SPARC Act

Preserving Federal Loan Access for Physicians and Other Health Professionals Under OBBBA Implementation; S. 942/H.R. 2028, the Resident Education Deferred Interest (REDI) Act; H.R. 4681/S. 1380, the Specialty Physicians Advancing Rural Care (SPARC) Act Expansion of Physician Workforce/surgical workforce shortages; in general

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

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

H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to student loans H.R.2028 - REDI Act, all provisions H.R.2314 - FAIR Act, all provisions H.R.3890 - Resident Physician Shortage Reduction Act of 2025, all provisions H.R.4681 - SPARC Act, all provisions H.R.4731 - Resident Physician Shortage Reduction Act of 2025, all provisions H.R.6468 - Rural Residency Planning and Development Act of 2025, all provisions S.1380 - SPARC Act, all provisions S.2439 - Resident Physician Shortage Reduction Act of 2025, all provisions S.2715 - FAIR Act of 2025, all provisions S.942 - REDI Act, all provisions Comment Letter: [ED-2025-OPE-1042-0002] Accreditation, Innovation, and Modernization: Secretary's Recognition of Accrediting Agencies: Institutional Eligibility under the Higher Education Act, as Amended, Student Assistance General Provisions Matters related to GME funding/teaching health centers Matters related to the National Health Service Corps (NHSC)/loan repayment programs Matters related to the National Resident Matching Program (MATCH) and foreign international medical graduates Matters related to the NHSC Scholarship program Matters related to Student Loans Matters related to caps on GME Matters related to J-1 visa sponsorship of international medical graduates

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

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

H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. Commented to Office of Management and Budget Director Russell Vought on July 13, 2026, regarding regulation for Federal Financial Assistance [OMB-2026-0034].

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

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), 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

H.R.8163 - To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program S.4254 - A bill to amend the Public Health Service Act to provide for a health care workforce innovation program. S.4109 - A bill to reauthorize the Stem Cell Therapeutic and Research Act of 2005, and for other purposes S.4110 - A bill to revise and extend health workforce programs under title VII of the Public Health Service Act H.R.7961 - Physicians and the Healthcare Workforce Act S.4086 - A bill to establish protections for health care providers who raise concerns about the quality of health care services, and for other purposes S.4039 - Professional Degree Access Restoration Act H.R.7884 - To amend the Internal Revenue Code of 1986 to provide a tax credit to health care professionals that provide health care services in qualifying facilities, and for other purposes; S.3908 - SOS: Sustaining Outpatient Services Act H.R.7686 - To recognize the importance of clinical roles of locum tenens physicians, and for other purposes H.R.7520 - Efficiency Adjustment Delay Act S.3762 - Prior Authorization Relief Act H.R.7118 - Genomic Answers for Childrens Health Act H.R. 1, the One Big, Beautiful Bill Act Improving seniors' timely access to care act (S. 1816 / H.R. 3514) Genomic Data Protection Act Tariffs PAMA reform S 1399, the Health Tech Investment Act H.R. 3580, the Oversight of Medicare Billing Code Cost Act S. 1916 - Protect Genetic information after bankruptcy S 1830 - HHS has no authority to regulate the practice of medicine LCD legislation HR2389/S1302 - Resident Physician Shortage Reduction Act S2333 - Public Health Workforce Loan Repayment Act S665/HR 4942 Conrad 30 and Physician Access Reauthorization Act CLIA Waiver CURES 2.0 To prevent across-the-board direct spending cuts HR 5392, the Timely Access to Coverage Decisions Act of 2023 Remote digital telepathology HR 4527 - HEALTH DATA Act Primary Care and Health Workforce Expansion Act Gene Therapy HR 6371 - budget neutrality bill S. 1546/H.R. 3152 The Patent Eligibility Restoration Act Cures 2.1 S. 4935, Physician Fee Stabilization Act Medical Lab Personnel Shortage Relief Act S. 1380 - SPARC Act S. 942/H.R. 2028 - REDI Act H.R. 879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issues relating to regulation of laboratory diagnostics CDC Division of Cancer Prevention and Control and cancer registries appropriations S. 2439 and H.R. 4731, Resident Physician Shortage Reduction Act H.R.5371 - Continuing Appropriations and Extensions Act, 2026 S 2420 / H.R. 4710 - No Surprises Act Enforcement Act S 2793 - Ensuring Access to Essential Providers Act of 2025 H.R. 5582 / S 2355 - Patients Deserve Price Tags Act Issues related to public health Conrad 30 Physician Workforce Optimization Act (S. 4637) H.R.9645 - Health Care Price Certainty for All Americans Act H.R. 9693 - The Patients First Act S 5180 Provider Reimbursement Stability Act S 5062 - FAIR DME Appeals Act H.R. 8500 / S. 5745 - Timely Access to Coverage Decisions Act ROOT Act HR 8890 the Enhancing CLIA Act

