Medicare Patient Access and Practice Stabilization Act of 2025

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 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

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

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

Issues related to access and physician reimbursement under Medicare Part B, including H.R. 879 - Medicare Patient Access and Practice Stabilization Act; H.R. 2474 - Strengthening Medicare for Patients and Providers Act; S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025 Implementation of provisions included in Subtitle B of PL.117-169-Inflation Reduction Act of 2022. H.R. 2484- Seniors' Access to Critical Medications Act of 2025. Issues related to prior authorization. H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act Issues related to stark regulation of in office dispensing of Part D drugs. Issues related to the Provider Reimbursement Stability Act of 2026 (H.R.8163). Issues related to the Patients First Act of 2026 (H.R.9693)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), 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 H.R. 9963, the Patients First Act H.R. 8500/S. 5475, the Timely Access to Coverage Decisions Act Issues relating to the CY2027 Medicare Physician Fee Schedule Proposed Rule

Client expense: $50,000 · 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. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act of 2025; H.R. 1, the One Big Beautiful Bill Act; H.R. 3164/S. 2426, the Ensuring Community Access to Pharmacist Services Act; Draft legislation to amend title XVIII of the Social Security Act to modify the conversion factor updates applicable to physicians' services under the Medicare program; Implementation of Centers for Medicare & Medicaid Services. (2025). Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program. Federal Register, 88, 90 FR 49266-50481; H.R. 6160, the Strengthening Medicare for Patients and Providers Act; H.R. 8163, the Provider Reimbursement Stability Act; H.R. 7520, the Efficiency Adjustment Delay Act; H.R. 8622, the Medicare Physician Data-driven Performance Payment System Act of 2026 H.R.9693, Patients First Act of 2026 H.R.4331, Access to Claims Data Act Proposed CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program

Client expense: $2,047,000 · Firm income: Not reported

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

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

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

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

Issues pertaining to physician payment and patient access to hospital care in PL 119-21, the One Big Beautiful Bill Act; various Presidential executive orders affecting health care providers; S. 1640/HR 879, the Medicare Patient Access and Practice Stabilization Act; S. 1816/HR 3514, the Improving Seniors' Timely Access to Care Act; S. 4641/HR 3954, the Improving Access to Medicare Coverage Act; HR 538, the Critical Access Hospitals Relief Act of 2025; provisions in CMS-1832-F, the CY 2026 Medicare Physician Fee Schedule Final Rule; health policy extensions in PL 119-75, FY2026 Consolidated Defense, LHHSED, Nat. Sec.-State, THUD, FSGG Approps. Act; HR 9693, Patients First Act of 2026

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

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

Issues related to Medicare and Medicaid payments to physicians; Issues related to medical imaging; Issues related to Appropriate Use Criteria (AUC); Issues related to prior authorization in Medicare and Medicaid; Issues related to H.R. 639 - Doctor Knows Best Act of 2025; Issues related to H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to H.R. 5737/S. 1692 - Radiology Outpatient Ordering Transmission (ROOT) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the CY 2025 Medicare Physician Fee Schedule proposed rule; Issues related to H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025; Issues related to Consolidated Appropriations Act, 2026 (PL 119-75); Issues related to SUPPORT for Patients and Communities Reauthorization Act of 2025 (PL 119-44).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

H.R. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. H.R. 9693, Patients First Act of 2026 would finally make structural changes needed to prevent cuts and create a payment system that helps ensure physicians can keep their doors open and provide seniors with quality, value-based healthcare. S. 1640/H.R. 879: Medicare Patient Access and Practice Stabilization Act of 2025 - This bill increases certain payment adjustments under the Medicare physician fee schedule for services furnished between April 1, 2025, and January 1, 2026. H.R. 8163/S. 5180: Provider Reimbursement Stability Act, to amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program. H.R. 8622: Medicare Physician Data-driven Performance Payment System Act to amend title XVIII of the Social Security Act to transform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule H.R. 6160: Strengthening Medicare for Patients and Providers Act to modify certain adjustments to payment amounts under the Medicare physician fee schedule S. 1460/H.R. 786: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation. H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation. H.R. 8500: Timely Access to Coverage Decisions Act of 2026: To amend title XVIII of the Social Security Act to ensure timely review of local coverage determination requests under the Medicare program. H.R. 4331, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage H.R. 1-One Big Beautiful Bill Act, to provide for reconciliation pursuant to title II of H. Con. Res. 14 H.R. 539-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. H.R. 771-Rural Health Care Access Act of 2025, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 772-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 879- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes H.R.1968-Full-Year Continuing Appropriations and Extensions Act, to provide appropriations for federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 2433-Reducing Unnecessary Medical Delays in Care Act of 2025, to ensure that prior authorization medical decisions under Medicare are determined by physicians. H.R. 3164-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services H.R. 4206-CONNECT for Health Act, to expand access to telehealth services H.R. 6160-Strengthening Medicare for Patients and Providers Act, provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index H.R. 6721-Medicare Advance Planning for Care Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive H.R. 7520-Efficiency Adjustment Delay Act, to delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule H.R. 8163-Provider Reimbursement Stability Act, ensure stability for provider payments under the Medicare program H.R. 8622-Medicare Data-driven Performance Payment System Act of 2026, to transform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule S. 106-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. S.1261-CONNECT for Health Act, to expand access to telehealth services S. 1640- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes S. 2426-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services S. 3473-Medicare Advance Planning for Care Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive S. 4927-Rural Hospital Emergency Room Guarantee Act, to establish a guaranteed funding stream to keep existing emergency rooms at America's rural hospitals open.

Client expense: $498,299 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the CY 2025 Medicare Physician Fee Schedule proposed rule; Issues related to H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025; Issues related to Consolidated Appropriations Act, 2026 (PL 119-75); Issues related to SUPPORT for Patients and Communities Reauthorization Act of 2025 (PL 119-44).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare and Medicaid payments to physicians; Issues related to medical imaging; Issues related to Appropriate Use Criteria (AUC); Issues related to prior authorization in Medicare and Medicaid; Issues related to H.R. 639 - Doctor Knows Best Act of 2025; Issues related to H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to H.R. 5737/S. 1692 - Radiology Outpatient Ordering Transmission (ROOT) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. 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

H.R. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act of 2025; H.R. 1, the One Big Beautiful Bill Act; H.R. 3164/S. 2426, the Ensuring Community Access to Pharmacist Services Act; Draft legislation to amend title XVIII of the Social Security Act to modify the conversion factor updates applicable to physicians' services under the Medicare program; Implementation of Centers for Medicare & Medicaid Services. (2025). Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program. Federal Register, 88, 90 FR 49266-50481; H.R. 6160, the Strengthening Medicare for Patients and Providers Act; H.R. 8163, the Provider Reimbursement Stability Act; H.R. 7520, the Efficiency Adjustment Delay Act; H.R. 8622, the Medicare Physician Data-driven Performance Payment System Act of 2026

Client expense: $580,000 · Firm income: Not reported

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

Issues related to access and physician reimbursement under Medicare Part B, including H.R. 879 - Medicare Patient Access and Practice Stabilization Act; H.R. 2474 - Strengthening Medicare for Patients and Providers Act; S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025 Implementation of provisions included in Subtitle B of PL.117-169-Inflation Reduction Act of 2022. H.R. 2484- Seniors' Access to Critical Medications Act of 2025. Issues related to prior authorization. H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act Issues related to stark regulation of in office dispensing of Part D drugs. Issues Related to the Provider Reimbursement Stability Act of 2026 (H.R.8163).

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

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

H.R. 929/S.266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 879/S.1640 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S.475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S.779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585/S.709 - Conrad State 30 and Physician Access Reauthorization Act H.R. 1909/S.2621 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S.931 - COMPLETE Care Act H.R. 4206/S.1261 - CONNECT for Health Act H.R. 1305 - Improving Measurements for Loneliness and Isolation Act H.R. 1902 - Helping Emergency Responders Overcome (HERO) Act H.R. 2223 - Building Capacity for Care Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 3266/S.1673 - Mental Health Infrastructure Improvement Act of 2025 H.R. 4619 - Medicare Mental Health Inpatient Equity Act S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2587 - Youth Mental Health Research Act H.R. 2483/S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 2630 - Youth Suicide Prevention Research Act H.R. 3655 - STAR Plus Scholarship Act H.R. 3890/S. 2439 - Resident Physician Shortage Reduction Act of 2025 H.R. 3885/S.3989 - Community TEAMS Act H.R. 1867 - To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 4723/S. 2446 - Mental Health for Latinos Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505 - Barriers to Suicide Act H.R.6249 - Addressing Addiction After Disasters Act H.R.7394/S.3783 - Mental Health Career Promotion Act H.R. 5074 - Protecting Young Minds Online Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R. 5557 - Mental Health Services for Students Act H.R.1197 - PREEMIE Reauthorization Act of 2025 H.R. 3514/S.1816 - Improving Seniors Timely Access to Care Act H.Res.792 - Youth Mental Health Day and Suicide Prevention Day Resolution H.R.5725 - Mental Health Crisis Response Act of 2025 H.R.5706 - Mental Health Emergency Responder Act S. 3064 - Relief of Chronic Pain Act H.R. 6226 - Latino Youth Mental Health Empowerment Act H.R. 5482 - Prevent Youth Suicide Act H.R.6672 - Mental Health Professionals Workforce Shortage Loan Repayment Act Letter to Letter to Department of Labor, Department of Health and Human Services, and Department of Treasury regarding mental health parity enforcement H.R. 3492 - Protect Children's Innocence Act H.R. 498 - Do No Harm in Medicaid Act H.R. 6817/ S. 1056 - Home-Based Telemental Health Care Act Communication with Congressional offices on SAMHSA grant terminations Input on Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) modernization Communication with Congressional offices on ghost networks S. 3486 - Expand the Behavioral Health Workforce Now Act H.R.7324/S. 683 - More Behavioral Health Providers Act H.R. 786/S. 1460 - Preserving Patient Access to Accountable Care Act H.R. 4331 - Access to Claims Data Act H.R.5281 - REAL Health Providers Act H.R.7875 - Providing Opportunities for Individuals in Need of Treatment and Support (POINTS) Act Letter to Congress on Agency for Healthcare Research and Quality (AHRQ) funding H.R. 6396 - Kid PROOF Act H.R. 6468 - Rural Residency Planning and Development Act of 2025 H.R. 8234 - Save Money, Save Lives Act H.R.7092 - RAYS Act H.R.7787 - Mental Health Workforce Act Letter in support of funding for gun violence prevention research at CDC, NIH and NIJ. S.4076 - Removing Medicare Mental Health Inpatient Limitations Act of 2026 Letter supporting funding for Maternal Mental Health and Substance Use Disorder Programs (MMHSUD) and National Maternal Mental Health Hotline. H.R. 5629 - To provide that the final rule of the Department of Health and Human Services titled Medications for the Treatment of Opioid Use Disorder except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect H.R. 7994 - The HERO Act H.R. 8124 - STOP Suicide Act S.1924 / H.R.3624 - Improving Mental Health Access for Students Act H.R.8261 - Chronic Care Management Act Letter in support of funding for the Pediatric Mental Health Care Access program H.R. 8201 - Expanding Community Access to Health Services Act Letter supporting increased funding for Childrens Hospital Graduate Medical Education Letter expressing concerns over H.R. 5629 and H.R. 5630 S. 1874 - Title VIII Nursing Workforce Reauthorization Act of 2025 S. 4110 - EMPOWER for Health Act H.R. 9044 - Minority Fellowship Program Reauthorization Act of 2026 H.R. 8163 - Provider Reimbursement Stability Act H.R.8961 - Student Suicide Prevention Awareness Act H.Res.1329 - Expressing support for the designation of May 2026 as Mental Health Awareness Month H.R.8989 - Evidence-Based Youth Suicide Prevention Act of 2026 H.R.8122/ S.4640 - 9-8-8 Connect Act H.R.8811/S.4552 - Moms Matter Act H.R.9257 - Primary and Behavioral Health Care Access Act H.R.8487/S.3401 - Ensuring Excellence in Mental Health Act Joint letter to SAMHSA regarding the planned removal of SAMHSAs buprenorphine practitioner locator and pharmacy locator.

Client expense: $137,391 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of

H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4074 - Optimizing Postpartum Outcomes Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5281 - REAL Health Providers Act, all provisions H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8487 - Ensuring Excellence in Mental Health Act, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 202, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.3750 - REAL Health Providers Act, all provisions S.3762 - Prior Authorization Relief Act, all provisions S.4070 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions S.4384 - Medicare Advantage Improvement Act of 2026, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1849-P] Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Statement for the Record: Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Medicare bonus payment for alternative payment model (APM) participation Draft: Medicare Budget Neutrality and MIPS reform Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Telehealth and Digital Health Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: CJR-X (Comprehensive Care for Joint Replacement Expanded) Model Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: MEI Update Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model

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

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

H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4074 - Optimizing Postpartum Outcomes Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5281 - REAL Health Providers Act, all provisions H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8487 - Ensuring Excellence in Mental Health Act, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 202, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.3750 - REAL Health Providers Act, all provisions S.3762 - Prior Authorization Relief Act, all provisions S.4070 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions S.4384 - Medicare Advantage Improvement Act of 2026, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1849-P] Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Statement for the Record: Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Medicare bonus payment for alternative payment model (APM) participation Draft: Medicare Budget Neutrality and MIPS reform Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Telehealth and Digital Health Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: CJR-X (Comprehensive Care for Joint Replacement Expanded) Model Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: MEI Update Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model

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

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

S. 1390/H.R.2191, Physician-Led and Rural Access to Quality Care Act: To revise certain physician self-referral exemptions relating to physician-owned hospitals. S. 1640, the Medicare Patient Access and Practice Stabilization Act: Io increase support for physicians and other practitioners in adjusting to Medicare payment changes S. 1816/H.R.3514, Improving Seniors Timely Access to Care Act of 2025: Prior authorization reform in Medicare Advantage S. 2439/H.R.3890, Resident Physician Shortage Reduction Act: Medicare funding for medical residency training. S. 2903/H.R.5509, Safe Step Act: To amend ERISA to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. H.R. 4331, Access to Claims Data Act: To establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R.6160, Strengthening Medicare for Patients and Providers Act: To provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 7520, Efficiency Adjustment Delay Act: To delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule. H.R. 8163, Provider Reimbursement Stability Act of 2026: Modifying Medicare's budget neutrality rules under the Medicare physician fee schedule. No Bill: Urging Congress to prevent funding for the proposed CMMI Wasteful and Inappropriate Service Reduction (WISeR) Model in the Medicare Fee-for-Service (FFS) program, which expandsprior authorization to traditional Medicare. No Bill: Urging Congress to modify MACRA to improve physician payment under the Medicare program, including improvements to the quality payment program.

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

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

S. 1390/H.R.2191, Physician-Led and Rural Access to Quality Care Act: To revise certain physician self-referral exemptions relating to physician-owned hospitals. S. 1640, the Medicare Patient Access and Practice Stabilization Act: Io increase support for physicians and other practitioners in adjusting to Medicare payment changes S. 1816/H.R.3514, Improving Seniors Timely Access to Care Act of 2025: Prior authorization reform in Medicare Advantage S. 2439/H.R.3890, Resident Physician Shortage Reduction Act: Medicare funding for medical residency training. S. 2903/H.R.5509, Safe Step Act: To amend ERISA to require a group health plan or health insurance coverage offered in connection with such a plan to provide an exceptions process for any medication step therapy protocol. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. H.R. 4331, Access to Claims Data Act: To establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R.6160, Strengthening Medicare for Patients and Providers Act: To provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 7520, Efficiency Adjustment Delay Act: To delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule. H.R. 8163, Provider Reimbursement Stability Act of 2026: Modifying Medicare's budget neutrality rules under the Medicare physician fee schedule. No Bill: Urging Congress to prevent funding for the proposed CMMI Wasteful and Inappropriate Service Reduction (WISeR) Model in the Medicare Fee-for-Service (FFS) program, which expands prior authorization to traditional Medicare. No Bill: Urging Congress to modify MACRA to improve physician payment under the Medicare program, including improvements to the quality payment program.

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

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

Issues pertaining to physician payment and patient access to hospital care in PL 119-21, the One Big Beautiful Bill Act; various Presidential executive orders affecting health care providers; S. 1640/HR 879, the Medicare Patient Access and Practice Stabilization Act; S. 1816/HR 3514, the Improving Seniors' Timely Access to Care Act; S. 4137/HR 3954, the Improving Access to Medicare Coverage Act; HR 538, the Critical Access Hospitals Relief Act of 2025; provisions in CMS-1832-F, the CY 2026 Medicare Physician Fee Schedule Final Rule; health policy extensions in PL 119-75, FY2026 Consolidated Defense, LHHSED, Nat. Sec.-State, THUD, FSGG Approps. Act

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

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.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

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.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R.7520, Efficiency Adjustment Delay Act. H.R.8163, Provider Reimbursement Stability Act of 2026. 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. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. S. 1640/H.R. 879: Medicare Patient Access and Practice Stabilization Act of 2025 - This bill increases certain payment adjustments under the Medicare physician fee schedule for services furnished between April 1, 2025, and January 1, 2026. H.R. 8163: Provider Reimbursement Stability Act, to amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program. H.R. 8622: Medicare Physician Data-driven Performance Payment System Act to amend title XVIII of the Social Security Act to transform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule H.R. 6160: Strengthening Medicare for Patients and Providers Act to modify certain adjustments to payment amounts under the Medicare physician fee schedule S. 1460/H.R. 786: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation.

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

Government targets: 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

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage H.R. 1-One Big Beautiful Bill Act, to provide for reconciliation pursuant to title II of H. Con. Res. 14 H.R. 539-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. H.R. 771-Rural Health Care Access Act of 2025, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 772-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 879- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes H.R.1968-Full-Year Continuing Appropriations and Extensions Act, to provide appropriations for federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 2433-Reducing Unnecessary Medical Delays in Care Act of 2025, to ensure that prior authorization medical decisions under Medicare are determined by physicians. H.R. 3164-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services H.R. 4206-CONNECT for Health Act, to expand access to telehealth services H.R. 6160-Strengthening Medicare for Patients and Providers Act, provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index H.R. 6721-Medicare Advance Planning for Care Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive H.R. 7520-Efficiency Adjustment Delay Act, to delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule H.R. 8163-Provider Reimbursement Stability Act, ensure stability for provider payments under the Medicare program S. 106-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. S.1261-CONNECT for Health Act, to expand access to telehealth services S. 1640- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes S. 2426-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services S. 3473-Medicare Advance Planning for Care Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive

Client expense: $468,727 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. 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

Issues related to access and physician reimbursement under Medicare Part B, including H.R. 879 - Medicare Patient Access and Practice Stabilization Act; H.R. 2474 - Strengthening Medicare for Patients and Providers Act; S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025 Implementation of provisions included in Subtitle B of PL.117-169-Inflation Reduction Act of 2022. H.R. 2484- Seniors' Access to Critical Medications Act of 2025. Issues related to prior authorization. H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S, 891, Bipartisan Health Care Act, all provisions H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R, 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No UPCODE Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R. 6160, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 7520, Efficiency Adjustment Delay Act, all provisions H.R. 7148, Consolidated Appropriations Act, 2026, provisions related to APM bonus extension/incentive payments/qualifying provider revenue thresholds freeze H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions related to APMs H.R. 8163, To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 483, Health Care Efficiency Through Flexibility Act, all provisions H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 8129, To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services Act, all provisions H.R. 2725, Affordable Housing Credit Improvement Act of 2025, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 5940, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions S. 3480, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions S. 1399, Health Tech Investment Act, all provisions S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to the ACA H.R. 498, Do No Harm in Medicaid Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 5737, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 3164, Equitable Community Access to Pharmacist Services Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services Act, all provisions S. 3934, Medical Nutrition Therapy Act of 2026, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions No Fees for EFTs Act, all provisions Drafts/Chronic Care Management Improvement Act Drafts/Access to Genetic Counselor Services Act Drafts/GOLD CARD Act Drafts/Medicare Advantage Improvement Act Draft/Value in Health Care Act Draft/Medicare Budget Neutrality and MIPS reform Draft/MACRA/MIPS program reform Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: MIPS quality and cost measures Medicare program: G2211 Inherent Complexity Code Medicare program: Alternative Payment Models (APMs) Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: ACO/APM flexibilities Medicare program: Prior authorization Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicare program: Site Neutral Payment Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: Coding Medicare program: MEI Update Medicare program: AI services/payment Medicare program: Indirect practice expense Medicare program: Telehealth and Digital Health Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Data-Driven Performance Payment System Medicare program: Promoting Interoperability (PI) Program Medicare program: Quality Payment Program Medicare program: Certified electronic health record and PI Medicare program: Advanced APM reporting Medicare program: Public Health Reporting and Data Exchange Medicare program: Provider directories Medicare program: Digital quality measures Medicare program: Aligned Networks and interoperability Medicare program: Health Information Technology/physician burdens Medicare program: Data privacy/cybersecurity Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicaid program: Gender affirming care Medicaid program: Work requirements, per capita caps, provider taxes, FMAP changes Medicaid program: Community engagement/medical frailty exemption

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

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

H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S, 891, Bipartisan Health Care Act, all provisions H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R, 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No UPCODE Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R. 6160, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 7520, Efficiency Adjustment Delay Act, all provisions H.R. 7148, Consolidated Appropriations Act, 2026, provisions related to APM bonus extension/incentive payments/qualifying provider revenue thresholds freeze H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions related to APMs H.R. 8163, To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 483, Health Care Efficiency Through Flexibility Act, all provisions H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 8129, To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services Act, all provisions H.R. 2725, Affordable Housing Credit Improvement Act of 2025, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 5940, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions S. 3480, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions S. 1399, Health Tech Investment Act, all provisions S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to the ACA H.R. 498, Do No Harm in Medicaid Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 5737, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 3164, Equitable Community Access to Pharmacist Services Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services Act, all provisions S. 3934, Medical Nutrition Therapy Act of 2026, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions No Fees for EFTs Act, all provisions Drafts/Chronic Care Management Improvement Act Drafts/Access to Genetic Counselor Services Act Drafts/GOLD CARD Act Drafts/Medicare Advantage Improvement Act Draft/Value in Health Care Act Draft/Medicare Budget Neutrality and MIPS reform Draft/MACRA/MIPS program reform Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: MIPS quality and cost measures Medicare program: G2211 Inherent Complexity Code Medicare program: Alternative Payment Models (APMs) Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: ACO/APM flexibilities Medicare program: Prior authorization Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicare program: Site Neutral Payment Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: Coding Medicare program: MEI Update Medicare program: AI services/payment Medicare program: Indirect practice expense Medicare program: Telehealth and Digital Health Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Data-Driven Performance Payment System Medicare program: Promoting Interoperability (PI) Program Medicare program: Quality Payment Program Medicare program: Certified electronic health record and PI Medicare program: Advanced APM reporting Medicare program: Public Health Reporting and Data Exchange Medicare program: Provider directories Medicare program: Digital quality measures Medicare program: Aligned Networks and interoperability Medicare program: Health Information Technology/physician burdens Medicare program: Data privacy/cybersecurity Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicaid program: Gender affirming care Medicaid program: Work requirements, per capita caps, provider taxes, FMAP changes Medicaid program: Community engagement/medical frailty exemption

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), 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

H.R.1096 - HOPE and Mental Wellbeing Act of 2025 H.R. 929/S. 266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S. 475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S. 779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585/S. 709 - Conrad State 30 and Physician Access Reauthorization Act H.R. 1909/S. 2621 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S. 931 - COMPLETE Care Act H.R. 4206/S. 1261 - CONNECT for Health Act H.R. 1305 - Improving Measurements for Loneliness and Isolation Act H.R. 1902 - Helping Emergency Responders Overcome (HERO) Act H.R. 2223 - Building Capacity for Care Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 3266/S.1673 - Mental Health Infrastructure Improvement Act of 2025 Mental Health Matters Act H.R. 4619 - Medicare Mental Health Inpatient Equity Act S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2587 - Youth Mental Health Research Act H.R. 2483/S. 2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 2630 - Youth Suicide Prevention Research Act H.R. 3655 - STAR Plus Scholarship Act H.R. 3890/S. 2439 - Resident Physician Shortage Reduction Act of 2025 H.R. 3885/S.3989 - Community TEAMS Act H.R. 1867 - To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 4723/S. 2446 - Mental Health for Latinos Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505 - Barriers to Suicide Act Letters to Congress to extend the enhanced premium tax credits H.R.6249 - Addressing Addiction After Disasters Act H.R.7394/S.3783 - Mental Health Career Promotion Act H.R. 5074 - Protecting Young Minds Online Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R. 5557 - Mental Health Services for Students Act H.R.1197 - PREEMIE Reauthorization Act of 2025 H.R. 3514/S.1816 - Improving Seniors Timely Access to Care Act H.Res.792 - Youth Mental Health Day and Suicide Prevention Day Resolution H.R.5725 - Mental Health Crisis Response Act of 2025 H.R.5706 - Mental Health Emergency Responder Act S. 3064 - Relief of Chronic Pain Act H.R. 6226 - Latino Youth Mental Health Empowerment Act H.R. 5482 - Prevent Youth Suicide Act H.R.6672 - Mental Health Professionals Workforce Shortage Loan Repayment Act Letter to Letter to Department of Labor, Department of Health and Human Services, and Department of Treasury regarding mental health parity enforcement H.R. 3492 - Protect Children's Innocence Act H.R. 498 - Do No Harm in Medicaid Act H.R. 6817/ S. 1056 - Home-Based Telemental Health Care Act Communication with Congressional offices on SAMHSA grant terminations Input on Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) modernization Communication with Congressional offices on ghost networks S. 3486 - Expand the Behavioral Health Workforce Now Act H.R.7324/S. 683 - More Behavioral Health Providers Act H.R. 786/S. 1460 - Preserving Patient Access to Accountable Care Act H.R. 4331 - Access to Claims Data Act H.R.5281 - REAL Health Providers Act H.R.7875 - Providing Opportunities for Individuals in Need of Treatment and Support (POINTS) Act Response to HHS proposed rule on nondiscrimination on the basis of disability Letter to Congress on Agency for Healthcare Research and Quality (AHRQ) funding H.R. 6396 - Kid PROOF Act H.R. 6468 - Rural Residency Planning and Development Act of 2025 H.R. 8234 - Save Money, Save Lives Act H.R.7092 - RAYS Act H.R.7787 - Mental Health Workforce Act Letter in support of funding for gun violence prevention research at CDC, NIH and NIJ. S.4076 - Removing Medicare Mental Health Inpatient Limitations Act of 2026 Letter supporting funding for Maternal Mental Health and Substance Use Disorder Programs (MMHSUD) and National Maternal Mental Health Hotline. H.R. 5629 - To provide that the final rule of the Department of Health and Human Services titled Medications for the Treatment of Opioid Use Disorder except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect H.R. 7994 - The HERO Act

Client expense: $205,809 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of

Issues related to the CY 2025 Medicare Physician Fee Schedule proposed rule; Issues related to H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025; Issues related to Consolidated Appropriations Act, 2026 (PL 119-75); Issues related to SUPPORT for Patients and Communities Reauthorization Act of 2025 (PL 119-44).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare and Medicaid payments to physicians; Issues related to medical imaging; Issues related to Appropriate Use Criteria (AUC); Issues related to prior authorization in Medicare and Medicaid; Issues related to H.R. 639 - Doctor Knows Best Act of 2025; Issues related to H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025; Issues related to Consolidated Appropriations Act, 2026 (PL 119-75); Issues related to SUPPORT for Patients and Communities Reauthorization Act of 2025 (PL 119-44); Issues related to H.R. 5737/S. 1692 - Radiology Outpatient Ordering Transmission (ROOT) Act.

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

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.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. 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. 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), 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

H.R. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act of 2025; H.R. 1, the One Big Beautiful Bill Act; H.R. 3164/S. 2426, the Ensuring Community Access to Pharmacist Services Act; Draft legislation to amend title XVIII of the Social Security Act to modify the conversion factor updates applicable to physicians' services under the Medicare program; Implementation of Centers for Medicare & Medicaid Services. (2025). Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program. Federal Register, 88, 90 FR 49266-50481; H.R. 6160, the Strengthening Medicare for Patients and Providers Act; H.R. 8163, the Provider Reimbursement Stability Act

Client expense: $620,000 · Firm income: Not reported

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

H.R. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. S. 1640/H.R. 879: Medicare Patient Access and Practice Stabilization Act of 2025 - This bill increases certain payment adjustments under the Medicare physician fee schedule for services furnished between April 1, 2025, and January 1, 2026. S. 1460/H.R. 786: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. H.R. 1509/S. 752: Accelerating Kids Access to Care Act - To amend titles XIX and XXI of the Social Security Act to streamline the enrollment process for eligible out-of-state providers under Medicaid and CHIP. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation. H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation.

Client expense: $210,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to physician payment and patient access to hospital care in PL 119-21, the One Big Beautiful Bill Act; various Presidential executive orders affecting health care providers; S. 1640/HR 879, the Medicare Patient Access and Practice Stabilization Act; S. 1816/HR 3514, the Improving Seniors' Timely Access to Care Act; S. 4137/HR 3954, the Improving Access to Medicare Coverage Act; HR 538, the Critical Access Hospitals Relief Act of 2025; provisions in CMS-1832-F, the CY 2026 Medicare Physician Fee Schedule Final Rule; health policy extensions in PL 119-75, FY2026 Consolidated Defense, LHHSED, Nat. Sec.-State, THUD, FSGG Approps. Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE