No UPCODE Act

Medicare and Medicaid dual eligible integration; Monitoring of Medicare Advantage, particularly as it relates to changes in coding intensity, benchmarks, health risk assessments, prompt pay, and brokers; Issues related to Medicare Advantage marketing practices, provider directories and prior authorization; S. 1105, No UPCODE Act; Issues related to street medicine; MedPAC nomination process; Issues related to Senate Finance Dear Colleague process

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

Government targets: SENATE

Issues related to Medicare Advantage; Issues related to site neutral payments; Issues related to PBM reforms; S. 1105, No UPCODE Act

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2120--Older Americans Act Reauthorization Act of 2025--Reauthorizes through FY2030, modifies, and establishes programs under the Older Americans Act, which supports social services and activities for individuals aged 60 years or older. S.1105--No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act--An act to improve the way Medicare Advantage plans assess patients health risks and reduce overpayments for care. H.R 4093--Apples to Apples--An act to require the Secretary of Health and Human Services to publish information on expenditures under the Medicare program, and for other purposes. S. 2625--Independent BROKERS TIME Act of 2025--An Act to carry out certain activities relating to the regulation of independent agents and brokers and third-party marketing organizations under parts C and D of the Medicare program, and for other purposes. H.R 5243--Increase data transparency for supplemental benefits under Medicare Advantage--An Act to increase data transparency around Medicare Advantage supplemental benefits for seniors. S. 2793--Require Medicare Advantage plans to cover items and services furnished by certain essential community providers within a service area--An act to add an Essential Community Provider (ECP) requirement to Medicare Advantage networks. H.R. 5454--Medicare Advantage Prompt Pay Act--An act to improve Medicare Advantages (MA) billing practices, offer certainty health care providers who contract with MA plans, and ensure that seniors arent stuck with unfair, confusing, or delayed bills after receiving critical care. HR 5746--Addressing Whole Health in Medicare Advantage Act--Supplemental Benefits for chronically Ill enrollees S. 3573--Medicare Advantage Supplemental Benefits Transparency Act--Improving Supplemental Benefits for MA beneficiaries HR 3514--To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage S 1816--A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans-Prior Authorization in Medicare Advantage H.R. 9393--Lower Costs, More Transparency Act of 2026--Promotes price transparency across hospitals, Ambulatory Surgical Centers (ASCs), and the broader health care sector H.R. 9392--Medicare Advantage Cost Transparency Act--An act to require MA plans and commercial plans to publicly post PA approval/denial rates, appeal outcomes, and average determination timelines H.R. 9395--Transparency in Medicare Advantage Steering Act--Statutory caps on compensation paid by MA organizations to agents and brokers H.R. 9544--Saving MEDICARE Act of 2026--To amend title XVIII of the Social Security Act to ensure appropriate payments under Medicare Advantage, and for other purposes. H.R.8163--Provider Reimbursement Stability Act of 2026--Medicare physician payment reform and Alternative Payment Model (APM) incentives H.R. 8375--Medicare Advantage Improvement Act--Prior authorization reform, plan transparency, prompt pay, and coverage standards alignment H.R. 9397--Premium Transparency Act--Requires MA plans to publish overhead costs, claims payment data, and MLR revenue detail H.R. 9396-Prior Authorization Accountability Act--Public posting of PA approval/denial rates, appeal outcomes, and processing times H.R. 9693--Patients First Act--Physician Fee Schedule reform H.R. 9645--Health Care Price Certainty for All Americans Act--Price transparency reform Health CARE Act of 2026--Reverse health care provisions from H.R. 1

Client expense: $290,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage & Medicare Part D Prescription Drug Program Medicare Advantage Supplemental Benefits In-Home Health Risk Assessments and Chart Review Medicare Stars Program The Apples-to-Apples Comparison Act (H.R. 4093 & S. 3848) No UPCODE Act (S. 1105) Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH) One Big Beautiful Bill Act (H.R. 1)