Client expense: $203,130 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act H.R. 9693/S. 5672 - Patients First Act of 2026 H.R. 4583/S. 1552 - Living Donor Protection Act of 2026 H.R. 8271 - ICU Bed Act of 2026 H.R. 5265 - SAFE Ride Act (E-bike Safety) Military Readiness Office of Management and Budget (OMB) Rule Womens Health and Cancer Rights Act (WHCRA) reform Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Regional Medical Operations Coordination Center (RMOCC) development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

Client expense: $40,000 · 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. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act H.R. 9693/S. 5672 - Patients First Act of 2026 H.R. 4583/S. 1552 - Living Donor Protection Act of 2026 H.R. 8271 - ICU Bed Act of 2026 H.R. 5265 - SAFE Ride Act (E-bike Safety) Military Readiness Office of Management and Budget (OMB) Rule Womens Health and Cancer Rights Act (WHCRA) reform Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Regional Medical Operations Coordination Center (RMOCC) development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

Client expense: $40,000 · 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. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act H.R. 9693/S. 5672 - Patients First Act of 2026 H.R. 4583/S. 1552 - Living Donor Protection Act of 2026 H.R. 8271 - ICU Bed Act of 2026 H.R. 5265 - SAFE Ride Act (E-bike Safety) Military Readiness Office of Management and Budget (OMB) Rule Womens Health and Cancer Rights Act (WHCRA) reform Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Regional Medical Operations Coordination Center (RMOCC) development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

Client expense: $230,000 · 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. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act H.R. 9693/S. 5672 - Patients First Act of 2026 H.R. 4583/S. 1552 - Living Donor Protection Act of 2026 H.R. 8271 - ICU Bed Act of 2026 H.R. 5265 - SAFE Ride Act (E-bike Safety) Military Readiness Office of Management and Budget (OMB) Rule Womens Health and Cancer Rights Act (WHCRA) reform Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Regional Medical Operations Coordination Center (RMOCC) development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

Client expense: $230,000 · Firm income: Not reported

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

The One Big Beautiful Bill Act, H.R. 1; Medicare physician payment including, the Medicare Patient Access and Practice Stabilization Act (H.R. 879); the Strengthening Medicare for Patients and Providers Act (H.R. 6160), the Provider Reimbursement Stability Act (S. 4935); the Provider Reimbursement Stability Act (H.R. 8163/S. 5180); and the Efficiency Adjustment Delay Act (H.R. 7520); new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act (H.R. 3890/S. 2439); provide a specialty physician loan repayment program with the SPARC Act (H.R 4681/S. 1380); provide deferred interest payments for residents on student loans with the Resident Education Deferred Interest (REDI) Act (H.R. 2028/S. 942); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy including the Physician Led Rural Access to Quality Care Act (H.R. 2191/S. 1390) and the Patient Access to Higher Quality Health Care Act (H.R. 4002); COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act; Increasing Access to Quality Cardiac Rehabilitation Care Act; the expansion of telehealth services, including the CONNECT for Health Act (H.R. 41894206/S. 1261), the Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 783/S. 248), and the Telehealth Modernization Act (H.R. 5081/S. 2709); Improving maternal health, including Connected Maternal Online Monitoring Act (Connected MOM Act) (H.R. 4977/S. 141), Preventing Maternal Deaths Reauthorization Act of 2025 (H.R. 1909), and Rural Obstetrics Readiness Act (H.R. 1254/S. 380), and the Womens Heart Health Expansion Act (H.R. 7417/S. 3944) ; prior authorization reform, including the Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816), the Reducing Medically Unnecessary Delays in Care Act (H.R. 2433), and the Safe Step Act (H.R. 5509/S. 2903); clinician-led registry access to federal claims data, including the Access to Claims Data Act (H.R. 4331); and expanding in home prescribing coverage provided in the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025 (H.R. 6894/S. 717), Centers for Medicare and Medicaid Innovation payment models, including the Ambulatory Specialty Model for Heart Failure.

