs also lobbies for Medicaid and Medicare payment for health centers and Medicaid unwinding policies. This includes: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); DUALS Act of 2024 (S.3950).

Client expense: $152,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

Federal Affairs lobbies for Teaching Health Centers; Nurse Corps; National Health Service Corps; 340B Drug Discount Program; Community Health Center Program Funding; Behavioral Health; Telehealth policies. This includes the 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act (H.R. 8574); Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); DUALS Act of 2024 (S.3950)

Client expense: $152,000 · Firm income: Not reported

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

Federal Affairs lobbies for Teaching Health Centers; Nurse Corps; National Health Service Corps; 340B Drug Discount Program; Community Health Center Program Funding; Behavioral Health; Telehealth policies. This includes the 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act (H.R. 8574); Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); DUALS Act of 2024 (S.3950)

Client expense: $145,000 · Firm income: Not reported

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

Federal Affairs also lobbies for Medicaid and Medicare payment for health centers and Medicaid unwinding policies. This includes: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 (S. 2016); HEALTH Act of 2023 (H.R. 5611); Telehealth Modernization Act (H.R. 7623); Preserving Telehealth, Hospital, and Ambulance Access Act (H.R.8261); Pay PCPs Act of 2024 (S.4338); DUALS Act of 2024 (S.3950).

Client expense: $145,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

Extension of COVID-19 public health emergency waivers Nurse staffing shortages Removing barriers to care (H.R.2713/S.2418) I CAN Act (S.1586/H.R.3623) Educating Future Nurses Act (S.1869) SITE Act (S.3860/H.R.7546) Nurse Overtime and Patient Safety Act (H.R.2530 / S.1113) Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (H.R. 7513) Protecting Americas Seniors Access to Care Act Issues surrounding Medicare Part B reform Issues surrounding CMS Long Term Care staffing final rule (H.J. Res. 139) Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting". (S.J. Res. 91) A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting". (S. 2016/H.R. 4189) CONNECT for Health Act (H.R.2583/S.3481) Increasing Access to Quality Cardiac Rehabilitation Care Act H.R.3227 - Ensuring Seniors Access to Quality Care Act H.R.468 - Building Americas Health Care Workforce Act (S.5236) Keeping Obstetrics Local Act S.4338 - Pay PCPs Act of 2024

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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