Client expense: $1,410,000 · Firm income: Not reported

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

AI Diabetic Retinopathy Screening H.R.3277/S. 1677- Ensuring Lasting Smiles Act Medicare Access and CHIP Reauthorization Act (P.L.114-10) Improvement Issues Medicare Physician Payment Issues Drug Pricing and Shortages Issues Medicare Part B Drug Price Issues Expansion of Telehealth Services Vision Research Funding and proposed policy changes for federal research programs Step therapy requirements reforms Medicare Coverage for Low Vision Devices Modifications for federal student loan programs Modifications to the Medicaid Program H.R. 879, the Medicare Patient Access and Practice Stabilization Act of 2025 Healthcare Workforce Issues S. 864, the Help Ensure Lower Patient Copays Act (HELP Copays Act) S. 1105, the No Upcode Act Funding for the Pediatric Specialty Loan Repayment Program H.R. 2527, the Early Detection of Vision Impairments for Children Act of 2024 (EDVI Act) H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 H.R. 3514/S. 1816- The Improving Seniors Timely Access to Care Act H.R. 7520, the Efficiency Adjustment Delay Act H.R. 3277/S. 1677, the Ensuring Lasting Smiles Act H.R. 10476, The Glaucoma Vision Act of 2026 H.R. 9693/S. 5672, the Patients First Act

Client expense: $254,772 · Firm income: Not reported

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

HR 3514 / S 1816, the Improving Seniors Timely Access to Care Act; HR 5243, a bill to increase data transparency for supplemental benefits under Medicare Advantage; HR 8375 / S 4384, the Medicare Advantage Improvement Act; HR 9392, Medicare Advantage Cost Transparency Act; S 1105, No UPCODE Act; S 1629, Same Care, Lower Cost Act; S 1936, Improving Access to Transfusion Care for Patients Act; S 4886, Medicare Cost Cap Act; CMS Interim Final Rule on Medicaid Work Requirements; Regulatory and legislative proposals to expand site-neutral payment in Medicare; Implementation of the Accelerating Kids Access to Care Act (HR 1509, S 752) Regulatory proposals related to most-favored nation drug pricing; Issues related to the cost of care, including consolidation and anti-competitive contracting

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

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

H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S.3350: ACO Assignment Improvement Act H.R. 8129: To amend title XVIII of the Social Security Act to establish a full risk ACO program H.R. 6852: Advanced Wound Care and Regenerative Medicine Access and Reform Act H.R. 8163: Provider Reimbursement Stability Act H.R. 8622: Medicare Physician Data Driven Performance Payment System H.R. 9693: Patients First Act S.5269: Pay PCPs Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.

Client expense: $177,310 · Firm income: Not reported

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

PBM Reform; Medicare Advantage payment issues; Medicaid Reform; One Big Beautiful Bill Act (H.R. 1, P.L. 119-21); enhanced premium tax credits; S.1105, No UPCODE Act; HR 5454, Medicare Advantage Prompt Pay Act

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

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

PBM Reform; Medicare Advantage payment issues; Medicaid Reform; One Big Beautiful Bill Act (H.R. 1, P.L. 119-21); enhanced premium tax credits; S.1105, No UPCODE Act

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

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

PBM Reform; Medicare Advantage payment issues; Medicaid Reform; One Big Beautiful Bill Act (H.R. 1, P.L. 119-21); S.1105, No UPCODE Act; HR 5454, Medicare Advantage Prompt Pay Act

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

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

Issues related to the value of in-home care for rural and underserved patients. Medicare Advantage reimbursement, as well as coding and billing issues. S. 1105, the No Upcode Act

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

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

Medicare Advantage.S.1105 - No UPCODE Act.