Client expense: $600,000 · Firm income: Not reported

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

Graduate Medical Education Certified Anesthesiologist Assistants Anesthesia workforce shortages HR 3890, Resident Physician Shortage Reduction Act of 2025: residency positions S.709, Conrad State 30 and Physician Access Reauthorization Act: Foreign physician immigration status S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act: physician shortages in rural areas HR 2028; Resident Education Deferred Interest Act (REDI Act): Student loan relief Anesthesia Research Funding Scope of Practice Merit-based Incentive Payment System, MIPS, MIPS Value Pathway Quality Payment Program, QPP Alternative Payment Model, APM QCDR - Qualified Clinical Data Registry Evaluation and Monitoring codes & cuts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Conditions of Participation - Anesthesia services, opt-outs, supervision CMS: Federal Independent Dispute Resolution (IDR) Process, Batching H.R.27, HALT Fentanyl Act: fentanyl scheduling and registration requirements H.R. 1227/S.475, Alternatives to PAIN Act of 2025: access to non-opioid pain management options Pain Medicine Prescription Drug Abuse CDC Opioid Prescribing Guideline H.R. 3595, Safe Prescribing Through Reporting Act of 2025: disclosure of certain records relating to substance use disorder medications to State prescription drug monitoring programs Drug shortages DEA Scheduling Propofol FDA Safe Use Initiative FDA Operating Room Fires FDA Opioids FDA Network of Experts FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) USP - US Pharmacopeia Compounding NIH Interagency Pain Research Coordinating Committee NIH: Funding, Indirect Costs, Indirect Grants, Overhead Agency for Healthcare Research and Quality (AHRQ) funding Long COVID research 21st Century Cures Initiative Out of Network/Out of Network Payment Network Adequacy Pre-authorization; prior authorization Insurance reform, shared savings, insurer accountability Affordable Care Act reform efforts Provider Nondiscrimination Change Healthcare, Change Healthcare data breach HR 292 Lorna Breen Reauthorization H.R. 3178, SAVE Healthcare Workers Act: To protect hospital personnel from violence, and for other purposes Maternal Mortality/Maternal Care Deserts Blood management 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care S. 2759/H.R. 5283, the Healthcare Workforce Resilience Act, Exemption for Physicians from New H-1B Visa Policy and $100,000 Fee Medical journal fees No Surprises Act (NSA) - H.R.4710 / S. 2420, the No Surprises Enforcement Act H.R. 3164, the Ensuring Community Access to Pharmacist Services Act Advance Premium Tax Credits (APTCs) Federal regulation of commercial health insurance companies One Big Beautiful Bill (OBBB) Commercial payer/payment H.R.7961: H-1Bs for Physicians and the Healthcare Workforce Act S.3822: Breaking Up Big Medicine Act H.R. 4681: Specialty Physicians Advancing Rural Care (SPARC) Act Low-carbon anesthesia OMB Proposed Rule on federal funding / grants U.S. Departments of State and Homeland Security Visa delays Venezuelan patients Pain management in C-sections DEA Regulations Controlled Substances Act Amendments

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Medicare physician reimbursement and the importance of long-term structural reform to the reimbursement system, including the Provider Reimbursement Stability Act (H.R. 8163), the Strengthening Medicare for Patients and Providers Act (H.R. 6160) and the Efficiency Adjustment Delay Act (H.R. 7520) The Safe Step Act (H.R. 5509/S. 2903) requires group health plans regulated by the Employee Retirement Income Security Act (ERISA) to provide a clear exception process for any medication step therapy protocol. The Specialty Physicians Advancing Rural Care (SPARC) Act (S. 1380; H.R. 4681), a bill designed to increase access to specialty care services in rural areas. Expanding the definition of a preventive service to surveillance colonoscopy. Efforts to secure appropriations language that guides action at the U.S. Department of Health and Human Services. Opposing National Institutes of Health (NIH) research cuts.

