Improving Seniors’ Timely Access to Care Act of 2024

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Oppose changes to Affordable Care Act in H.R.1: limitations on premium tax credit eligibility, reductions to special enrollment period. Urge legislative delay of premium tax credit eligibility restrictions included in H.R. 1. Discuss support for permanently extending expiring Affordable Care Act premium tax credits with Congressional staff. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comments on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training sites, and immigration reforms that expedite entry for foreign health care workers. Support passage of the SAVE Healthcare Workers Act (H.R. 3178/S. 1600). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702). Support SEPSIS Act (S.1929). Discuss New York State application for Section 1331 Basic Health Plan waiver with Congressional staff and CMS staff. Discuss Section 1332 State Innovation Waiver with Congressional staff. Discuss legislative proposals to regulate the use of artificial intelligence in health care settings with Congressional staff. Discuss non-profit tax-exempt status of hospitals with Congressional staff and discuss examples of community benefit for IRS purposes.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

S.864, Help Ensure Lower Patient (HELP) Copays Act H.R.1509/S.752, Accelerating Kids Access to Care Act H.R.8702/S.4532, Improving Seniors Timely Access to Care Act (118th Congress) H.R.1532/S.822, Scientific External Process for Educated Review of Therapeutics (EXPERT) Act H.R.1262/S.932, Give Kids a Chance Act H.R.1990, American Innovation and R&D Competitiveness Act H.R.1414, Camerons Law

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Prior Authorization Simplification - H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments. Increase transparency around MA prior authorization requirements and its use. Clarify CMS authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests. Expand beneficiary protections to improve enrollee experiences and outcomes. Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Prior Authorization Simplification - H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments. Increase transparency around MA prior authorization requirements and its use. Clarify CMS authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests. Expand beneficiary protections to improve enrollee experiences and outcomes. Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care priorities of ACCC: a) Prior authorization (Including: Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702 in the 118th Congress); 2) Oncology drug and medical supply shortages; 3) Patient navigation; 4) Financial toxicity; 5) Inflation Reduction Act implementation, especially Protecting Patient Access to Cancer and Complex Therapies Act (S.2764/H.R.5391 in the 118th Congress); 6) Reducing Physician Payment Reimbursement Cuts under Medicare Part B that went into effect on 1/1/2025; 7) Medicare Multi-Cancer Early Detection Screening Coverage Act (H.R.842/S.339); and 8) Extension of Medicare reimbursement for telehealth services.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Prior Authorization Simplification - H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments. Increase transparency around MA prior authorization requirements and its use. Clarify CMS authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests. Expand beneficiary protections to improve enrollee experiences and outcomes. Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Prior Authorization Simplification - H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments. Increase transparency around MA prior authorization requirements and its use. Clarify CMS authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests. Expand beneficiary protections to improve enrollee experiences and outcomes. Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Discuss with Congressional staff opposition to Medicaid proposals in H.R.1: work requirements as a condition of coverage, changes to state-directed payments, reductions to Federal matching funds, reductions to the safe harbor threshold for provider taxes, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule, cost-sharing for Medicaid beneficiaries, reductions to retroactive coverage, elimination of reasonable opportunity window, reductions in coverage for immigrants. Oppose changes to Affordable Care Act in H.R.1: limitations on premium tax credit eligibility, limitations on basic health program eligibility, reductions to special enrollment period. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Educate Congressional staff on hospital price transparency federal rule (84 FR 65602). Oppose changes to national provider identifier (NPI)s for hospital outpatient departments (118th: H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822). Discuss with Congressional staff S.891, Bipartisan Health Care Act, and comment on following provisions: support for delay of Medicaid DSH cut, codification and expansion of Federal price transparency rule, oppose NPI requirements for hospital outpatient departments, support reauthorization of Community Health Centers, support reauthorization of National Health Service Corps, support reauthorization of Teaching Health Center Graduate Medical Education funding, support PAHPA reauthorization, support SUPPORT Act reauthorization. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comments on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals. Discuss legislative proposals with Congressional staff to stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support); make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss Medicare Graduate Medical Education (GME) provisions in the Consolidated Appropriations Act (CAA), 2021 and CAA, 2023 with HHS staff. Discuss with Congressional staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855); concerns on Rural Physician Workforce Preservation Act and opposition to modifications to ongoing slot distribution; Senate Finance Committee draft proposals to increase GME slots. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training sites, and immigration reforms that expedite entry for foreign health care workers. Support passage of the SAVE Healthcare Workers Act (H.R. 3178/S. 1600). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Support health extenders in H.R. 1968 (Full-Year Continuing Appropriations and Extensions Act, 2025): extend COVID-19 Medicare-covered telehealth flexibilities, Acute Hospital Care at Home waiver, Medicaid DSH cut delay; discuss with Congressional staff and HHS staff. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702). Discuss Congressional activity on antitrust exemptions for medical residencies with Congressional staff. Support SEPSIS Act (S.1929). Support Streamline Emergency Care Act (H.R. 3980). Provide health care deregulation suggestions to OMB, HHS: make CMMI models voluntary, repeal certain reporting mandates, ease telehealth restrictions, urge nonenforcement of laboratory developed tests final rule.

Client expense: $570,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

S.864, Help Ensure Lower Patient (HELP) Copays Act H.R.1509/S.752, Accelerating Kids Access to Care Act H.R.8702/S.4532, Improving Seniors Timely Access to Care Act (118th Congress) H.R.1532/S.822, Scientific External Process for Educated Review of Therapeutics (EXPERT) Act H.R.1262/S.932, Give Kids a Chance Act H.R.1990, American Innovation and R&D Competitiveness Act H.R.1414, Camerons Law

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

NAPA Reauthorization Act (S. 133 / H.R. 619 - P.L. 118-92) Alzheimers Accountability and Investment Act (S. 134 / H.R. 620 - P.L. 118-93) Comprehensive Care for Alzheimers Act (S. 626 / H.R. 1637) Reauthorization of the BOLD Infrastructure for Alzheimer's Act (P.L. 115-406) BOLD Infrastructure for Alzheimer's Reauthorization Act of 2024 (S. 3775/ H.R. 7218 - P.L. 118-142) Accelerating Access to Dementia & Alzheimers Provider Training (AADAPT) Act (S. 4276/H.R. 7688) Elizabeth Dole Home Care Act, of 2023 (S. 141 / H.R. 542) Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (H.R. 8371) VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023 (S. 10) Access to Innovative Treatments Act of 2023 (H.R. 2408) Mandating Exclusive Review of Individual Treatments (MERIT) Act (H.R. 133) Elder Justice Reauthorization and Modernization Act of 2023 (S. 1198/H.R. 2718) Expanding Veterans Options for Long-Term Care Act (S. 495/H.R.1815) Palliative Care and Hospice Education and Training Act (S. 2243) Facilitating Innovative Nuclear Diagnostics (FIND) Act of 2023 (S. 1544/H.R. 1199) Supporting Our Seniors Act (S. 2584) Alleviating Barriers for Caregiving Act (S. 3109) Credit for Caring Act of 2024 (S. 3702/H.R. 7165) Credit for Caring Act of 2025 (S. 925/H.R. 2036) Lifespan Respite Care Reauthorization Act of 2024 (S. 4325/H.R. 6160) Lifespan Respite Care Reauthorization Act of 2025 (S.830/H.R.2560) DeOndra Dixon INvestigation of Co-occurring Conditions across the Lifespan to Understand Down Syndrome (INCLUDE) Project Act of 2024 (H.R. 7406) Paid Family and Medical Leave Tax Credit Extension Act (S. 3680) Paid Family and Medical Leave Tax Credit Extension and Enhancement Act (S. 400/H.R. 996) CONNECT for Health Act of 2023 (S. 2016/H.R. 4189) PACE Part D Choice Act of 2023 (S. 1703/H.R. 3549) Improving Seniors' Access to Timely Care Act of 2024 (S. 4532/H.R. 8702) Harmonizing Environmental Analyses and Launching Therapeutic Hubs to Yield Bolstered Research And Innovation in Neurological Science (HEALTHY BRAINS) Act of 2024 (H.R. 9233) Better Empowerment Now to Enhance Framework and Improve Treatments Act of 2023 (BENEFIT)(S. 526/H.R. 1092) Essential Caregivers Act of 2024 (S. 4280/H.R. 8331) Ensuring Patient Access to Critical Breakthrough Products Act of 2024 (H.R. 1691) Linking Seniors to Needed Legal Services Act of 2024 (H.R. 8588) Amending the Rules of the House of Representatives to establish a Permanent Select Committee on Aging (H. Res. 1029) Catching Up Family Caregivers Act of 2024 (S. 5149 / H.R. 9764) Improving Retirement Security for Family Caregivers Act of 2024 (S. 5148 / H.R. 9765) Charitable Act (S. 317/H.R. 801) Other matters related to disaster preparedness and older adults, public health emergencies, public health preparedness and response, telehealth, health disparities, and older Americans/people with disabilities in all phases of emergencies Other matters related to Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease Other matters related to care payment models, including the GUIDE model Other matters related to Medicare care planning code 99483 Other matters related to health care workforce shortages Other matters related to home- and community-based services Other matters related to disaster preparedness and older adults Other matters related to Social Security Other matters related to technology-enabled collaborative learning and capacity-building models (Project ECHO) Other matters related to beta-amyloid PET scans Other matters related to selected diagnoses and services rendered under ICD-10 Other matters related to caregiving Other matters related to medical devices Other matters related to rural health Other matters related to veterans' health Other matters related to Tricare Other matters related to research Other matters related to biomarkers including blood based tests and cerebral spinal fluid (CSF) Other matters related to public health

Client expense: $530,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

The Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future (SUSTAIN) 340B Act draft legislation from 118th Congress - all provisions. Continuing the federal Medicare telehealth geographic and site restriction waivers. Extending waivers for the federal Acute Hospital Care at Home program. Continued funding for the Medicare-Dependent Hospital and Low-Volume Hospital Adjustment programs. General concerns about Medicare underpayments to hospitals. H.R. 8702 & S. 4532 - Improving Seniors' Timely Access to Care Act of 2024 H.Con.Res.14 - Title II Section 201(b)(4).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future (SUSTAIN) 340B Act draft legislation from 118th Congress - all provisions. Continuing the federal Medicare telehealth geographic and site restriction waivers. Extending waivers for the federal Acute Hospital Care at Home program. Continued funding for the Medicare-Dependent Hospital and Low-Volume Hospital Adjustment programs. General concerns about Medicare underpayments to hospitals. H.R. 8702 & S. 4532 - Improving Seniors' Timely Access to Care Act of 2024 H.Con.Res.14 - Title II Section 201(b)(4).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.864, Help Ensure Lower Patient (HELP) Copays Act H.R.1509/S.752, Accelerating Kids Access to Care Act H.R.8702/S.4532, Improving Seniors Timely Access to Care Act (118th Congress) H.R.1532/S.822, Scientific External Process for Educated Review of Therapeutics (EXPERT) Act H.R.1262/S.932, Give Kids a Chance Act H.R.1990, American Innovation and R&D Competitiveness Act H.R.1414, Camerons Law

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Prior Authorization Simplification - H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments. Increase transparency around MA prior authorization requirements and its use. Clarify CMS authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests. Expand beneficiary protections to improve enrollee experiences and outcomes. Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Prior Authorization Simplification - H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments. Increase transparency around MA prior authorization requirements and its use. Clarify CMS authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests. Expand beneficiary protections to improve enrollee experiences and outcomes. Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage (MA) Policy and Reimbursement Enactment of policies in Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies Medicare Part D Issues Medicaid Policy Issues Including Dual Eligibles Pharmacy Benefit Managers (PBM) and Pharmacy Policy and Reimbursement Issues Home Health Policy and Reimbursement Issues Implementation of Inflation Reduction Act of 2022 Public Law No. 117-169 H.R.8702/S.4532, Improving Seniors Timely Access to Care Act (118th Congress) Prior Authorization Policy and Regulatory Issues CMS-4185-F2 Medicare Advantage Risk Adjustment Data Validation Final Rule Primary Care and Value-Based Care Policy and Reimbursement Clinical Policy Issues Including Workforce and Mental Health Calendar Year (CY) 2024 Home Health Prospective Payment System Final Rule (CMS-1780-F) Hospital Outpatient Prospective Payment System (OPPS): Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 Final Rule (CMS 1793-F) Implementation of CMS Interoperability and Prior Authorization final rule (CMS-0057-F) Calendar Year (CY) 2025 Home Health Prospective Payment System Final Rule (CMS-1803-F) Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies Final Calendar Year (CY) 2025 Part D Redesign Program Instructions Fiscal Year (FY) 2025 Hospice Payment Rate Update Final Rule (CMS-1810-F) Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-P) Calendar Year (CY) 2026 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies H.Con.Res.14, Establishing the congressional budget for the United States Government for fiscal year 2025 and setting forth the appropriate budgetary levels for fiscal years 2026 through 2034 S.Con.Res.7, An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2025 and setting forth the appropriate budgetary levels for fiscal years 2026 through 2034

Client expense: $2,510,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Issues related to surprise billing; Issues related to prior authorization in Medicare and Medicaid; Issues related to H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act of 2024.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care priorities of ACCC: a) Prior authorization (Including: Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702 in the 118th Congress); 2) Oncology drug and medical supply shortages; 3) Patient navigation; 4) Financial toxicity; 5) Inflation Reduction Act implementation, especially Protecting Patient Access to Cancer and Complex Therapies Act (S.2764/H.R.5391 in the 118th Congress); 6) Reducing Physician Payment Reimbursement Cuts under Medicare Part B that went into effect on 1/1/2025; 7) Medicare Multi-Cancer Early Detection Screening Coverage Act (H.R.842/S.339); and 8) Extension of Medicare reimbursement for telehealth services.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Discuss with Congressional staff opposition to proposals to reduce the Medicaid program: work requirements as a condition of coverage, changes to state-directed payments, block grants, per capita caps, reductions to federal matching funds, reductions to the safe harbor threshold for provider taxes, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Educate Congressional staff on hospital price transparency federal rule (84 FR 65602). Oppose changes to NPIs for hospital outpatient departments (118th: H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822). Discuss with Congressional staff S.891, Bipartisan Health Care Act, and comment on following provisions: support for delay of Medicaid DSH cut, codification and expansion of Federal price transparency rule, oppose National Provider Identifier (NPI) requirements for hospital outpatient departments, support reauthorization of Community Health Centers, support reauthorization of National Health Service Corps, support reauthorization of Teaching Health Center Graduate Medical Education funding, support PAHPA reauthorization, support SUPPORT Act reauthorization. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comments on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals. Discuss legislative proposals with Congressional staff to stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support); make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss Medicare Graduate Medical Education (GME) provisions in the Consolidated Appropriations Act (CAA), 2021 and CAA, 2023 with HHS staff. Discuss with Congressional staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855); concerns on Rural Physician Workforce Preservation Act and opposition to modifications to ongoing slot distribution; Senate Finance Committee draft proposals to increase GME slots. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training site, and immigration reforms that expedite entry for foreign health care workers. Support passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S.2768). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Support health extenders in H.R. 1968 (Full-Year Continuing Appropriations and Extensions Act, 2025): extend COVID-19 Medicare-covered telehealth flexibilities, Acute Hospital Care at Home waiver, Medicaid DSH cut delay; discuss with Congressional staff and HHS staff. Discuss legislative proposals to regulate the use of artificial intelligence in health care delivery with Congressional staff and National Science Foundation. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702).

Client expense: $530,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

Discuss with Congressional staff and HHS staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855); concerns on Rural Physician Workforce Preservation Act; Senate Finance Committee proposals to increase GME slots. Discuss technical amendment to CAA, 2021, Sec. 131 pertaining to Medicare GME with Congressional staff. Discuss with Congressional staff distribution methodology for Medicare GME slots created in the CAA, 2021. Discuss expiring COVID-19 Public Health Emergency (PHE) Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to extend PHE telehealth flexibilities and Acute Hospital Care at Home Waiver. Support extension of Medicare Dependent Hospital and Low-Volume Adjustment programs. Support proposals to reduce payment cut in CY 2025 Physician Fee Schedule final rule. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Oppose changes to NPIs for hospital outpatient departments (H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822). Comment on FY 2024 IPPS rule to increase payment update to hospitals, Transforming Episodic Accountability Model, AHEAD Model, and CAA, 2023 Sec 4122 GME slot distribution methodology, and discuss comments with Congressional staff and CMS staff. Discuss proposals that stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support), make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss with Congressional staff opposition to proposals to reduce the Medicaid program: work requirements as a condition of coverage, changes to state-directed payments, block grants, per capita caps, reductions to federal matching funds, reductions to the safe harbor threshold for provider taxes, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule. Support certain changes to Medicaid DSH payments: support two-year elimination of Medicaid DSH cut scheduled for January 1, 2025; support Save Our Safety Net Hospitals Act (H.R. 9351) to restore pre-CAA, 2021 DSH cap calculation methodology and include dual-eligible patients in state DSH cap calculation. Discuss Medicaid waiver proposal with Congressional staff and HHS. Discuss CMMI initiatives on global budgets and primary care in NYS Medicaid waiver. Discuss Medicaid IMD exclusion policies with Congressional staff. Support legislation to increase Medicaid payment rates for labor and delivery services for certain hospitals (118th Congress: S.5236). Discuss with Congressional staff support for CMS approval of Medicaid managed care organization tax proposed in New York State budget. Oppose CMS final rule to establish minimum nurse staffing in Medicare- and Medicaid-certified long-term care facilities (89 FR 40876) and support legislative efforts to repeal rule. Support Medicare Advantage prior authorization reforms - Improving Seniors Timely Access to Care Act (118th Congress: S. 4532/H.R. 8702). Discuss wage index issues with Congressional staff: H.R. 8561 to address MA local area growth under projection, FY 2025 IPPS/LTCH interim final rule, indirect medical education (IME) payments to hospitals. Meet with CMS leadership to discuss Medicare and Medicaid issues: prior authorization and MA insurance denials, concerns on mandatory participation for AHEAD and TEAM models, Medicare support for health care workforce; support for telehealth flexibilities and Acute Hospital Care at Home waiver extension. Discuss Medicare wage index issues with CMS. Discuss Medicare Part B payment for unlicensed physicians with CMS. Support New York State Essential Plan (Medicaid Section 1332 Waiver) and oppose proposals to reduce coverage. Urge delayed enforcement of CMS final rule prohibiting nurses from performing glucose tests using high-complexity devices in point-of-care situations.

Client expense: $530,000 · Firm income: Not reported

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

H.R. 8702/S. 4532 Improving Seniors Timely Access to Care Act of 2024 H.R. 972/ S. 312 Outpatient Surgery Quality and Access Act of 2023

Client expense: $45,000 · Firm income: Not reported

Health care priorities of ACCC: a) Oncology patient navigation; b) Oncology drug shortages; c) Financial toxicity for patients with cancer; and d) Inflation Reduction Act implementation (including Protecting Patient Access to Cancer and Complex Therapies Act (S. 2764/H.R. 5391). Medicare Multi-Cancer Early Detection Screening Coverage Act (H.R. 2407, S. 2085); SCREENS for Cancer Act (H.R. 3916, S. 1840); Clinical Trial Modernization Act (H.R. 8412); Prior authorization, including Improving Seniors Timely Access to Care Act of 2024 (S. 4532, H.R. 8702); House resolution designating September 30, 2024 as Rare Cancer Day (H.Res. 1521); Extension of Medicare reimbursement for telehealth services; Medicare physician payment increases.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Issues: Medicaid/Medicare: - Medicaid Disproportionate Share Hospital (DSH) Cuts: Advocated for the elimination of cuts. - Public Health Emergency (PHE) Waivers: Supported extension of waivers, including telehealth flexibilities and the hospital-at-home program. - Medicare Site-Neutral Payments: Opposed proposed cuts to site-neutral payments. Healthcare Workforce: - Graduate Medical Education (GME): Supported increasing the number of GME slots. Administrative Reforms: - National Provider Identifier (NPI): Opposed burdensome policies that would impact NPI requirements under H.R. 5378. - Prior Authorization Improvements: Advocated for measures to improve access to care and reduce administrative delays. Healthcare Programs: - Community Health Center Funding: Advocated for the extension of federal funding for community health centers. - Urged members of Congress to sign the bipartisan Dear Colleague letter on Medicaid DSH, led by Representatives Clarke, Crenshaw, DeGette, and Bilirakis. Legislation Monitored and Supported/Opposed: - H.R. 8260 / S. 4350 - Hospital Inpatient Services Modernization Act - H.R. 5378 - Lower Costs, More Transparency Act - H.R. 2389 - Resident Physician Shortage Reduction Act of 2023 - H.R. 9351 - Save Our Safety-Net Hospitals Act of 2024 - H.R. 8702 / S. 4532 - Improving Seniors Timely Access to Care Act of 2024

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Specific Lobbying Issues: Medicaid/Medicare: - Medicaid Disproportionate Share Hospital (DSH) Cuts: Advocated for elimination of cuts. Medicare Site-Neutral Payments: - Opposed proposed cuts to site-neutral payments. Extension of Public Health Emergency (PHE) Waivers: - Supported continuation of waivers for Hospital-at-Home (H@H) programs and telehealth services. Healthcare Workforce: - Graduate Medical Education (GME): Advocated for increased GME slots. Improving Medicaid and CHIP Provider Enrollment Processes: - Supported proposals to streamline enrollment. Healthcare Programs: - 340B Drug Pricing Program: Supported the program and opposed efforts to impose restrictive policies. - Community Health Center Funding: Advocated for extension of funding. Administrative Reforms: - Prior Authorization Improvements: Supported measures to improve access to timely care. - National Provider Identifier (NPI): Opposed proposals included in H.R. 5378 that would impact the NPI process. Legislation Monitored and Supported/Opposed: H.R. 7635 / S. 5021 - 340B PATIENTS Act of 2024 H.R. 8260 / S. 4350 - Hospital Inpatient Services Modernization Act H.R. 5378 - Lower Costs, More Transparency Act H.R. 2389 - Resident Physician Shortage Reduction Act of 2023 H.R. 9351 - Save Our Safety-Net Hospitals Act of 2024 H.R. 8702 / S. 4532 - Improving Seniors Timely Access to Care Act of 2024 H.R. 4758 - Accelerating Kids Access to Care Act H.R. 2407 - Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act Meetings/letters with Congressional offices to discuss the above issues and legislative priorities. Advocacy for specific funding levels, policy changes, and program extensions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

HR 4758 / S 2372, the Accelerating Kids Access to Care Act; HR 5526 / S 3458, the Seniors' Access to Critical Medications Act; HR 8702 / S 4532, Improving Seniors Timely Access to Care Act; HR 1613, the Drug Price Transparency in Medicaid Act; HR 4473, the Medicare Patient Access to Cancer Treatment Act; HR 5378, The Lower Costs, More Transparency Act; HR 7512, the Real-Time Benefit Tool Implementation Act; S 2186, the Improving Access to Transfusion Care for Hospice Patients Act; S 1869, the Site-based Invoicing and Transparency Enhancement (SITE) Act; S 4349, the Electronic Prior Authorization for Prescription Drugs Act Implementation of the Inflation Reduction Act, specifically provisions relating to the Medicare Part D annual and monthly maximum out-of-pocket caps; Proposals to add work requirements to Medicaid programs; Medicaid policies related to the end of certain federal Medicaid maintenance-of-effort requirements; Proposals to promote parity in certain Medicare reimbursement across hospital outpatient and provider office settings;

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support the Strengthening Medicare for Patients and Providers Act, (H.R. 2474), which provides a permanent annual update equal to the increase in the MEI, and the Provider Reimbursement Stability Act (H.R. 6371), which would reform budget neutrality requirements. Generally support elimination or reduction in scheduled Medicare physician fee schedule conversion factor for CY205. Support repeal of the Medicare Appropriate Use Criteria Program for advanced diagnostic imaging. No specific legislation Support the the Improving Seniors Timely Access to Care Act (H.R. 8702/S. 4532)

Client expense: Not reported · Firm income: $22,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention H.R. 766/S 114, Dr. Michael C. Burgess Preventive Health Savings Act H.R. 1147/S. 1957, Whole Milk for Healthy Kids Act of 2023 H.R. 1843/S.1001, Telehealth Expansion Act of 2023 H.R. 2411/S. 1150, National Nursing Workforce Centers Act of 2023 H.R. 2663/S. 1176, Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 2713/S. 2418, Improving Care and Access to Nurses (I CAN) Act H.R. 2901, Food Labeling Modernization Act of 2023 H.R. 3073/S. 1452, Community Mental Wellness and Resilience Act of 2023 H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023 H.R. 3305/S. 1606, Black Maternal Health Momnibus Act H.R. 3331/S. 754, Improving Mental Health and Wellness in Schools Act H.R. 3433, Give Kids a Chance Act H.R. 3633, Promoting Resources to Expand Vaccination, Education, and New Treatments for HPV Cancers (PREVENT HPV Cancers) Act of 2023 H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023 H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act of 2023 H.R. 4758/S. 2372, Accelerating Kids Access to Care Act H.R. 4775, Helping Tobacco Users Quit Act H.R. 4892/S. 3921, Medicaid Bump Act H.R. 5012/S. 2647, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2023 H.R. 5378, Lower Costs, More Transparency Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 6122/S. 2853, Train More Nurses Act H.R. 6149/S. 1291, Protecting Kids on Social Media Act H.R. 6766/S. 3512, Transparency, Readability, Understandability, Truth, and Helpfulness (TRUTH) in Labeling Act H.R. 6960/S. 3765, Emergency Medical Services for Children Reauthorization Act of 2024 H.R. 7002/S. 2815, Nurse Faculty Shortage Reduction Act of 2024 H.R. 7153/S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 7224, To reauthorize the Stop, Observe, Ask, and Respond to Health and Wellness Training Program. H.R. 7808, Early Action and Responsiveness Lifts Youth (EARLY) Minds Act H.R. 8467, Farm, Food, and National Security Act of 2024 H.R. 8818, American Privacy Rights Act H.R. 9076, Protecting Americas Children by Strengthening Families Act H.R. 9425, Tobacco User Fee Modernization Act of 2024 H.R. 9774/S. 5194, Health Care Affordability Act of 2024 H.R. 9828, End the Vaccine Carveout Act H.R. 9886, BUPE for Recovery Act S. 397, Promoting Physical Activity for Americans Act S. 644/H.R. 1359, Modernizing Opioid Treatment Access Act S. 1409/H.R. 7891, Kids Online Safety Act S. 1418/H.R. 7890, Children and Teens Online Privacy Protection Act S. 1840/H.R. 3916, Screening for Communities to Receive Early and Equitable Needed Services (SCREENS) for Cancer Act of 2023 S. 1884/H.R. 3713, Mental Health Services for Students Act of 2023 S. 2073, Kids Online Safety and Privacy Act S. 2840, Bipartisan Primary Care and Health Workforce Act S. 3085, Preventing Adverse Childhood Experiences (PACE) Act S. 3193/H.R. 5163, Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act S. 3364/H.R. 6663, Kid Providing Resources for Optimal Outcomes against Fatalities (Kid PROOF) Act of 2023 S. 3393/H.R. 4531, SUPPORT for Patients and Communities Reauthorization Act S. 3453/H.R. 9684, Peer-to-Peer Mental Health Support Act S. 3770/H.R. 7266, Future Advancement of Academic Nursing (FAAN) Act S. 4041, Creating Access and Resources in Education (CARE) for Student Mental Health Act S. 4532/H.R. 8702, Improving Seniors Timely Access to Care Act S. 4745, Federal Food Administration Act

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

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

Inpatient Rehabilitation Facility (IRF) Review Choice Demonstration (RCD) Project IRF Three-Hour Rule - H.R. 6110, the Access to Inpatient Rehabilitation Therapy Act of 2023 Prior Authorization Reform - H.R. H.R.8702/S. 4532, the Improving Seniors' Timely Access to Care Act of 2024 - H.R. 4822, the Health Care Price Transparency Act of 2023 - H.R. 4968, the Getting Over Lengthy Delays in Care As Required by Doctors Act of 2023 - H.R. 5213, the Reducing Medically Unnecessary Delays in Care Act of 2023 Medicare Reimbursement / Physician Payment Schedule Cuts - H.R. 2474, the Strengthening Medicare for Patients and Providers Act of 2023 - H.R. 10073, the Medicare Patient Access and Practice Stabilization Act of 2024 Scope of Practice - H.R. 2713, the Improving Care and Access to Nurses Act of 2023 - H.R. 618 / S. 131, the Improving Access to Workers' Compensation for Injured Federal Workers Act - National Standards of Practice at the Department of Veterans Affairs Telehealth - Extension of federal telehealth waivers first implemented during COVID-19 public health emergency

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

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

COVID-19 / Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) / Long COVID - S. 801 / H.R. 1616, the CARE for Long COVID Act of 2023 - H.R. 1114, the Long COVID Recovery Now Act of 2023 - H.R. 3258, the TREAT Long COVID Act of 2023 - S. 2560, the Long COVID Support Act of 2023 - H.R. 9907 / S. 4964, the Long COVID Research Moonshot Act of 2024 Funding for Rehabilitation Research Inpatient Rehabilitation Facility (IRF) Review Choice Demonstration (RCD) Project Streamlining access to rehabilitation for Medicare beneficiaries (SNF three day rule, IRF three hour rule) - H.R. 6110, the Access to Inpatient Rehabilitation Therapy Act of 2023 Prior Authorization Reform - H.R. H.R.8702 /S. 4532, the Improving Seniors' Timely Access to Care Act of 2024 - H.R. 4822, the Health Care Price Transparency Act of 2023 - H.R. 4968, the Getting Over Lengthy Delays in Care As Required by Doctors Act of 2023 - H.R. 5213, the Reducing Medically Unnecessary Delays in Care Act of 2023 Medicare Reimbursement / Physician Payment Schedule Cuts - H.R. 2474, the Strengthening Medicare for Patients and Providers Act of 2023 - H.R. 10073, the Medicare Patient Access and Practice Stabilization Act of 2024 Scope of Practice - H.R. 2713, the Improving Care and Access to Nurses Act of 2023 - H.R. 618 / S. 131, the Improving Access to Workers' Compensation for Injured Federal Workers Act - National Standards of Practice at the Department of Veterans Affairs Telehealth - Extension of federal telehealth waivers first implemented during COVID-19 public health emergency

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Linking Seniors to Needed Legal Services Act (H.R. 8588) Accelerating Access to Dementia & Alzheimers Provider Training (AADAPT) Act (S. 4276/H.R. 7688) Amending the Rules of the House of Representatives to establish a Permanent Select Committee on Aging (H. Res. 1029) Improving Seniors' Access to Timely Care Act (S. 4532/H.R. 8702) to amend Title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans Harmonizing Environmental Analyses and Launching Therapeutic Hubs to Yield Bolstered Research And Innovation in Neurological Science (HEALTHY BRAINS) Act (H.R. 9233) Better Empowerment Now to Enhance Framework and Improve Treatments Act of 2023 (BENEFIT) Act (S. 526/H.R. 1092) Essential Caregivers Act of 2024 (S. 4280/H.R. 8331) Ensuring Patient Access to Critical Breakthrough Products Act (H.R. 1691) PACE Part D Choice Act of 2023 (S. 1703/H.R. 3549) Credit for Caring Act of 2024 (S. 3702/H.R. 7165) Paid Family and Medical Leave Tax Credit Extension and Enhancement Act (S. 3680) CONNECT for Health Act of 2023 (S. 2016 / H.R. 4189) Lifespan Respite Care Reauthorization Act (H.R. 6160) to amend the Public Health Service Act to reauthorize a lifespan respite care program DeOndra Dixon Investigation of Co-occurring Conditions across the Lifespan to Understand Down Syndrome (INCLUDE) Project Act of 2024 (H.R. 7406) NAPA Reauthorization Act (S. 133/H.R. 619/P.L. 118-92) Alzheimers Accountability and Investment Act (S. 134/H.R. 620/P.L. 118-93) Comprehensive Care for Alzheimers Act (S. 626/H.R. 1637) Elizabeth Dole Home Care Act of 2023 (S. 141/H.R. 542) Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (H.R. 8371) VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023 (S. 10) Mandating Exclusive Review of Individual Treatments (MERIT) Act (H.R. 133) Access to Innovative Treatments Act of 2023 (H.R. 2408) Elder Justice Reauthorization and Modernization Act of 2023 (H.R. 2718/S. 1198) Expanding Veterans Options for Long Term Care Act (H.R.1815/S. 495) Palliative Care and Hospice Education and Training Act (S.2243) Facilitating Innovative Nuclear Diagnostics Act of 2023 (H.R. 1199/S. 1544) Supporting Our Seniors Act (S. 2584) Alleviating Barriers for Caregiving Act (S. 3109) Reauthorization of the BOLD Infrastructure for Alzheimer's Act (P.L. 115-406) BOLD Reauthorization Act (P.L.118-142) Catching Up Family Caregivers Act (S. 5149 / H.R. 9764) Improving Retirement Security for Family Caregivers Act (S. 5148 / H.R. 9765) Other matters related to Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimers Disease Other matters related to care payment models, including the GUIDE model Other matters related to Medicare care planning code 99483 Other matters related to health care workforce shortages Other matters related to home- and community-based services Other matters related to disaster preparedness and older adults Other matters related to Social Security Other matters related to technology-enabled collaborative learning and capacity-building models (Project ECHO) Other matters related to beta amyloid PET scans Other matters related to selected diagnoses and services rendered under ICD-10 Other matters related to caregiving Other matters related to medical devices other matters related to rural health other matters related to veterans health other matters related to Tricare Other matters related to research Other matters related to biomarkers including blood based tests and cerebral spinal fluid (csf)

Client expense: $480,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

Monitored issues regarding PPS exempt hospitals. Issues concerning reimbursement for hospital services. Issues regarding hospital transparency. Monitored H.R.2389 / S. 1302, Resident Physician Shortage Reduction Act of 2023. H.R. 977, Patient Access to Higher Quality Health Care Act of 2023. Issues regarding healthcare sector consolidation. H.R. 5378, the Lower Costs, More Transparency Act, as it relates to hospitals. Issues concerning drug shortages. Issues involving the extension of the Acute Care Hospital at Home program. H.R. 6213, National Quantum Initiative Reauthorization Act. Monitored H.R.5159 / S. 2137, the Preserving Access to Home Health Care Act of 2023. Issues related to telehealth. H.R. 4758 / S. 2372, Accelerating Kids Access to Care Act. H.R. 6094, Providing Realistic Opportunity to Equal and Comparable Treatments (PROTECT) Rare Act. Issues concerning cybersecurity. H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act. Issues regarding the IOTA Model final rule. H.R. 10445, Furthering Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 and H.R. 10545, The American Relief Act of 2025 and issues related to hospitals. H.R. 8702 / S.4532, Improving Seniors Timely Access to Care Act of 2024.

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

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

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad - Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare and adds requirements for Part D plan contracts with PBMs including reporting and delinking provisions H.R. 7996 - Improving CARE for Youth Act - Rep. Dunn, Neal - allows for same-day billing for mental health services for youth Medicaid beneficiaries who are being seen for a primary care service H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 948 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - establishes programs and requirements to support maternal health services under Medicaid and CHIP S. 1002 - No UPCODE Act - Sen. Cassidy, Bill - modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Client expense: $2,610,000 · Firm income: Not reported

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

Congressional outreach and monitoring regarding the following: -Healthcare and hospital workforce budget and appropriations, generally; -340B Drug Discount Program & HRSA/CMS policies; -CMS Wage Index; -National Provider Identification; -Telehealth, generally; -Site Neutral Payment Proposals; -Rural Medicare Programs; -Medicaid DSH Payments; -Medicare reimbursement rates, generally; -H.R. 10545, Further Continuing Appropriations Act, 2025; -H.R. 2584 / S. 2768, Safety From Violence for Healthcare Employees Act; -H.R. 7635 / S. 3922, The 340B PATIENTS Act of 2024; -H.R.8702 / S. 4532, Improving Seniors Timely Access to Care Act of 2024.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S.4532/H.R. 8702), Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage program. H.R. 9001, Physician Led and Rural Access to Quality Care Act: To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals and allow physician ownership of rural hospitals H.R.9805, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R. 10073, Medicare Patient Access and Practice Stabilization Act of 2024 (H.R.10073): To eliminate the 2.8% Medicare physician fee schedule(MPFS) cut and provide an inflationary update for calendar year 2025. No bill: Medicare payment reforms, including positive annual updates, adjustments to Medicare's budget neutrality requirements, improving alternative payment models, modifying the Merit-based Improvement Payment System and expanding relevant quality improvement measures.

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. FY2024 Defense Appropriations Act Fiscal 2024 Labor-HHS-Education Appropriations P.L. 116-136, CARES Act P.L. 113-5 Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) S. 127 - Pharmacy Benefit Manager Transparency Act H.R. 830 - The HELP Copays Act S. 1375 - HELP Copays Act H.R. 1202 - Resident Education Deferred Interest Act, or REDI Act S. 704 - REDI Act S. 665, HR 4942 - Conrad State 30 and Physician Access Reauthorization Act H.R. 2389 - Resident Physician Shortage Reduction Act S. 1302 - Resident Physician Shortage Reduction Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act S. 652, H.R. 2630 - Safe Step Act S. 1339 - Pharmacy Benefit Manager Reform Act H.R. 2670 - National Defense Authorization Act H.R. 2816 - Pharmacy Benefit Manager Sunshine and Accountability Act H.R. 2679 - Pharmacy Benefits Manager Accountability Act H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.6371 - Provider Reimbursement Stability Act of 2023 S. 2764 - Protecting Patient Access to Cancer and Complex Therapies Act H.R. 5391 - Protecting Patient Access to Cancer and Complex Therapies Act Appropriation legislation related to Medicare Physician Payments cuts implemented in 2024 Appropriations legislation related to the Congressionally Directed Medical Research Program Appropriations legislation related to the National Institutes of Health S. 705 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 2761 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 8702 - Improving Seniors Timely Access to Care Act of 2024 S. 4532 - Improving Seniors Timely Access to Care Act of 2024 H.R. 6664 - The Innovation in Pediatric Drugs Act S. 4349 - Electronic Prior Authorization for Prescription Drugs Act HR. 6487 - No Fees for EFTs Act S. 3805 - No Fees for EFTs Act S. 4935 - Physician Fee Stabilization Act H.R. 7623 - Telehealth Modernization Act S. 3967 - Telehealth Modernization Act H.R. 7153 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 3679 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act H.R. 6545 - Physician Fee Schedule Update and Improvements Act H.R. 10545 - American Relief Act of 2025 H.R. 8774 - Department of Defense Appropriations Act, 2025 H.R. 9029 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. FY2024 Defense Appropriations Act Fiscal 2024 Labor-HHS-Education Appropriations P.L. 116-136, CARES Act P.L. 113-5 Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) S. 127 - Pharmacy Benefit Manager Transparency Act H.R. 830 - The HELP Copays Act S. 1375 - HELP Copays Act H.R. 1202 - Resident Education Deferred Interest Act, or REDI Act S. 704 - REDI Act S. 665, HR 4942 - Conrad State 30 and Physician Access Reauthorization Act H.R. 2389 - Resident Physician Shortage Reduction Act S. 1302 - Resident Physician Shortage Reduction Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act S. 652, H.R. 2630 - Safe Step Act S. 1339 - Pharmacy Benefit Manager Reform Act H.R. 2670 - National Defense Authorization Act H.R. 2816 - Pharmacy Benefit Manager Sunshine and Accountability Act H.R. 2679 - Pharmacy Benefits Manager Accountability Act H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.6371 - Provider Reimbursement Stability Act of 2023 S. 2764 - Protecting Patient Access to Cancer and Complex Therapies Act H.R. 5391 - Protecting Patient Access to Cancer and Complex Therapies Act Appropriation legislation related to Medicare Physician Payments cuts implemented in 2024 Appropriations legislation related to the Congressionally Directed Medical Research Program Appropriations legislation related to the National Institutes of Health S. 705 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 2761 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 8702 - Improving Seniors Timely Access to Care Act of 2024 S. 4532 - Improving Seniors Timely Access to Care Act of 2024 H.R. 6664 - The Innovation in Pediatric Drugs Act S. 4349 - Electronic Prior Authorization for Prescription Drugs Act HR. 6487 - No Fees for EFTs Act S. 3805 - No Fees for EFTs Act S. 4935 - Physician Fee Stabilization Act H.R. 7623 - Telehealth Modernization Act S. 3967 - Telehealth Modernization Act H.R. 7153 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 3679 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act H.R. 6545 - Physician Fee Schedule Update and Improvements Act H.R. 10545 - American Relief Act of 2025 H.R. 8774 - Department of Defense Appropriations Act, 2025 H.R. 9029 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. FY2024 Defense Appropriations Act Fiscal 2024 Labor-HHS-Education Appropriations P.L. 116-136, CARES Act P.L. 113-5 Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) S. 127 - Pharmacy Benefit Manager Transparency Act H.R. 830 - The HELP Copays Act S. 1375 - HELP Copays Act H.R. 1202 - Resident Education Deferred Interest Act, or REDI Act S. 704 - REDI Act S. 665, HR 4942 - Conrad State 30 and Physician Access Reauthorization Act H.R. 2389 - Resident Physician Shortage Reduction Act S. 1302 - Resident Physician Shortage Reduction Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act S. 652, H.R. 2630 - Safe Step Act S. 1339 - Pharmacy Benefit Manager Reform Act H.R. 2670 - National Defense Authorization Act H.R. 2816 - Pharmacy Benefit Manager Sunshine and Accountability Act H.R. 2679 - Pharmacy Benefits Manager Accountability Act H.R. 2474 - The Strengthening Medicare for Patients and Providers Act H.R.6371 - Provider Reimbursement Stability Act of 2023 S. 2764 - Protecting Patient Access to Cancer and Complex Therapies Act H.R. 5391 - Protecting Patient Access to Cancer and Complex Therapies Act Appropriation legislation related to Medicare Physician Payments cuts implemented in 2024 Appropriations legislation related to the Congressionally Directed Medical Research Program Appropriations legislation related to the National Institutes of Health S. 705 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 2761 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 8702 - Improving Seniors Timely Access to Care Act of 2024 S. 4532 - Improving Seniors Timely Access to Care Act of 2024 H.R. 6664 - The Innovation in Pediatric Drugs Act S. 4349 - Electronic Prior Authorization for Prescription Drugs Act HR. 6487 - No Fees for EFTs Act S. 3805 - No Fees for EFTs Act S. 4935 - Physician Fee Stabilization Act H.R. 7623 - Telehealth Modernization Act S. 3967 - Telehealth Modernization Act H.R. 7153 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 3679 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act H.R. 6545 - Physician Fee Schedule Update and Improvements Act H.R. 10545 - American Relief Act of 2025 H.R. 8774 - Department of Defense Appropriations Act, 2025 H.R. 9029 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025

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

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

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S.4532/H.R. 8702), Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage program. H.R. 9001, Physician Led and Rural Access to Quality Care Act: To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals and allow physician ownership of rural hospitals H.R.9805, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R. 10073, Medicare Patient Access and Practice Stabilization Act of 2024 (H.R.10073): To eliminate the 2.8% Medicare physician fee schedule (MPFS) cut and provide an inflationary update for calendar year 2025. No bill: Medicare payment reforms, including positive annual updates, adjustments to Medicare's budget neutrality requirements, improving alternative payment models, modifying the Merit-based Improvement Payment System and expanding relevant quality improvement measures.

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Funding for Disproportionate Share Hospitals (Medicaid DSH). Support for H.R.7327 - Protecting Front Line Multimission Hospitals Act of 2024. Support of telehealth policies, including for audio-only telehealth services. H.R.7053/S.3792 - acute hospital care at home waiver flexibility. H.R.3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023. H.R.5378, Lower Costs, More Transparency Act; Medicare physician payment reductions, in general. H.R.6545, Physician Fee Schedule Update and Improvements Act. H.R.2474, Strengthening Medicare for Patients and Providers Act. S.3450, Mental and Physical Health Care Comorbidities Act of 2023. H.R. 10073, the Medicare Patient Access and Practice Stabilization Act of 2024. S.4532/H.R. 8702, Improving Seniors Timely Access to Care Act of 2024. In general, support provisions to reform Medicare physician fee schedule payment policies and access to physician services.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1526/S. 765 -Reducing Hereditary Cancer Act of 2023; bill provides for Medicare coverage of germline mutation testing for individuals with a personal or family history of a hereditary cancer gene mutation or suspected history of hereditary cancer, as well as for associated coverage of risk-reducing surgeries and screenings H.R. 1780/S. 642 - Finn Sawyer Access to Cancer Testing Act; bill provides for coverage of certain cancer diagnostic and laboratory tests under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Specifically, the bill provides for coverage of microarray analysis, DNA and RNA sequencing, whole-exome sequencing, and other next-generation sequencing for individuals diagnosed with cancer. H.R. 2407/S. 2085 - Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act; bill allows for Medicare coverage and payment for multi-cancer early detection screening tests that are approved by the Food and Drug Administration and that are used to screen for cancer across many cancer types, if the Centers for Medicare & Medicaid Services determines such coverage is appropriate. H.R. 3086 - Find It Early Act; a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals at greater risk for breast cancer. H.R. 4189/S. 2016 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes. H.R. 3876/S .2323 - Access to Genetic Counselor Services Act of 2023; This bill provides for coverage under Medicare of genetic counseling services that are furnished by genetic counselors. Covered services include those services, as well as incidental services and supplies, that would otherwise be covered under Medicare if provided by a physician. H.R.8702/S.4532 - Improving Seniors Timely Access to Care Act - a bill to establish an electronic prior authorization standard to streamline approvals, reduce the amount of time a health plan is allowed to consider a prior authorization request, require MA plans to report on their use of prior authorization and the rate of approvals and denials, and encourage MA plans to adopt policies that adhere to evidence-based guidelines. H.R. 1770/S. 2477 - Equitable Community Access to Pharmacist Services Act ; would ensure Medicare beneficiaries receive prompt care and services from pharmacists to prevent, diagnose, and treat common infectious diseases. S. 3892 - Community Health Worker Access Act; a bill to amend titles XVIII and XIX of the Social Security Act to increase access to community health workers under the Medicare and Medicaid programs. Medicare coverage policy for breast cancer treatments and services Proposed waivers under Sections 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to PBM reform Policies related to the implementation of the Inflation Reduction Act

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

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

S. 1967, the Patients Before Middlemen (PBM) Act, establishing new requirements relating to the responsibility of pharmacy benefit managers under Medicare part D; H.R. 3282, Promoting Transparency and Healthy Competition in Medicare Act; H.R. 2880, the Protecting Patients Against PBM Abuses Act; H.R. 5376, the Share the Savings with Seniors Act; H.R. 5385, the Medicare PBM Accountability Act; H.R.4881, To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program. Including issues related to point-of-sale rebates in Part D Low-Income Subsidy under the Medicare program; H.R. 5393, the Transparency and Fairness for Pharmacies Act; H.R. 5372, the Expanding Seniors Access to Lower Cost Medicines Act of 2023; H.R. 1352, the Increasing Access to Biosimilars Act; H.R. 5386, the Cutting Copays Act; Issues related to Pharmacy Direct and Indirect Remuneration (DIR), including the Contract Year (CY) 2023 Policy and Technical Changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit (Part D) Programs proposed rule; H.R. 7623, Telehealth Modernization Act of 2024; H.R. 8702/ S.4532, Improving Seniors' Timely Access to Care Act; P.L. No: 118-158 and draft FY2025 Continuing Resolution, issues related to Medicare/Medicare Advantage.

Client expense: $1,420,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Acute Hospital Care at Home - Recommended Congress make certain flexibilities related to the Acute Hospital Care at Home Program permanent or, pass an extension before flexibilities expired. Home Infusion - Shared concerns regarding changes to Medicare reimbursement for certain Home Infusion Treatments, encouraged passage of the Preserving Patient Access to Home Infusion Act (S.1976/H.R.4104) Issues related to hospital and provider payment Medicaid Disproportionate Share Hospital (DSH) Program - Urged Congress to avert the cuts to Medicaid DSH payments set to take place at the end of the year; encouraged passage of legislation to preserve DSH payments on a longer-term basis, endorsed passage of the Supporting Safety Net Hospitals Act (H.R.2665) Medicare Drug Price Negotiation Program (MDPNP) - Responded to the Centers for Medicare & Medicaid Services (CMS) on CMSs ICR on implementation of Medicare Drug Price Negotiation Program. Encouraged the agency to continue considering provider perspectives as it works to implement the MDPNP Medicare Prospective Payment System Updates - Urged Congress to consider additional financial support for hospitals beyond increases in the IPPS and OPPS payment rules to more adequately adjust for increased provider costs. PAYGO Budget Cuts - Encouraged congress to act to avert statutory Pay-As-You-Go (PAYGO) cuts set to go into effect in 2025 Physician Payment - Encouraged Congress to avoid enacting the reimbursement reduction for physicians and other clinicians treating Medicare patients included in the CY 2025 Medicare Physician Fee Schedule (MPFS) Proposed Rule; Urged Congress to consider long-term legislative solutions to refine the current Medicare physician payment system Prior Authorization - Provided feedback to improve prior authorization (PA) processes for various plans and payers, including Medicare Advantage (MA) organizations and Medicaid managed care plans. Endorsed legislation to streamline the prior authorization process in the Improving Seniors Timely Access to Care Act (S.4532/H.R.8702) Rural Emergency Hospital (REH) Designation - Urged corrective action to allow REHs to bill both the Medicare and Medicaid programs. Advocated for increased eligibility among REHs to allow for future Medicaid DSH payments to certain hospital facilities. Site-Neutral Payment Policies - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. Monitoring development of the Lower Costs, More Transparency Act (H.R. 5378)

Client expense: $260,000 · 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.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; H.R. 7623, Telehealth Modernization Act, Issues pertaining to Telehealth, Hospital at Home, Unique Health Identifier; S. 1110, the Rural Hospital Support Act, all provisions; H.R. 6430, Assistance for Rural Community Hospitals (ARCH)Act, all provisions; 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; H.R. 4946, Medicare Mental Health Inpatient Equity Act of 2023, all provisions; H.R. 6033,Supporting Patient Education and Knowledge (SPEAK) Act of 2023all provisions; H.R. 1406, Sustainable Cardiopulmonary Rehabilitation Services in the Home Act, all provisions; DRAFT, DRAFT Clarifying that Rural Emergency Hospitals are eligible for Medicaid hospital reimbursement; DRAFT, DRAFT, Expanding services Rural Emergency Hospitals (REHs) are paid at the enhanced outpatient prospective payment system rate, allow eligibility for Small Rural Hospital improvement Grants; DRAFT, DRAFT, Issues pertaining to freestanding emergency departments; H.R. 1666, Protecting Access to Ground Ambulance Medical Services Act of 2023, All provisions; H. R. 8246, Second Chances for Rural Hospitals Act, Issues pertaining to expansion of physician-owned Rural Emergency Hospitals; Draft Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; Centers for Medicare & Medicaid Services (CMS), Medicare Severity-Long Term Care-Diagnosis Related Groups (MS-LTC-DRGs) used as part of the LTCH prospective payment system (PPS), Feedback on Medicare Severity-Long Term Care-Diagnosis Related Groups (MS-LTC-DRGs) used as part of the LTCH prospective payment system (PPS); Centers for Medicare & Medicaid Services (CMS), Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2026, Navigators and non-navigator assistance personnel working within hospitals and health systems to assist consumers; Centers for Medicare & Medicaid Services (CMS) Medicare Part C Utilization Management Annual Data Submission and Audit Protocol Data Request, Proposed Medicare Part C Utilization Management and data submission and audit protocol; Medicare Payment Advisory Commission (MedPAC), Physician fee schedule payments, advanced alternative payment model (A-APM) incentives and Medicare Advantage (MA) network adequacy; Centers for Medicare & Medicaid Services (CMS), Affordable drugs, Medicare $2 Drug List Model request for information; Centers for Medicare & Medicaid Services (CMS), Changes to the Fiscal Year 2025 Hospital Inpatient Prospective Payment System (IPPS) Rates Due to Court Decision, Low Wage Index Policy changes due to recent court change; Centers for Medicare & Medicaid Services (CMS), Medicare Transaction Facilitator and the Medicare drug negotiation program, Information collection request (ICR) regarding the Medicare Transaction Facilitator (MTF) and the Medicare drug negotiation program; 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; 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; Physician Payments, Issues pertaining to proposed solutions to improve MACRA, alternative payment models, mental health of workforce, scheduled physician reimbursement cuts for 2025, extension of Medicare's Advanced Alternative Payment Model (AAPM) incentive payments; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, REH's; National Provider Identifier (NPI), Unique identifiers for off-campus Hospital Outpatient Departments (HOPDs); Organ Transplant Final Rule, Increasing Organ Transplant Access (IOTA) Final Rule, IOTA Model impact on hospitals.

Client expense: $6,570,000 · 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