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage, Medicare Part D, Medicaid Managed Care. Issues related to prescription drug costs and delivery. PBM Reform issues. CY 2027 Medicare Advantage Rate Notice. S. 1105 - No UPCODE Act. H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. H.R. 4093 - Apples to Apples Comparison Act of 2026.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to prescription drug pricing and transparency. Issues related to health IT & interoperability. S.1105 - No UPCODE Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare Advantage. Issues related to Medicaid managed care. S. 1105 - No UPCODE Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare and Medicaid payments and the Medicare Advantage Prescription Drug Pricing program. S.1105 - No UPCODE Act CY 2027 Medicare Advantage Rate Notice. H.R. 4093 - Apples to Apples Comparison Act of 2025. H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage (MA) Policy and Reimbursement 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. 3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025 (119th 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 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) 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 PL 119-21, One Big Beautiful Bill Act S.1105, No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act H.R. 3467, Medicare Advantage Reform Act Policy issues related to VA-eligible Medicare beneficiaries Final Calendar Year (CY) 2026 Part D Redesign Program Instructions 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-F) Final Guidance for Medicare Drug Price Negotiation Program guidance for initial price applicability year 2028 CMS Health Tech Ecosystem initiative H.R. 1732, GUARD VA Benefits Act H.R. 5454/S. 2789, Medicare Advantage Prompt Pay Act Contract Year 2027 Medicare Advantage and Part D Final Rule (CMS-4208-F3/CMS-4212-F) Calendar Year (CY) 2027 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2027 Rate Announcement) 2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS-0062-P) Medicare Drug Price Negotiation Program Proposed Rule (CMS-4215-P) Healthcare cybersecurity and Artificial Intelligence (AI) policy issues Request for Information (RFI): Pharmacy Benefit Manager Compensation and Data Collection (CMS-4218-NC) Consolidated Appropriations Act of 2026 Fiscal Year 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Final Rule (CMS-1851-F) Fiscal Year 2027 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1843-F) Manufacturer Effectuation of MFP Draft Guidance for 2028 Medicare Drug Price Negotiation Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule (CMS-1848-P) Calendar Year (CY) 2027 Home Health Prospective Payment System Proposed Rule (CMS-1844-P) Request for Information (RFI): Medicare Part D Reasonable and Relevant Pharmacy Contracting Standards (CMS-4217-NC)

Client expense: $1,520,000 · 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

Medicare Advantage (MA) and MA Rate Notice; Medicaid Cuts; Site Neutral Payment reform; MA Reform; Program Fraud Waste and Abuse; Durable Medical Equipment S. 1105 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage H.R. 842 - Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act To amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening tests. Sponsor: Rep Jodey Arrington H.R. 9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. H.R. 3514 - Improving Seniors Timely Access to Care Act of 2025 To amend Title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. H.R. 8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. S. 3762 - Prior Authorization Relief Act To amend part C of the title XVIII of the Social Security Act to provide for prior authorization reforms under the Medicare Advantage program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4093 - Apples to Apples Comparison Act of 2025, all provisions H.R. 483 - Health Care Efficiency Through Flexibility Act, all provisions H.R. 6728 - Linking Seniors to Needed Legal Services Act of 2025, all provisions H.R. 9393 - Lower Costs, More Transparency Act, all provisions H.R. 9397 - Premium Transparency Act, all provisions H.R. 9468 - Saving Today's Ascute-Care Resouces (STAR) act, all provisions H.R. 9693 - The Patients First Act of 2026 - all provisions H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions H.R.9392 - Medicare Advantage Cost Transparency Act, all provisions H.R.9644 - Medicare Advantage MLR Transparency Act, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.5168 - Provider Reimbursement Stability Act of 2026, all provisions S.5180 - Provider Reimbursement Stability Act, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1844-P] CY 2027 Home Health Prospective Payment System proposed rule Comment Letter: [CMS-1848-P] Medicare Physician Fee Schedule, including conversion factors, Modifier -25 payment reduction, efficiency adjustment, RPM/RTM, Maternity Care Services codes, CPT request for information, MIPS/MVP transition, Medicare Shared Savings Program, and Qualifying APM Participant determinations Comment Letter: [CMS-1850-P] Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots Comment Letter: [CMS-2452-P] Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes Comment Letter: [CMS-2454-IFC] Medicaid Program; Community Engagement Requirement for Certain Individuals Comment Letter: [CMS-3847-NC] Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Comment Letter: [HHS-OS-2026-0332] Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making Comment Letter: Request for Information (RFI) Strengthening the Medicare Physician Payment System Statement for the Record: Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Informed decision-making among beneficiaries Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Promoting Interoperability Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: State directed payments Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth and Digital Health Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Transparency in Downcoding Model Act Draft: Value in Health Care Act Matters related to downcoding by Insurace plans Matters related to drug price negotiations Matters related to expiring Medicare Physician payment rates Matters related to Modifier-25/Multiple Procedure Payment Reductions