Client expense: $218,460 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467

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

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. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467

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

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. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467

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

The One Big Beautiful Bill Act, H.R. 1; Medicare physician payment including, the Medicare Patient Access and Practice Stabilization Act (H.R. 879); the Strengthening Medicare for Patients and Providers Act (H.R. 6160), the Provider Reimbursement Stability Act (S. 4935); the Provider Reimbursement Stability Act (H.R. 8163); and the Efficiency Adjustment Delay Act (H.R. 7520); new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act (H.R. 3890/S. 2439); provide a specialty physician loan repayment program with the SPARC Act (H.R 4681/S. 1380); provide deferred interest payments for residents on student loans with the Resident Education Deferred Interest (REDI) Act (H.R. 2028/S. 942); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy including the Physician Led Rural Access to Quality Care Act (H.R. 2191/S. 1390) and the Patient Access to Higher Quality Health Care Act (H.R. 4002); COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act; Increasing Access to Quality Cardiac Rehabilitation Care Act; the expansion of telehealth services, including the CONNECT for Health Act (H.R. 41894206/S. 1261), the Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 783/S. 248), and the Telehealth Modernization Act (H.R. 5081/S. 2709); Improving maternal health, including Connected Maternal Online Monitoring Act (Connected MOM Act) (H.R. 4977/S. 141), Preventing Maternal Deaths Reauthorization Act of 2025 (H.R. 1909), and Rural Obstetrics Readiness Act (H.R. 1254/S. 380), and the Womens Heart Health Expansion Act (H.R. 7417/S. 3944) ; prior authorization reform, including the Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816), the Reducing Medically Unnecessary Delays in Care Act (H.R. 2433), and the Safe Step Act (H.R. 5509/S. 2903); clinician-led registry access to federal claims data, including the Access to Claims Data Act (H.R. 4331); and expanding in home prescribing coverage provided in the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025 (H.R. 6894/S. 717), Centers for Medicare and Medicaid Innovation payment models.

Client expense: $680,000 · Firm income: Not reported

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

H.R.2028 - REDI Act, all provisions H.R.2314 - FAIR Act, all provisions H.R.3890 - Resident Physician Shortage Reduction Act of 2025, all provisions H.R.4681 - SPARC Act, all provisions H.R.4731 - Resident Physician Shortage Reduction Act of 2025, all provisions H.R.6468 - Rural Residency Planning and Development Act of 2025, all provisions S.1380 - SPARC Act, all provisions S.2439 - Resident Physician Shortage Reduction Act of 2025, all provisions S.2715 - FAIR Act of 2025, all provisions S.942 - REDI Act, all provisions GME funding/teaching health centers National Health Service Corps (NHSC)/loan repayment programs National Resident Matching Program (MATCH) and foreign international medical graduates NHSC Scholarship program Student Loans

Client expense: $5,130,000 · Firm income: Not reported

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

H.R.2028 - REDI Act, all provisions H.R.2314 - FAIR Act, all provisions H.R.3890 - Resident Physician Shortage Reduction Act of 2025, all provisions H.R.4681 - SPARC Act, all provisions H.R.4731 - Resident Physician Shortage Reduction Act of 2025, all provisions H.R.6468 - Rural Residency Planning and Development Act of 2025, all provisions S.1380 - SPARC Act, all provisions S.2439 - Resident Physician Shortage Reduction Act of 2025, all provisions S.2715 - FAIR Act of 2025, all provisions S.942 - REDI Act, all provisions GME funding/teaching health centers National Health Service Corps (NHSC)/loan repayment programs National Resident Matching Program (MATCH) and foreign international medical graduates NHSC Scholarship program Student Loans

Client expense: $513,000 · Firm income: Not reported

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

Graduate Medical Education Certified Anesthesiologist Assistants Anesthesia workforce shortages HR 3890, Resident Physician Shortage Reduction Act of 2025: residency positions S.709, Conrad State 30 and Physician Access Reauthorization Act: Foreign physician immigration status S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act: physician shortages in rural areas HR 2028; Resident Education Deferred Interest Act (REDI Act): Student loan relief Anesthesia Research Funding Scope of Practice Merit-based Incentive Payment System, MIPS, MIPS Value Pathway Quality Payment Program, QPP Alternative Payment Model, APM QCDR - Qualified Clinical Data Registry Evaluation and Monitoring codes & cuts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Conditions of Participation - Anesthesia services, opt-outs, supervision CMS: Federal Independent Dispute Resolution (IDR) Process, Batching H.R.27, HALT Fentanyl Act: fentanyl scheduling and registration requirements H.R. 1227/S.475, Alternatives to PAIN Act of 2025: access to non-opioid pain management options Pain Medicine Prescription Drug Abuse CDC Opioid Prescribing Guideline H.R. 3595, Safe Prescribing Through Reporting Act of 2025: disclosure of certain records relating to substance use disorder medications to State prescription drug monitoring programs Drug shortages DEA Scheduling Propofol FDA Safe Use Initiative FDA Operating Room Fires FDA Opioids FDA Network of Experts FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) USP - US Pharmacopeia Compounding NIH Interagency Pain Research Coordinating Committee NIH: Funding, Indirect Costs, Indirect Grants, Overhead Agency for Healthcare Research and Quality (AHRQ) funding Long COVID research 21st Century Cures Initiative Out of Network/Out of Network Payment Network Adequacy Pre-authorization; prior authorization Insurance reform, shared savings, insurer accountability Affordable Care Act reform efforts Provider Nondiscrimination Change Healthcare, Change Healthcare data breach HR 292 Lorna Breen Reauthorization H.R. 3178, SAVE Healthcare Workers Act: To protect hospital personnel from violence, and for other purposes Maternal Mortality/Maternal Care Deserts Blood management 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care S. 2759/H.R. 5283, the Healthcare Workforce Resilience Act, Exemption for Physicians from New H-1B Visa Policy and $100,000 Fee Medical journal fees No Surprises Act (NSA) - H.R.4710 / S. 2420, the No Surprises Enforcement Act H.R. 3164, the Ensuring Community Access to Pharmacist Services Act Advance Premium Tax Credits (APTCs) Federal regulation of commercial health insurance companies One Big Beautiful Bill (OBBB) Commercial payer/payment H.R.7961: H-1Bs for Physicians and the Healthcare Workforce Act S.3822: Breaking Up Big Medicine Act H.R. 4681: Specialty Physicians Advancing Rural Care (SPARC) Act Low-carbon anesthesia OMB Proposed Rule on federal funding / grants U.S. Departments of State and Homeland Security Visa delays Venezuelan patients Pain management in C-sections

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues related to Medicare physician payment. 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, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, 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, Ally's 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, Provider Reimbursement Stability Act of 2026. H.R.9237, Take Care of America's Veterans Act. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. S.1105, No UPCODE Act. Commented on May 20, 2026, House Energy and Commerce Health Subcommittee hearing regarding Medicare Physician Fee Schedule, MACRA, and opportunities for payment reforms. Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; regarding their April 23 discussion draft of legislation to modernize the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; urging them to include provisions in their physician payment reform legislation that would address the impending cut to the Medicare Physician Fee Schedule scheduled to take effect in 2027 and address the efficiency adjustment cuts expected to continue on an indefinite three-year cycle.

Client expense: $286,331 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025.

Client expense: $286,331 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) RMOCC development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

Client expense: $30,000 · 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. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) RMOCC development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

Client expense: $30,000 · 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. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) RMOCC development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

Client expense: $240,000 · 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. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) RMOCC development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

Client expense: $240,000 · 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.8163 - To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program S.4254 - A bill to amend the Public Health Service Act to provide for a health care workforce innovation program. S.4109 - A bill to reauthorize the Stem Cell Therapeutic and Research Act of 2005, and for other purposes S.4110 - A bill to revise and extend health workforce programs under title VII of the Public Health Service Act H.R.7961 - Physicians and the Healthcare Workforce Act S.4086 - A bill to establish protections for health care providers who raise concerns about the quality of health care services, and for other purposes S.4039 - Professional Degree Access Restoration Act H.R.7884 - To amend the Internal Revenue Code of 1986 to provide a tax credit to health care professionals that provide health care services in qualifying facilities, and for other purposes; S.3908 - SOS: Sustaining Outpatient Services Act H.R.7686 - To recognize the importance of clinical roles of locum tenens physicians, and for other purposes H.R.7520 - Efficiency Adjustment Delay Act S.3762 - Prior Authorization Relief Act H.R.7118 - Genomic Answers for Childrens Health Act H.R. 1, the One Big, Beautiful Bill Act Improving seniors' timely access to care act (S. 1816 / H.R. 3514) Genomic Data Protection Act Tariffs PAMA reform S 1399, the Health Tech Investment Act H.R. 3580, the Oversight of Medicare Billing Code Cost Act S. 1916 - Protect Genetic information after bankruptcy S 1830 - HHS has no authority to regulate the practice of medicine LCD legislation HR2389/S1302 - Resident Physician Shortage Reduction Act S2333 - Public Health Workforce Loan Repayment Act S665/HR 4942 Conrad 30 and Physician Access Reauthorization Act CLIA Waiver CURES 2.0 To prevent across-the-board direct spending cuts HR 5392, the Timely Access to Coverage Decisions Act of 2023 Remote digital telepathology HR 4527 - HEALTH DATA Act Primary Care and Health Workforce Expansion Act Gene Therapy HR 6371 - budget neutrality bill S. 1546/H.R. 3152 The Patent Eligibility Restoration Act Cures 2.1 S. 4935, Physician Fee Stabilization Act Medical Lab Personnel Shortage Relief Act S. 1380 - SPARC Act S. 942/H.R. 2028 - REDI Act H.R. 879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issues relating to regulation of laboratory diagnostics CDC Division of Cancer Prevention and Control and cancer registries appropriations S. 2439 and H.R. 4731, Resident Physician Shortage Reduction Act H.R.5371 - Continuing Appropriations and Extensions Act, 2026 S 2420 / H.R. 4710 - No Surprises Act Enforcement Act S 2793 - Ensuring Access to Essential Providers Act of 2025 H.R. 5582 / S 2355 - Patients Deserve Price Tags Act Issues related to public health

Client expense: $180,107 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Preserving Federal Loan Access for Physicians and Other Health Professionals Under OBBBA Implementation; S. 942/H.R. 2028, the Resident Education Deferred Interest (REDI) Act; H.R. 4681/S. 1380, the Specialty Physicians Advancing Rural Care (SPARC) Act Expansion of Physician Workforce/surgical workforce shortages; in general

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

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

Medicare Physician Payment Reform; in general; Mitigating cuts for Medicare Part B cuts; in general; Concerns regarding Expansion of Prior Authorization in Medicare FFS; H.R. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act; H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act; H.R. 3514/S.1816, the Improving Seniors Timely Access to Care Act; H.R. 539/S. 106, the Chiropractic Medicare Coverage Modernization Act; H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act; H.R. 4681/S. 1380, the Specialty Physicians Advancing Rural Care (SPARC) Act; H.R. 7520, the Efficiency Adjustment Delay Act; H.R. 1616/S. 1805, the Promoting Access to Diabetic Shoes Act; H.R. 8163, the Provider Reimbursement Stability Act of 2026 Expansion of Physician Workforce/surgical workforce shortages; in general

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

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

H.R.8163 - To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program S.4254 - A bill to amend the Public Health Service Act to provide for a health care workforce innovation program. S.4109 - A bill to reauthorize the Stem Cell Therapeutic and Research Act of 2005, and for other purposes S.4110 - A bill to revise and extend health workforce programs under title VII of the Public Health Service Act H.R.7961 - Physicians and the Healthcare Workforce Act S.4086 - A bill to establish protections for health care providers who raise concerns about the quality of health care services, and for other purposes S.4039 - Professional Degree Access Restoration Act H.R.7884 - To amend the Internal Revenue Code of 1986 to provide a tax credit to health care professionals that provide health care services in qualifying facilities, and for other purposes; S.3908 - SOS: Sustaining Outpatient Services Act H.R.7686 - To recognize the importance of clinical roles of locum tenens physicians, and for other purposes H.R.7520 - Efficiency Adjustment Delay Act S.3762 - Prior Authorization Relief Act H.R.7118 - Genomic Answers for Childrens Health Act H.R. 1, the One Big, Beautiful Bill Act Improving seniors' timely access to care act (S. 1816 / H.R. 3514) Genomic Data Protection Act Tariffs PAMA reform S 1399, the Health Tech Investment Act H.R. 3580, the Oversight of Medicare Billing Code Cost Act S. 1916 - Protect Genetic information after bankruptcy S 1830 - HHS has no authority to regulate the practice of medicine LCD legislation HR2389/S1302 - Resident Physician Shortage Reduction Act S2333 - Public Health Workforce Loan Repayment Act S665/HR 4942 Conrad 30 and Physician Access Reauthorization Act CLIA Waiver CURES 2.0 To prevent across-the-board direct spending cuts HR 5392, the Timely Access to Coverage Decisions Act of 2023 Remote digital telepathology HR 4527 - HEALTH DATA Act Primary Care and Health Workforce Expansion Act Gene Therapy HR 6371 - budget neutrality bill S. 1546/H.R. 3152 The Patent Eligibility Restoration Act Cures 2.1 S. 4935, Physician Fee Stabilization Act Medical Lab Personnel Shortage Relief Act S. 1380 - SPARC Act S. 942/H.R. 2028 - REDI Act H.R. 879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issues relating to regulation of laboratory diagnostics CDC Division of Cancer Prevention and Control and cancer registries appropriations S. 2439 and H.R. 4731, Resident Physician Shortage Reduction Act H.R.5371 - Continuing Appropriations and Extensions Act, 2026 S 2420 / H.R. 4710 - No Surprises Act Enforcement Act S 2793 - Ensuring Access to Essential Providers Act of 2025 H.R. 5582 / S 2355 - Patients Deserve Price Tags Act Issues related to public health

Client expense: $305,901 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare physician reimbursement and the importance of long-term structural reform to the reimbursement system, including the Provider Reimbursement Stability Act (H.R. 8163), the Strengthening Medicare for Patients and Providers Act (H.R. 6160) and the Efficiency Adjustment Delay Act (H.R. 7520) The Safe Step Act (H.R. 5509/S. 2903) requires group health plans regulated by the Employee Retirement Income Security Act (ERISA) to provide a clear exception process for any medication step therapy protocol. The Specialty Physicians Advancing Rural Care (SPARC) Act (S. 1380; H.R. 4681), a bill designed to increase access to specialty care services in rural areas. Expanding the definition of a preventive service to surveillance colonoscopy. Efforts to secure appropriations language that guides action at the U.S. Department of Health and Human Services. Opposing National Institutes of Health (NIH) research cuts.

Client expense: $67,545 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549

Client expense: $40,000 · 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. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549

Client expense: $40,000 · 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. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549

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

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

The One Big Beautiful Bill Act, H.R. 1; Medicare physician payment including, the Medicare Patient Access and Practice Stabilization Act (H.R. 879); the Strengthening Medicare for Patients and Providers Act (H.R. 6160), the Provider Reimbursement Stability Act (S. 4935); the Provider Reimbursement Stability Act (H.R. 8163); and the Efficiency Adjustment Delay Act (H.R. 7520); new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act (H.R. 3890/S. 2439); provide a specialty physician loan repayment program with the SPARC Act (H.R 4681/S. 1380); provide deferred interest payments for residents on student loans with the Resident Education Deferred Interest (REDI) Act (H.R. 2028/S. 942); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy including the Physician Led Rural Access to Quality Care Act (H.R. 2191/S. 1390) and the Patient Access to Higher Quality Health Care Act (H.R. 4002); COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act; Increasing Access to Quality Cardiac Rehabilitation Care Act; the expansion of telehealth services, including the CONNECT for Health Act (H.R. 41894206/S. 1261), the Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 783/S. 248), and the Telehealth Modernization Act (H.R. 5081/S. 2709); Improving maternal health, including Connected Maternal Online Monitoring Act (Connected MOM Act) (H.R. 4977/S. 141), Preventing Maternal Deaths Reauthorization Act of 2025 (H.R. 1909), and Rural Obstetrics Readiness Act (H.R. 1254/S. 380), and the Womens Heart Health Expansion Act (H.R. 7417/S. 3944) ; prior authorization reform, including the Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816), the Reducing Medically Unnecessary Delays in Care Act (H.R. 2433), and the Safe Step Act (H.R. 5509/S. 2903); clinician-led registry access to federal claims data, including the Access to Claims Data Act (H.R. 4331); and expanding in home prescribing coverage provided in the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025 (H.R. 6894/S. 717), Centers for Medicare and Medicaid Innovation payment models.

Client expense: $600,000 · Firm income: Not reported

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

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Rural Health Innovation Act of 2025 (H.R.1480) Fair Access In Residency Act (H.R. 2314/S.2715) Teaching Health Center Graduate Medical Education National Institutes of Health Research Pathways to Health Professions Act (H.R. 593) Bipartisan Rural America Health Corps Act (H.R. 1127) Expanding Medical Education Act (H.R. 2106, S. 975) Community TEAMS Act (H.R. 3885, S.3989) Specialty Physicians Advancing Rural Care Act (S. 1380) Post GRAD Act (H.R. 3711) Physician and Patient Safety Act (H.R. 3413, S. 1767) IHS Workforce Production Act ( S.632) Rural Health Focus Act (S.403) Rural Health Transformation Program Healthcare Advisory Council Resident Physician Shortage Reduction Act (H.R.4731/S.2439) Medical Student Education Authorization Act (H.R.5248) Palliative Care and Hospice Education and Training Act (S.2287) Improving Care in Rural America Reauthorization Act (S.2301) Health Care Workforce Expansion Act (S.2954) Resident Education Deferred Interest (REDI Act) (H.R. 2028,S. 942) Save Americas Rural Hospitals Act (H.R. 3684) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R. 4262) Train More Primary Care Doctors Act of 2025 (H.R. 958) Rural Hospital Flexibility Act (S. 3250) Rural Behavioral Health Improvement Act (H.R.5217) Community Health Workforce Development Act (H.R. 7289) Student Loan Tax Elimination Act (H.R. 3165 / S.3538) Healthcare is Human Act of 2026 (H.R. 7884) Rural Residency Planning and Development Act of 2025 (H.R. 6468) Healthcare Education in AI Literacy (HEAL A.I.) Act (H.R. 6077) PSLF Payment Completion Fairness Act (H.R. 3267 / S.3487) Foreign Medical School Accountability Fairness Act (S. 3757) Medically Tailored Home-Delivered Meals Program Pilot Act (H.R. 5439, S. 2834) Nutrition Education Community Academic Health Systems

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

H.R. 2028, Resident Education Deferred Interest (REDI) Act, all provisions S. 942, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 2314, Fair Access In Residency (FAIR) Act, provisions to the MATCH, and foreign medical graduates S. 2715, Fair Access In Residency (FAIR) Act, provisions to the MATCH, and foreign medical graduates S. 632, IHS Workforce Parity Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions relating to Graduate Medical Education, and student loans H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4681, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions H.R. 6468, Rural Residency Planning and Development Act of 2025, all provisions H.R. 3885, Community Training, Education, and Access for Medical Students (Community TEAMS) Act of 2025, all provisions S. 632, IHS Workforce Parity Act of 2025, all provisions GME funding/teaching health centers National Health Service Corps (NHSC)/loan repayment programs NHSC Scholarship program

Client expense: $7,970,000 · Firm income: Not reported

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

H.R. 2028, Resident Education Deferred Interest (REDI) Act, all provisions S. 942, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 2314, Fair Access In Residency (FAIR) Act, provisions to the MATCH, and foreign medical graduates S. 2715, Fair Access In Residency (FAIR) Act, provisions to the MATCH, and foreign medical graduates S. 632, IHS Workforce Parity Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions relating to Graduate Medical Education, and student loans H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4681, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions H.R. 6468, Rural Residency Planning and Development Act of 2025, all provisions H.R. 3885, Community Training, Education, and Access for Medical Students (Community TEAMS) Act of 2025, all provisions S. 632, IHS Workforce Parity Act of 2025, all provisions GME funding/teaching health centers National Health Service Corps (NHSC)/loan repayment programs NHSC Scholarship program

Client expense: $7,970,000 · Firm income: Not reported

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

Medicare Physician Payment Reform; in general; Mitigating cuts for Medicare Part B cuts; in general; Concerns regarding Expansion of Prior Authorization in Medicare FFS; H.R. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act; H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act of 2025; H.R. 3514/S.1816, the Improving Seniors Timely Access to Care Act of 2025; H.R. 539/S. 106, the Chiropractic Medicare Coverage Modernization Act; H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act of 2025; H.R. 4681/S. 1380, the Specialty Physicians Advancing Rural Care (SPARC) Act; H.R. 7520, the Efficiency Adjustment Delay Act; H.R. 1616/S. 1805, the Promoting Access to Diabetic Shoes Act; H.R. 8163, the Provider Reimbursement Stability Act of 2026

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

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

Preserving Federal Loan Access for Physicians and Other Health Professionals Under OBBBA Implementation; S. 942/H.R. 2028, the Resident Education Deferred Interest (REDI) Act; H.R. 4681/S. 1380, the Specialty Physicians Advancing Rural Care (SPARC) Act

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025.

Client expense: $319,200 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare physician payment. 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, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, 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, Ally's 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.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. 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. S.1105, No UPCODE Act. Commented on policies to modernize the Medicare Access and CHIP Reauthorization Act of 2015. Commented on the Department of Homeland Security proclamation Restriction on Entry of Certain Nonimmigrant Workers. Submitted an Appropriations request of $310 million for smoking cessation programs in the Centers for Disease Control Submitted comments to CMS on CY 2027 Medicare Advantage and Part D Advance Notice Submitted response to CMS RFI on Comprehensive Regulations to Uncover Suspicious Healthcare Activity (CRUSH) Regulation RFI

Client expense: $319,200 · Firm income: Not reported

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