Client expense: $4,540,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

S.1506 Medicare for All Act - in support. H.R.3069 - Medicare for All Act - in support. Issues related to the Centers for Medicare and Medicaid Services. Issues related to Medicare Advantage. S.1105 - No UPCODE Act - in support. Issues related to the Wasteful and Inappropriate Service Reduction Model. S.J.Res.198 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services relating to "Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model". - in support.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare reimbursements for physicians Prior Authorization reform Medicare Advantage reforms to reduce administrative burdens HR 2433 H.R.1, the One Big Beautiful Bill Act Implementation S.1105 S.1816/H.R.3514 HR.4559 Provider Reimbursement Stability Act H.R. 7520 Medicare Provider Enrollment Issues Medicare HETS System Changes Medicare Program Integrity Initiatives Patients First Act Protecting Approved Care Act RESULTS Act Medicare Targeted Probe and Educate Program

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

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

Medicare reimbursements for physicians Prior Authorization Reform H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 Medicare Advantage burden reduction reform One Big Beautiful Bill Act S. 1105 - No Upcode Act Medicare coverage for allergy immunotherapy Protecting Approved Care Act Patients First Act

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

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

Legislation and regulation related to the Medicare and Medicare Advantage programs, as well as Medicare and Medicaid coverage, care delivery and financing. Issues related to Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4208-F3/CMS-4212-F) and 2027 Medicare Advantage and Part D Advance Notice. S. 1105 - No UPCODE Act H.R.3514, S.1816 - Improving Seniors Timely Access to Care Act H.R. 9693 - Patients First Act of 2026

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

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

General healthcare policy issues, including Medicare Advantage, Medicare Part D and other payer policy matters, and health care clinical services; S.1105: No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act; PL 119-21: One Big Beautiful Bill Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.3170/S.3296, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4606/S.3400, Ally's Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.5509/S.2903, Safe Step Act. S.1105, No UPCODE Act.

Client expense: $388,538 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare physician payment, specifically proposed changes by CMS to reimbursement for services provided on the same day using Modifier 25. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R.7520, Efficiency Adjustment Delay Act. H.R.8163/S.5180, Provider Reimbursement Stability Act of 2026. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. H.R.9693, Patients First Act of 2026. S.1105, No UPCODE Act. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on August 21, 2026, regarding CY 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Extended HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies [CMS-1844-P]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on September 11, 2026, regarding CY 2027 Medicare Physician Fee Schedule and Quality Payment Program proposed rule [CMS-1848-P]. Submitted statement for the record supporting H.R. 4331, the Access to Claims Data Act, on September 15, 2026, at the House Energy and Commerce Health Subcommittee hearing: Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity.

Client expense: $388,538 · Firm income: Not reported

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

Issues related to Medicare physician payment, specifically proposed changes by CMS to reimbursement for services provided on the same day using Modifier 25. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164/S.2426, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170/S.3296, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Allys Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R. 5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R. 7520, Efficiency Adjustment Delay Act. H.R.8163/S.5180, Provider Reimbursement Stability Act of 2026. H.R.9237, Take Care of Americas Veterans Act. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. H.R.9693, Patients First Act of 2026. S.1105, No UPCODE Act. Commented to Office of Management and Budget Director Russell Vought on July 13, 2026, regarding regulation for Federal Financial Assistance [OMB-2026-0034]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on August 21, 2026, regarding CY 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Extended HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies [CMS-1844-P]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on September 11, 2026, regarding CY 2027 Medicare Physician Fee Schedule and Quality Payment Program proposed rule [CMS-1848-P]. Submitted statement for the record supporting H.R. 4331, the "Access to Claims Data Act," on September 15, 2026, at the House Energy and Commerce Health Subcommittee hearing: "Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity."

Client expense: $388,538 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Medicare Advantage: Star Ratings, Risk Adjustment, Supplemental Benefits (H.R. 5746, H.R. 5243), No UPCODE Act (S. 1105), Medicare Prior Authorization and Electronic Prior Authorization (H.R. 3514, H.R. 8375), Provider Directories (S. 891), Telehealth Extending Flexibilities (H.R. 4206, S. 1261), Transparency & PBMs (S. 882; S. 891, S. 3345, H.R. 9392), Physician Fee Schedule, Site Neutrality (H.R. 7149), Broker/Agents (H.R. 9395), MLR (H.R. 9644).

Client expense: $670,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied on issues related to longitudinal primary care in the home and the No UPCODE Act (S. 1105); legislation to advance a full risk Accountable Care Organization option (H.R. 8129); legislation to prevent skin substitutes fraud and abuse and the Skin Substitute Access and Payment Reform Act of 2025 (S. 2561); physician payment reform legislation (no bill yet); extension of the Comprehensive Kidney Care Choices (CKCC) model (no bill number); and the COMPLETE Care Act (S. 931) for integrated behavioral health.

Client expense: $210,000 · 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

Lobbied on issues related to longitudinal primary care in the home and the No UPCODE Act (S. 1105); legislation to advance a full risk Accountable Care Organization option (H.R. 8129); legislation to prevent skin substitutes fraud and abuse and the Skin Substitute Access and Payment Reform Act of 2025 (S. 2561); physician payment reform legislation (no bill yet); extension of the Comprehensive Kidney Care Choices (CKCC) model (no bill number); and the COMPLETE Care Act (S. 931) for integrated behavioral health.

Client expense: $210,000 · 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

Medicare and Medicaid dual eligible integration; Issues related to Medicare Advantage, including automatic enrollment and assignment, benchmark setting for payment, health risk assessments and chart review, hospice and MA, prior authorization, quality and star ratings, two years of data for payment; S. 1105, No UPCODE Act; H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; Medicare Advantage (MA) quality Star ratings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3164/S. 2426, Ensuring Community Access to Pharmacist Services Act H.R. 4093, S. 3848, Apples to Apples Comparison Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act H.R. 6010/S. 1105, No UPCODE Act H.R. 6130/ S. 3267, Alzheimers Screening and Prevention Act U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P) U.S Department of Health and Human Services, Centers for Medicare & Medicaid ServicesAdvance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (CMS-2026-0034) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program (CMS-9883-P) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule (RIN 0955-AA09) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Request for Information: Accelerating the Adoption and Use of Artificial Intelligence as Part of Clinical Care (RIN 0955-AA13)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 3164/S. 2426, Ensuring Community Access to Pharmacist Services Act H.R. 4093, S. 3848, Apples to Apples Comparison Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act H.R. 6010/S. 1105, No UPCODE Act H.R. 6130/ S. 3267, Alzheimers Screening and Prevention Act U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P) U.S Department of Health and Human Services, Centers for Medicare & Medicaid ServicesAdvance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (CMS-2026-0034) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program (CMS-9883-P) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule (RIN 0955-AA09) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Request for Information: Accelerating the Adoption and Use of Artificial Intelligence as Part of Clinical Care (RIN 0955-AA13)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS' Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors' Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark - prior authorization under Medicare Advantage H.R. 6110 - To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7189 - PrEP Access Act - Rep. Pocan, Mark - HIV prevention services under Medicare H.R. 7409 - Defend Rural Health Act - Rep. Taylor, Dave - Medicare definition of rural hospital H.R. 7727 - Sustaining Rural Healthcare Act - Rep. Alford, Mark - Medicare CAH designation H.R. 7778 - Medicaid PNA Modernization Act - Rep. Subramanyam, Suhas - Medicaid minimum monthly personal needs allowance H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid H.R. 8375 - Medicare Advantage Improvement Act - Rep. Joyce, John - MA programmatic reforms H.R. 8377 - Stop Deadly Denials Act - Rep. Khanna, Ro - MA prior authorization prohibition H.R. 8875 - Improving Home Dialysis Act - Rep. Miller, Carol - Home dialysis coverage under Medicare S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors' Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids' Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors' Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3727 - Putting an N to Learing about Fraud Act - Sen. Ernst, Joni - Federal program fraud prevention S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours S. 4384 - Medicare Advantage Improvement Act - Sen. Marshall, Roger - MA programmatic reforms 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; Waste Fraud and Abuse; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; 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; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; MA reporting requirements; MA provider networks and network adequacy; implementation of the One Big Beautiful Bill Act; Medicaid provider taxes; Medicaid community engagement requirements; and VA's community care program.

Client expense: $3,010,000 · Firm income: Not reported

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

Legislation and regulation related to the Medicare and Medicare Advantage programs, as well as Medicare and Medicaid coverage, care delivery and financing. Issues related to Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4208-F3/CMS-4212-F) and 2027 Medicare Advantage and Part D Advance Notice. S. 1105 - No UPCODE Act H.R.3514, S.1816 - Improving Seniors Timely Access to Care Act

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), SENATE

Issues related to Medicare Part D, Medicare Advantage, Medicaid, mental health, and telehealth. Issues related to pharmacy testing, vaccination, and treatment. Issues related to Accountable Care Organizations. Issues related to Medicare Shared Savings Program. Issues related to Medicaid. S. 882, The Patients Before Middlemen (PBM) Act S. 927, The Protecting Pharmacies in Medicaid Act S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act S. 3345, The PBM Price Transparency and Accountability Act H.R. 4317, The Pharmacy Benefit Manager (PBM) Reform Act H.R. 4093, Apple to Apples Comparison Act H.R. 6575, CommonGround for Affordable Health Care Act H.R. 6703, The Lower Healthcare Premiums for All Americans Act H.R.6609, Pharmacists Fight Back in Medicare and Medicaid Act

Client expense: $3,570,000 · 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

S.1105--No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act--An act to improve the way Medicare Advantage plans assess patients health risks and reduce overpayments for care. H.R 4093--Apples to Apples--An act to require the Secretary of Health and Human Services to publish information on expenditures under the Medicare program, and for other purposes. S. 2625--Independent BROKERS TIME Act of 2025--An Act to carry out certain activities relating to the regulation of independent agents and brokers and third-party marketing organizations under parts C and D of the Medicare program, and for other purposes. H.R. 5243--Increase data transparency for supplemental benefits under Medicare Advantage--An Act to increase data transparency around Medicare Advantage supplemental benefits for seniors. S. 2793--Require Medicare Advantage plans to cover items and services furnished by certain essential community providers within a service area--An act to add an Essential Community Provider (ECP) requirement to Medicare Advantage networks. H.R. 5454--Medicare Advantage Prompt Pay Act--An act to improve Medicare Advantages (MA) billing practices, offer certainty health care providers who contract with MA plans, and ensure that seniors arent stuck with unfair, confusing, or delayed bills after receiving critical care. H.R. 5746--Addressing Whole Health in Medicare Advantage Act--Supplemental Benefits for chronically ill enrollees S. 3573--Medicare Advantage Supplemental Benefits Transparency Act--Improving Supplemental Benefits for MA beneficiaries H.R. 3514--To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage S 1816--A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage H.R. 9393--Lower Costs, More Transparency Act of 2026--Promotes price transparency across hospitals, Ambulatory Surgical Centers (ASCs), and the broader health care sector H.R. 9392--Medicare Advantage Cost Transparency Act--An act to require MA plans and commercial plans to publicly post PA approval/denial rates, appeal outcomes, and average determination timelines H.R. 9395--Broker Compensation Bill--Statutory caps on compensation paid by MA organizations to agents and brokers H.R. 9544--Saving MEDICARE Act of 2026--To amend title XVIII of the Social Security Act to ensure appropriate payments under Medicare Advantage, and for other purposes. H.R. 8163--Provider Reimbursement Stability Act of 2026--Medicare physician payment reform and APM incentives H.R. 8375--Medicare Advantage Improvement Act--Prior authorization reform, plan transparency, prompt pay, and coverage standards alignment Issues related to data collection and sharing among health plans, providers, and community-based organizations issues Issues related to mental and behavioral health issues in Medicare Advantage Rural Network Adequacy Issues

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3514, Improving Seniors Timely Access to Care Act; HR 5243, a bill to increase data transparency for supplemental benefits under Medicare Advantage; HR 9392, Medicare Advantage Cost Transparency Act; S 1105, No UPCODE Act; S 1629, Same Care, Lower Cost Act; S 1936, Improving Access to Transfusion Care for Patients Act; S 4886, Medicare Cost Cap Act; CMS Interim Final Rule on Medicaid work requirements; Regulatory and legislative proposals to expand site-neutral payment in Medicare; Implementation of the Accelerating Kids Access to Care Act (HR 1509, S 752); Regulatory proposals related to most-favored-nation drug pricing;

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

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

Medicare Advantage (MA) Policy and Reimbursement 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. 3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025 (119th 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 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) 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 PL 119-21, One Big Beautiful Bill Act S.1105, No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act H.R. 3467, Medicare Advantage Reform Act Policy issues related to VA-eligible Medicare beneficiaries Final Calendar Year (CY) 2026 Part D Redesign Program Instructions 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-F) Final Guidance for Medicare Drug Price Negotiation Program guidance for initial price applicability year 2028 CMS Health Tech Ecosystem initiative H.R. 1732, GUARD VA Benefits Act H.R. 5454/S. 2789, Medicare Advantage Prompt Pay Act Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) Contract Year 2027 Medicare Advantage and Part D Final Rule (CMS-4208-F3/CMS-4212-F) Calendar Year (CY) 2027 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2027 Rate Announcement) Fiscal Year (FY) 2027 Skilled Nursing Facility Prospective Payment System Proposed Rule (CMS 1843-P) Fiscal Year (FY) 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Proposed Rule (CMS-1851-P) 2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS-0062-P) Medicare Drug Price Negotiation Program Proposed Rule (CMS-4215-P) Healthcare cybersecurity and Artificial Intelligence (AI) policy issues Pharmacy Benefit Manager Compensation and Data Collection (CMS-4218-NC)

Client expense: $440,000 · 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

Medicare Advantage.S.1105 - No UPCODE Act. CY 2027 Advance Notice

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S.3350: ACO Assignment Improvement Act H.R. 4313/ S.2237: Hospital Inpatient Services Modernization Act H.R. 8129: To amend title XVIII of the Social Security Act to establish a full risk ACO program H.R. 6852: Advanced Wound Care and Regenerative Medicine Access and Reform Act H.R. 8375/ S.4384: Medicare Advantage Improvement Act H.R. 8163: Provider Reimbursement Stability Act H.R. 8622: Medicare Physician Data Driven Performance Payment System H.J. Res 187/ S.J. Res 192: Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services relating to Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model. Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.

Client expense: $142,230 · Firm income: Not reported

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

Issues relating to Medicare Advantage; Issues related to the use of AI and its correlation to prior authorization and utilization management policies; S. 1105, No UPCODE Act; Issues related to Senate Finance Dear Colleague process

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid dual eligible integration; Issues related to Medicare Advantage, including automatic enrollment and assignment, benchmark setting for payment, health risk assessments and chart review, hospice and MA, prior authorization, quality and star ratings, two years of data for payment; S. 1105, No UPCODE Act; H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; Medicare Advantage (MA) quality Star ratings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid dual eligible integration; Monitoring of Medicare Advantage, particularly as it relates to changes in coding intensity, benchmarks, health risk assessments, prompt pay, and brokers; Issues related to Medicare Advantage marketing practices, provider directories and prior authorization; S. 1105, No UPCODE Act; Issues related to street medicine; MedPAC nomination process; Issues related to Senate Finance Dear Colleague process

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE