No Surprises Act Enforcement Act

S. 2420/H.R. 4710, the No Surprises Enforcement Act: To increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Educated members on the importance of worker classification, project labor agreements, and Davis-Bacon prevailing wage protections on federal construction and infrastructure projects. H.R. 4615, Pay for Performance Act; equitable adjustments and payment for changes to federal construction contracts. Lobbied in support of the application of Davis-Bacon prevailing wage protections to federal funds administered through states, including related defense authorization provisions. Educated members on H.R. 4710 / S. 2420, No Surprises Act Enforcement Act; balance billing enforcement and independent dispute resolution provisions affecting employer health plans.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability S.4027 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Husted, Jon [R-OH] H.R.6248 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3] S.380 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.1254 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Rep. Kelly, Robin L. [D-IL-2] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.1521 - DOC Access Act of 2025 To amend title XXVII of the Public Health Service Act to improve health care coverage under vision and dental plans, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.3097 - Health Information Privacy Reform Act To provide additional protections with respect to health information, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2026 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. S.2355 - Patients Deserve Price Tags Act - To amend the Public Health Service Act to provide for hospital and insurer price transparency. H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. H.R.9397 - Premium Transparency Act - To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. H.R.9396 - Prior Authorization Accountability Act - To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates.

Client expense: $820,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 90 - Health Coverage Choice Act - Rep. Biggs, Andy - Duration of STLDHI plans H.R. 114 - Responsible Path to Full Obamacare Repeal Act - Rep. Biggs, Andy - ACA repeal H.R. 247 - Health Care Affordability Act - Rep. Underwood, Lauren - ACA tax credit extension H.R. 267 - Health Care Price Transparency Act - Rep. Davidson, Warren - Hospital and insurer transparency requirements H.R. 639 - Doctor Knows Best Act - Rep. Van Drew, Jefferson - Commercial market prior authorization H.R. 957 - Parity Enforcement Act - Rep. Norcross, Donald - Penalties for mental health parity violations H.R. 1385 - DOC Access Act - Rep. Carter, Earl "Buddy" - Rate setting for dental and optometric services H.R. 1397 - Increasing Access to Dental Insurance Act - Rep. Miller-Meeks, Mariannette - Standalone dental plans H.R. 1776 - New Health Options Act - Rep. Palmer, Gary - ACA reinsurance H.R. 2079 - Insurance Fraud Accountability Act - Rep. Ross, Deborah - fraudulent ACA enrollments H.R. 2082 - WISH Act - Rep. Suozzi, Thomas - Long-term care insurance benefits H.R. 2199 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 2553 - Capping Prescription Costs Act - Rep. Horsford, Steven - Prescription cost-sharing H.R. 2554 - Lower Drug Costs for Families Act - Rep. Horsford, Steven - Commercial market drug rebates H.R. 2636 - Making Insulin Affordable for All Children Act - Rep. Landsman, Greg - Commercial market insulin cost-sharing H.R. 3020 - Addressing Anti-Competitive Health Care Contract Clauses Act - Rep. Spartz, Victoria - Study on anti-competitive contracting H.R. 3257 - Bridge to Medicaid Act - Rep. Sewell, Terri - ACA subsidies for non-Medicaid expansion states H.R. 3701 - Family Vaccine Protection Act - Rep. Pallone, Frank - ACIP codification and vaccine coverage H.R. 4406 - State-Based Universal Health Care Act - Rep. Khanna, Ro - State-based universal health care H.R. 4710 - No Surprises Act Enforcement Act - Rep. Murphy, Greg - Surprise billing penalties for noncompliance by health insurers H.R. 5145 - Bipartisan Premium Tax Credit Extension Act - Rep. Kiggans, Jennifer - Temporary extension of ACA enhanced premium tax credits H.R. 5509 - Safe Step Act - Rep. Allen, Rick - Step therapy requirements H.R. 5582 - Patients Deserve Price Tags Act - Rep. James, John - Hospital and insurer price transparency requirement H.R. 6171 - ACA Copay CAP Act of 2025 - Rep. Auchincloss, Jake - establish out of pocket limit on prescription drugs H.R. 6248 - Healthy Competition for Better Care Act - Rep. Arrington, Jodey - ban anticompetitive terms in contracts, promote higher quality, lower cost care H.R. 6703 - Lower Health Care Premiums for All Americans Act - Rep. Miller-Meeks, Mariannette - amend ERISA to lower premiums H.R. 7023 - Affordable CHOICE Act - Rep. Schakowsky, Janice - public option under ACA H.R. 7164 - Capping Costs for Consumers Act - Rep. Schrier, Kim - ACA cost-sharing reductions H.R. 8270 - Every Dollar Counts Act - Rep. Murphy, Greg - Requirements for deductibles and MOOP to include expenditures for DTC prescriptions H.R. 8684 - Transparency in Billing Act - Rep. Foxx, Virginia - Transparency enforcement H.R. 9393 - Lower Costs, More Transparency Act - Rep. Guthrie, Brett - Healthcare price transparency H.R. 9645 - Health Care Price Certainty for All Americans Act - Rep. Smith, Jason - Price transparency requirements H.R. 10024 - Health Insurance Transparency for Patients Act - Rep. Hinson, Ashley - Price transparency requirements S. 46 - Health Care Affordability Act - Sen. Shaheen, Jeanne - ACA tax credit extension S. 729 - Hospital Transparency Compliance Enforcement Act - Sen. Kennedy, John - Hospital price transparency requirements S. 864 - HELP Copays Act - Sen. Marshall, Roger - Cost-sharing requirements S. 976 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - fraudulent ACA enrollments S. 2355 - Patients Deserve Price Tags Act - Sen. Marshall, Roger - Hospital and insurer price transparency requirements S. 2420 - No Surprises Act Enforcement Act - Sen. Marshall, Roger - Surprise billing penalties for noncompliance by health insurers S. 2903 - Safe Step Act - Sen. Murkowski, Lisa - Step therapy requirement S. 3599 - Affordable CHOICE Act - Sen. Whitehouse, Sheldon - public option under ACA S. 4189 - INSULIN Act - Sen. Collins, Susan - Insulin cost-sharing caps S. 4512 - Affordable Insulin Now Act - Sen. Kennedy, John - Insulin cost-sharing caps Issues related to implementation rule implementing the No Surprises Act prohibiting surprise medical bills; transparency report requirements; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Waste Fraud and Abuse; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; coverage of weight loss drugs; Transparency in Coverage; No Surprises Act; ACA Marketplace Integrity; ACA Enhanced Tax Credits; Prior Authorization; affordability; and health savings accounts.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of the Vice President of the United States, SENATE, White House Office

S. 2355, Patients Deserve Price Tags Act; H.R. 9645, Health Care Price Certainty for All Americans Act; H.R. 9393, Lower Costs More Transparency Act re: Health Care Price Transparency H.R. 4710/ S. 2420, No Surprises Act Enforcement Act; H.R. 10788, Lower Premiums Faster Payments Act re: No Surprises Act reform Rural Health Transformation Fund re: implementation S.709/HR1585, Conrad State 30 and Physician Access Reauthorization Act re: physician workforce S. 3315, Health Care Cybersecurity and Resiliency Act of 2025 re: cybersecurity requirements

Client expense: $760,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3164: Ensuring Community Access to Pharmacist Services Act; all provisions H.R. 3514: Improving Seniors' Timely Access to Care Act of 2025; all provisions H.R. 4710: No Surprises Act Enforcement Act; all provisions H.R. 6160: Strengthening Medicare for Patients and Providers Act; provisions related to Medicare physician payments S. 1816: Improving Seniors Timely Access to Care Act of 2025; all provisions S. 2420: No Surprise Act Enforcement Act; all provisions HHS-OS-2026-0332-0001: Categories Used in Federal Vaccine Recommendations and the Roles of Shared Clinical Decision-Making; all provisions

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

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

S 2420/HR 4710 - No Surprises Act Enforcement Act including issues related to independent dispute resolution abuse; S (not yet introduced)/HR 10788 - Lower Premiums, Faster Payments Act including issues related to the appeals process

Client expense: $4,090,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 2420/HR 4710 No Surprises Act Enforcement Act, provisions related to employee health plans

Client expense: $2,640,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues: ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability Bills: S.4027 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Husted, Jon [R-OH] H.R.6248 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9117 - Clear Healthcare Expense Cost Knowledge Act (CHECK Act) To promote the availability of certain healthcare information, and for other purposes. Sponsor: Rep. Langworthy, Nicholas A. [R-NY-23] H.R.9390 - Prices on the Wall Act of 2026 To amend title XXVII of the Public Health Service Act to require certain facilities to post prices on the walls. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R. 8209 - School Based-Health Centers Reauthorization Act To amend the Public Health Service Act to reauthorize the school-based health centers grant program. Sponsor: Rep. Tonko, Paul [D-NY-20] H.R.9389 - Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 To amend the Public Health Service Act to authorize funding for nutrition education and chronic disease prevention at federally qualified health centers, and for other purposes. Sponsor: Rep. Harshbarger, Diana [R-TN-1] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3] S.380 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.1254 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Rep. Kelly, Robin L. [D-IL-2] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.1521 - DOC Access Act of 2025 To amend title XXVII of the Public Health Service Act to improve health care coverage under vision and dental plans, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.3097 - Health Information Privacy Reform Act To provide additional protections with respect to health information, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2026 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC]

Client expense: $100,000 · 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), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability S.4027 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Husted, Jon [R-OH] H.R.6248 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9117 - Clear Healthcare Expense Cost Knowledge Act (CHECK Act) To promote the availability of certain healthcare information, and for other purposes. Sponsor: Rep. Langworthy, Nicholas A. [R-NY-23] H.R.9390 - Prices on the Wall Act of 2026 To amend title XXVII of the Public Health Service Act to require certain facilities to post prices on the walls. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R. 8209 - School Based-Health Centers Reauthorization Act To amend the Public Health Service Act to reauthorize the school-based health centers grant program. Sponsor: Rep. Tonko, Paul [D-NY-20] H.R.9389 - Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 To amend the Public Health Service Act to authorize funding for nutrition education and chronic disease prevention at federally qualified health centers, and for other purposes. Sponsor: Rep. Harshbarger, Diana [R-TN-1] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3] S.380 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.1254 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Rep. Kelly, Robin L. [D-IL-2] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.1521 - DOC Access Act of 2025 To amend title XXVII of the Public Health Service Act to improve health care coverage under vision and dental plans, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.3097 - Health Information Privacy Reform Act To provide additional protections with respect to health information, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2026 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC]

Client expense: $1,240,000 · 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), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

Issues: ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability Bills: H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R. 8209 - School Based-Health Centers Reauthorization Act To amend the Public Health Service Act to reauthorize the school-based health centers grant program. Sponsor: Rep. Tonko, Paul [D-NY-20] H.R.9389 - Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 To amend the Public Health Service Act to authorize funding for nutrition education and chronic disease prevention at federally qualified health centers, and for other purposes. Sponsor: Rep. Harshbarger, Diana [R-TN-1] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3]

Client expense: $276,347 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General business issues; Pharmacy benefit manager issues; Medicare advantage; Issues relating to health insurance; General healthcare competition issues; H.R.4710/S.2420 - No Surprises Enforcement Act; Budget reconciliation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HJRes 197 / SJRes 197, CRA related to the 2027 NBPP; HR 247 / S 46, Health Care Affordability Act; HR 6867 / S 3562, the NIH Clinical Trial Integrity Act; HR 3521 / S 4440, the Clinical Trial Modernization Act; HR 4710 / S 2420, No Surprises Act Enforcement Act; HR 5526 / S 1954, Biosimilar Red Tape Elimination Act; HR 5582 / S 2355, the Patients Deserve Price Tags Act; HR 6248 / S 4027, Healthy Competition for Better Care Act HR 6485 / S 43, Skinny Labels, Big Savings Act; HR 6867 / S 3562, NIH Clinical Trial Integrity Act; HR 7895, the PBM Kickback Prohibition Act; HR 8879 / S 4509, Patients Before Monopolies Act; HR 8908, the STOP GAMES Act; HR 9393, Lower Costs, More Transparency Act; HR 9396, the Prior Authorization Accountability Act; HR 9397, the Premium Transparency Act; HR 9645, the Health Care Price Certainty for All Americans Act; HR 9661 / S 1414, the Expedited Access to Biosimilars Act; HR 10370, the AIM to Cure Kids with Cancer Act; HR 10788, the Lower Premiums, Faster Payments Act; S 976, the Insurance Fraud Accountability Act; S 1041, Affordable Prescriptions for Patients Act; S 1095, Stop STALLING Act; S 1096, Preserve Access to Affordable Generics & Biosimilars Act S 1097, Interagency Patent Coordination & Improvements Act; S 2658, Medication Affordability & Patent Integrity Act; S 3014, Ensuring Timely Access to Generics Act; S 3822, the Break Up Big Medicine Act Policies to address the expiration of the enhanced Advanced Premium Tax Credits; Policies to improve transparency in hospital and insurer costs and finances; Policies to streamline pediatric patient access to subspecialist care via telemedicine; Policies to protect patients and consumers from junk insurance, including short-term limited duration insurance; Policies related to modernization of clinical trials; Policies related to the 2027 FDA user fee agreements; Implementation of the No Surprises Act; Policies related to oversight of insurance agents and brokers; Oversight and patient impact of the 340B program; Policies related to consolidation within the healthcare sector;

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

Government targets: Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), SENATE

H.R. 2102 Major Richard Star Act H.R. 2199 - Restore Protections for Dialysis Patients Act H.R. 4710 No Surprises Act Enforcement Act H.R. 8347, the Reinforcing Underserved, Rural, and Local (RURAL) Healthcare Act H.R. 9237 Take Care of Americas Veterans Act Hearing: Less Red Tape, More Opportunity: Unleashing American Workers and Job Creators Rep. Dingell heat safety letter and legislation S. 1032 Major Richard Star Act S. 2355 - Patients Deserve Price Tags Act S. 2420 - No Surprises Act Enforcement Act S. 4378 - Protecting American Taxpayers Act S. 4744 Take Care of Americas Veterans Act S.2420 No Surprises Act Enforcement Act S.4189 - INSULIN Act S.4742 - AI DATA Act S.J.Res. 198 to end WISeR demonstration program in Medicare S.J.Res.197 - CRA resolution to halt HHS ACA rule S.J.Res.198 - CRA resolution to halt the Wasteful and Inappropriate Service Reduction program Toxic Substance Control Act- Draft bills

Client expense: $920,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to the implementation of provisions included in Subtitle BB of PL.116-260- No Surprises Act, including the No Surprises Act Enforcement Act (H.R. 4710/S. 2420). Issues relating to the Federal Independent Dispute Resolution Operations proposed rule

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The IBEW lobbied on provider payment and surprise medical bills issues raised by the No Surprises Enforcement Act (S. 2420 and H.R. 4710) The IBEW lobbied on ERISA preemption issues and other issues raised in the Patients Deserve Price Tags Act (S. 2355), the Health Care Price Certainty for All Act (H.R. 9645), as well as DOC Access Act (H.R. 1521), dealing with payment structures for optometrists and dentists.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to employer sponsored insurance; H.R.4710/S.2420 - No Surprises Act Enforcement Act.

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

Government targets: HOUSE OF REPRESENTATIVES

Affordable Care Act (ACA), ACA subsidies and tax credits; Transparency in Coverage, Rural healthcare; Surprise Billing; Prior Authorization; Managed Care Organizations; Maternal Health; Artificial Intelligence; Hospital billing; Individual Market Reforms and eAPTC Extension; Healthcare Affordability. H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R. 9117- Clear Healthcare Expense Cost Knowledge Act (CHECK Act) To promote the availability of certain healthcare information, and for other purposes. Sponsor: Rep. Langworthy, Nicholas A. [R-IA-1] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for the National Institutes of Health: Discussions on the impact of forward funding procedures, facilities and administration costs; the importance of the merit review system; Concerns about the proposed "Regulation for Federal Financial Assistance" (H.R. 4710/S. 2420) "No Surprises Enforcement Act" - concerns about unintended abuses of the dispute resolution process

Client expense: $140,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

7/10 - Letter in opposition to the No Surprises Act Enforcement Act (H.R. 4710/S. 2420)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Behavioral Health Issues related to behavioral health - no specific bill Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 2191, Physician Led and Rural Access to Quality Care Act Support of community water fluoridation - no specific bill Extend Premium Tax Credits - no specific bill Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 929/S.266 the Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 3890/S. 2439, the Resident Physician Shortage Reduction Act H.R. 5283/S. 2759, the Healthcare Workforce Resilience Act H.R. 3164, the Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4002, the Patient Access to Higher Quality Health Care Act of 2025 HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R.1585/S.709 the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign H.R.1061/S.455 Protecting Sensitive Locations Act Infrastructure Issues related to broadband access - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health H.R. 3480 Health Coverage for IVF Act S. 2035 Protect IVF Act S.3743 - Supporting Healthy Moms and Infants Act Issues related to maternal health - no specific bill S. 141, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid H.R. 9693, the Patients First Act. H.R. 8163, the Provider Reimbursement Stability Act S. 1816/H.R. 3514, Improving Seniors Timely Access to Care Act of 2025 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 2757 Medicare Audiology Access Improvement Act of 2025 S. 575 the Improving Care and Access to Nurses Act H.R. 879 the Medicare Patient Access and Practice Stabilization Act H.R. 8163, the Provider Reimbursement Stability Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025 Issues related to Medicare Advantage - no specific bill H.R. 1, One Big Beautiful Bill Act H.R. 2757, Medicare Audiology Access Improvement Act S. 106/H.R. 539, the Chiropractic Medicare Coverage Modernization Act of 2025 Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill (including H.R.1) Opioids/ Substance Use Disorder MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment H.R. 2483 SUPPORT for Patients and Communities Reauthorization Act S.4941 Modernizing Opioid Treatment Access Act 2.0 of 2026 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill HR 4002, The Patient Access to Higher Quality Health Care Act Publications Open access to information based on publicly funded research - no specific bill Request for Information for NIH Plan to Enhance Public Access to the Results of NIH-Supported Research Issues related to scholarly and scientific publishing and public access - no specific bill Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing H.R. 4710/S. 2420, the No Surprises Act Enforcement Act Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth S. 1261, the CONNECT for Health Act of 2025 H.R. 5081/S. 2709, the Telehealth Modernization Act of 2025 H.R. 1650, the Telehealth Expansion Act of 2025 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines H.R.5448/S.2857 Protecting Free Vaccines Act of 2025 H.R.3701/S.3323 Family Vaccine Protection Act Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P) Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole Proposed Rule (CMS-2448-P) Notice: Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA); Interpretation of Federal Public Benefit NIH RFI on Maximizing Research Funds by Limiting Allowable Publishing Costs File Code CMS-3481-P. Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children File Code CMS-2451-P Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children OMB-2026-0034, Proposed Revisions to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards File Code CMS-2454-IFC. Medicaid Program; Community Engagement Requirement for Certain Individuals Docket No. HHS-OS-2026-0332; RIN 0991-ZA62 - Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making (91 Fed. Reg. 54724, Aug. 24, 2026) File Code CMS-1848-P. Medicare and Medicaid Programs; 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 Notice of Proposed Rulemaking, Fee for Certain H-1B Petitions, 91 Fed. Reg. 54817 (Aug. 25, 2026); DHS Docket No. USCIS-2026-0298; CIS No. 2861-26; RIN 1615-AD20 Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes, File Code: CMS-2452-P, RIN 0938-AV93, 91 Fed. Reg. 46562 (published July 23, 2026) File Code CMS-1848-P; Medicare Program; CY 2027 Payment Policies Under the Physician Payment Schedule and Other Changes to Part B Payment and Coverage Policies; (July 16, 2026). Accounting for E/M Resource Overlap Between Stand-Alone Visits and Global Periods File Code ACF-2026-0595-0001; Reducing Federal Burden for Head Start Programs

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

Behavioral Health Issues related to behavioral health - no specific bill Childcare Issues related to childcare - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 2191, Physician Led and Rural Access to Quality Care Act Support of community water fluoridation - no specific bill Extend Premium Tax Credits - no specific bill Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 929/S.266 the Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 3890/S. 2439, the Resident Physician Shortage Reduction Act H.R. 5283/S. 2759, the Healthcare Workforce Resilience Act H.R. 3164, the Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4002, the Patient Access to Higher Quality Health Care Act of 2025 HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R.1585/S.709 the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign H.R.1061/S.455 Protecting Sensitive Locations Act Infrastructure Issues related to broadband access - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health H.R. 3480 Health Coverage for IVF Act S. 2035 Protect IVF Act S.3743 - Supporting Healthy Moms and Infants Act Issues related to maternal health - no specific bill S. 141, The Connected Maternal Online Monitoring (MOM) Act Medicare/Medicaid H.R. 9693, the Patients First Act. H.R. 8163, the Provider Reimbursement Stability Act S. 1816/H.R. 3514, Improving Seniors Timely Access to Care Act of 2025 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 2757 Medicare Audiology Access Improvement Act of 2025 S. 575 the Improving Care and Access to Nurses Act H.R. 879 the Medicare Patient Access and Practice Stabilization Act H.R. 8163, the Provider Reimbursement Stability Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025 Issues related to Medicare Advantage - no specific bill H.R. 1, One Big Beautiful Bill Act H.R. 2757, Medicare Audiology Access Improvement Act S. 106/H.R. 539, the Chiropractic Medicare Coverage Modernization Act of 2025 Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill (including H.R.1) Opioids/ Substance Use Disorder MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment H.R. 2483 SUPPORT for Patients and Communities Reauthorization Act S.4941 Modernizing Opioid Treatment Access Act 2.0 of 2026 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill HR 4002, The Patient Access to Higher Quality Health Care Act Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing H.R. 4710/S. 2420, the No Surprises Act Enforcement Act Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth S. 1261, the CONNECT for Health Act of 2025 H.R. 5081/S. 2709, the Telehealth Modernization Act of 2025 H.R. 1650, the Telehealth Expansion Act of 2025 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines H.R.5448/S.2857 Protecting Free Vaccines Act of 2025 H.R.3701/S.3323 Family Vaccine Protection Act Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P) Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole Proposed Rule (CMS-2448-P) Notice: Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA); Interpretation of Federal Public Benefit NIH RFI on Maximizing Research Funds by Limiting Allowable Publishing Costs File Code CMS-3481-P. Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children File Code CMS-2451-P Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children File Code CMS-2454-IFC. Medicaid Program; Community Engagement Requirement for Certain Individuals Docket No. HHS-OS-2026-0332; RIN 0991-ZA62 - Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making (91 Fed. Reg. 54724, Aug. 24, 2026) File Code CMS-1848-P. Medicare and Medicaid Programs; 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 Notice of Proposed Rulemaking, Fee for Certain H-1B Petitions, 91 Fed. Reg. 54817 (Aug. 25, 2026); DHS Docket No. USCIS-2026-0298; CIS No. 2861-26; RIN 1615-AD20 Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes, File Code: CMS-2452-P, RIN 0938-AV93, 91 Fed. Reg. 46562 (published July 23, 2026) File Code CMS-1848-P; Medicare Program; CY 2027 Payment Policies Under the Physician Payment Schedule and Other Changes to Part B Payment and Coverage Policies; (July 16, 2026). Accounting for E/M Resource Overlap Between Stand-Alone Visits and Global Periods File Code ACF-2026-0595-0001; Reducing Federal Burden for Head Start Programs

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Air medical services H.R. 4710 / S. 2420 - No Surprises Enforcement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Air medical services H.R. 4710 / S. 2420 - No Surprises Enforcement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Increased radar funding Policies that ensure air ambulance care providers get adequate reimbursements Air medical services H.R. 4710 / S. 2420 - No Surprises Enforcement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (ACA), ACA subsidies and tax credits; Telehealth/telehealth flexibilities, ACA Fraud; Transparency in Coverage; Exchanges; Rural Healthcare; Prior Authorization (PA); Managed Care Organizations; Hospital Billing/Consolidation; Maternal Health; Employer Provided Health Coverage; Individual Marketplace Program Integrity; EAPTC Extension; HealthCare Affordability; Suprise Billing; Artificial Intelligence S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Roger Marshall H.R. 4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Cide if 1986 to increase penalties for group health plans, health insurance issuers and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep Gergory Murphy S. 2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Cide if 1986 to increase penalties for group health plans, health insurance issuers and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Roger Marshall S. 4027- Health Competition For Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care Sponsor: Sen Jon Justed H.R. 6248 Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care Sponsor: Rep Jodey Arrington H.R. 2079 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. H.R. 8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. H.R. 9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector S. 2301 - Improving Care in Rural Camerica Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Res 1519 - Supporting the Designation of September 17, 2026 as National Physician Suicide Awareness Day to Raise Awareness of, and promote a national discussion about, physician suicide and to reduce the stigma of mental health conditions, and for other purposes. H. Res. 1528 - Recognizing Suicide as a serious public health problem and expressing support for the designation of September 2026 as National Physician Suicide Prevention Month, as well as September 10, 2026 as World Suicide Prevention Day. H.R. 1 - One Big Beautiful Bill Act, provisions relating to artificial intelligence (AI), provisions related to changes in medicaid regarding "Release the Pressure" hypertension control campaign H.R. 1254 - Rural Obstetrics Readiness Act, all provisions H.R. 2314 - Fair Access In Residency (FAIR) Act, all provisions H.R. 3492 - Protect Children's Innocence Act, all provisions H.R. 9390 - Prices on the Wall Act, all provisions H.R. 9395 - Transparency in Medicare Advantage Steering Act, all provisions H.R. 9645 - Health Care Price Certainty for All Americans Act, all provisions H.R. 9693 - The Patients First Act of 2026 - all provisions H.R.10444 - The Stop Corporate Takeovers of Physicians Act, all provisions H.R.1520 - Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions H.R.2191 - Physician Led and Rural Access to Quality Care Act, all provisions H.R.2332 - SHARE Act of 2025, all provisions H.R.2483 - SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R.2850 - Youth Sports Facilities Act of 2025, all provisions H.R.3022 - Restoring Rights of Physicians to Own Hospitals Act, all provisions H.R.3164 - Ensuring Community Access to Pharmacist Services Act, all provisions H.R.3170 - Improving Access to Workers Compensation for Injured Federal Workers Act of 2025, all provisions H.R.4583 - Living Donor Protection Act of 2025, all provisions H.R.4710 - No Surprises Act Enforcement Act, all provisions H.R.5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R.5861 - Legacy Act of 2025, all provisions H.R.628 - Honor Our Living Donors Act, all provisions H.R.7023 - Affordable CHOICE Act, all provisions H.R.7868 - Expanding Support for Living Donors Act of 2026, all provisions H.R.7884 - Healthcare is Human Act of 2026, all provisions H.R.8794 - FED UP with Bleeding Disorders Act of 2026, all provisions H.R.9192 - Prior Authorization Reform for Autoimmune and Blood Disorders Act, all provisions H.R.929 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions H.R.9393 - Lower Costs, More Transparency Act of 2026, all provisions H.R.9396 - Prior Authorization Accountability Act, all provisions S. 380 - Rural Obstetrics Readiness Act, all provisions S.1390 - Physician Led and Rural Access to Quality Care Act, all provisions S.1419 - Youth Sports Facilities Act of 2025, all provisions S.1552 - Living Donor Protection Act of 2025, all provisions S.1782 - Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions S.2355 - Patients Deserve Price Tags Act, all provisions S.2420 - No Surprises Act Enforcement Act, all provisions S.2426 - Equitable Community Access to Pharmacist Services , all provisions S.266 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S.3097 - Health Information Privacy Reform Act, all provisions S.3315 - Health Care Cybersecurity and Resiliency Act of 2026, all provisions S.3599 - Affordable CHOICE Act, all provisions S.3907 - Health Information Privacy Reform Act, all provisions S.5419 - The Stop Corporate Takeovers of Physicians Act, all provisions S.5496 - Health for the Commonwealth through Affordability Reform and Expansion Health Care (CARE) Act, all provisions "Legitimate Medical Purpose" definition under the Controlled Substance Act "Still at Risk" wristband initiative Jeanette Acosta Invest in Women's Health Act Comment Letter: [ACF-2026-0595] Reducing Federal Burden for Head Start Programs Comment Letter: [CMS-2026-1255-0001] 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, etc. Comment Letter: [REG-118484-25; CMS-9879-P; RIN 0938-AV94; RIN 1210-AC40; RIN 1545-BS02] Excepted Fertility Benefits Comment Letter: Request for Information (RFI) on Health Coverage that Works for Everyone Comment Letter: [2120-AM18] Improving Emergency Medical Kit Efficacy and Flexibility in Commercial Airline Operations Draft: Health Infrastructure Security and Accountability Act Draft: Noncompete clauses in physician contracts Matters related to AI use in prior authorization Matters related to Alternative Payment Model bonuses/incentive payments and freezing the qualifying provider revenue thresholds Matters related to Data privacy, cybersecurity, and AI Matters related to Health care consolidation Matters related to the Health Insurance Portability and Accountability Act (HIPAA) and electronic records Matters related to Maternal health and hypertensive disorder during pregnancy Matters related to Medical devices Matters related to Nutrition Matters related to the Office of the National Coordinator for Health Information Technology (ONC) improving electronic health record certification; implementation of 21st Century Cures Act provisions; digital health policies, and reduction of technology burden on physicians entering into the Quality Payment Program Matters related to Payment for AI services within health care Matters related to the Public Health effects of opioid medications Matters related to Unbundling of Maternity Care of Current Procedural Terminology (CPT) Codes Matters related to the United States Preventive Services Task Force (USPSTF) Matters related to Vaccines/ACIP Matters related to ACA benefits and payments Matters related to high-resolution anoscopy services Matters related to peptides Matters related to physician prescribing of antibiotics Matters related to reproductive health Matters related to the Authorization of ENDS Products Age Verification

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

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Treasury, Dept of

Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); S.2420/H.R.4710, the No Surprises Act Enforcement Act.

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

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

General legislative and regulatory issues including health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs; H.R.919, Chronic Disease Flexible Coverage Act; H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260) implementation; S.2420/H.R.4710, the No Surprises Act Enforcement Act; H.R.1, One Big Beautiful Bill Act (P.L.119-21) implementation; H.R.6248/S.4027, the Healthy Competition for Better Care Act; S.2355, Patients Deserve Price Tags Act.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

General legislative and regulatory issues including health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs; H.R.919, Chronic Disease Flexible Coverage Act; H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260) implementation; S.2420/H.R.4710, the No Surprises Act Enforcement Act; H.R.1, One Big Beautiful Bill Act (P.L.119-21) implementation; H.R.6248/S.4027, the Healthy Competition for Better Care Act; S.2355, Patients Deserve Price Tags Act.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act and Extending Enhanced APTCs (H.R. 247; S. 46), Individual Market/ACA exchanges; Fraudulent Enrollments in Qualified Health Plans (S. 976, HR 2079), Behavioral Health, Employer-Provided Health Coverage; Surprise Billing (S. 2420, H.R. 4710); Cybersecurity; Health IT, Health Care Innovation, Transparency & PBMs (S. 891, H.R. 6703), PBM Compensation (H.R. 7895), Prescription Drugs (S. 1954, S. 1096, S.1040), Price Transparency (S. 2355, H.R. 9393, H.R. 9397, H.R. 9645, H.R. 9390), Prior Authorization (H.R. 9396), 340B, Insulin (S. 4189), Corporate Practice of Medicine, Anticompetitive Contracting (H.R. 6248, S. 4027).

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

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

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

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

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

No Surprises Act implementation Eliminating prior authorization requirements in Medicare Advantage 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. 3514-Improving Seniors Timely Access to Care Act of 2025, to improve and streamline prior authorization under Medicare Advantage Plans H.R. 4710-No Surprises Act Enforcement Act, to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements. S. 1816-Improving Seniors Timely Access to Care Act of 2025, to improve and streamline prior authorization under Medicare Advantage Plans S. 2420- No Surprises Act Enforcement Act, to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to surprise emergency medical bills, including implementation of provisions in P.L. 116-260, the Consolidated Appropriations Act, 2021, included in Requirements Related to Surprise Billing; Part I Interim Final Rule (86 FR 36872), Requirements Related to Surprise Billing; Part II Interim Final Rule (86 FR 55980), and Requirements Related to Surprise Billing Final Rule (87 FR 52618); Federal Independent Dispute Resolution (IDR) Process Administrative Fee and Certified IDR Entity Fee Ranges Proposed Rule (88 FR 65888) and Final Rule (88 FR 88494); Federal Independent Dispute Resolution Operations Proposed Rule (88 FR 75744); Federal Independent Dispute Resolution (IDR) Process Partial Reopening of Dispute Initiation Guidance (October 2023); and FAQs About Consolidated Appropriations Act, 2021 Implementation Part 62. S. 2420/H.R. 4710, the No Surprises Act Enforcement Act. Issues related to health plan policies. Issues related to health care innovation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to funding for Medicaid and Medicare. Issues related to the No Surprises Act Enforcement Act (H.R.4710/S.2420).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, to reauthorize programs created by the act designed to improve access to behavior health services for clinicians. Support H.R.4710/S.2420, No Surprises Act Enforcement Act, which would protect patients from illegal balance bills and maintain access to care by closing loopholes in enforcement of the No Surprises Act. Support oversight, investigations, and application of penalties related to plan and issuer noncompliance with patient protection and timely payment provisions of the No Surprises Act.

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

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

H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 90 - Health Coverage Choice Act - Rep. Biggs, Andy - Duration of STLDHI plans H.R. 114 - Responsible Path to Full Obamacare Repeal Act - Rep. Biggs, Andy - ACA repeal H.R. 247 - Health Care Affordability Act - Rep. Underwood, Lauren - ACA tax credit extension H.R. 267 - Health Care Price Transparency Act - Rep. Davidson, Warren - Hospital and insurer transparency requirements H.R. 639 - Doctor Knows Best Act - Rep. Van Drew, Jefferson - Commercial market prior authorization H.R. 957 - Parity Enforcement Act - Rep. Norcross, Donald - Penalties for mental health parity violations H.R. 1385 - DOC Access Act - Rep. Carter, Earl Buddy - Rate setting for dental and optometric services H.R. 1397 - Increasing Access to Dental Insurance Act - Rep. Miller-Meeks, Mariannette - Standalone dental plans H.R. 1776 - New Health Options Act - Rep. Palmer, Gary - ACA reinsurance H.R. 2079 - Insurance Fraud Accountability Act - Rep. Ross, Deborah - fraudulent ACA enrollments H.R. 2199 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 2553 - Capping Prescription Costs Act - Rep. Horsford, Steven - Prescription cost-sharing H.R. 2554 - Lower Drug Costs for Families Act - Rep. Horsford, Steven - Commercial market drug rebates H.R. 2636 - Making Insulin Affordable for All Children Act - Rep. Landsman, Greg - Commercial market insulin cost-sharing H.R. 3020 - Addressing Anti-Competitive Health Care Contract Clauses Act - Rep. Spartz, Victoria - Study on anti-competitive contracting H.R. 3527 - Bridge to Medicaid Act - Rep. Sewell, Terri - ACA subsidies for non-Medicare expansion states H.R. 3701 - Family Vaccine Protection Act - Rep. Pallone, Frank - ACIP codification and vaccine coverage H.R. 4406 - State-Based Universal Health Care Act - Rep. Khanna, Ro - State-based universal health care H.R. 4710 - No Surprises Act Enforcement Act - Rep. Murphy, Greg - Surprise billing penalties for noncompliance by health insurers H.R. 5145 - Bipartisan Premium Tax Credit Extension Act - Rep. Kiggans, Jennifer - Temporary extension of ACA enhanced premium tax credits H.R. 5509 - Safe Step Act - Rep. Allen, Rick - Step therapy requirements H.R. 5582 - Patients Deserve Price Tags Act - Rep. James, John - Hospital and insurer price transparency requirement H.R. 6171 - ACA Copay CAP Act of 2025 - Rep. Auchincloss, Jake - establish out of pocket limit on prescription drugs H.R. 6248 - Healthy Competition for Better Care Act - Rep. Arrington, Jodey - ban anticompetitive terms in contracts, promote higher quality, lower cost care H.R. 6703 - Lower Health Care Premiums for All Americans Act - Rep. Miller-Meeks, Mariannette - amend ERISA to lower premiums H.R. 7023 - Affordable CHOICE Act - Rep. Schakowsky, Janice - public option under ACA H.R. 7164 - Capping Costs for Consumers Act - Rep. Schrier, Kim - ACA cost-sharing reductions H.R. 8270 - Every Dollar Counts Act - Rep. Murphy, Greg - Requirements for deductibles and MOOP to include expenditures for DTC prescriptions H.R. 8684 - Transparency in Billing Act - Rep. Foxx, Virginia - Transparency enforcement H.R. 9393 - Lower Costs, More Transparency Act - Rep. Guthrie, Brett - Healthcare price transparency S. 46 - Health Care Affordability Act - Sen. Shaheen, Jeanne - ACA tax credit extension S. 729 - Hospital Transparency Compliance Enforcement Act - Sen. Kennedy, John - Hospital price transparency requirements S. 864 - HELP Copays Act - Sen. Marshall, Roger - Cost-sharing requirements S. 976 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - fraudulent ACA enrollments S. 2355 - Patients Deserve Price Tags Act - Sen. Marshall, Roger - Hospital and insurer price transparency requirements S. 2420 - No Surprises Act Enforcement Act - Sen. Marshall, Roger - Surprise billing penalties for noncompliance by health insurers S. 2824 - A bill to amend the Internal Revenue Code of 1986 to extend the temporary enhanced premium tax credits - Sen. Murkowski, Lisa - Temporary extension of ACA enhanced premium tax credits S. 2903 - Safe Step Act - Sen. Murkowski, Lisa - Step therapy requirement S. 3599 - Affordable CHOICE Act - Sen. Whitehouse, Sheldon - public option under ACA S. 3990 - PrEP Access and Coverage Act - Sen. Smith, Tina - Coverage requirements for HIV services S. 4189 - INSULIN Act - Sen. Collins, Susan - Insulin cost-sharing caps S. 4512 - Affordable Insulin Now Act - Sen. Kennedy, John - Insulin cost-sharing caps Issues related to implementation rule implementing the No Surprises Act prohibiting surprise medical bills; transparency report requirements; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Waste Fraud and Abuse; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; coverage of weight loss drugs; Transparency in Coverage; No Surprises Act; ACA Marketplace Integrity; ACA Enhanced Tax Credits; Prior Authorization; affordability; and health savings accounts.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues: ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability; Preventative Care Bills: S.4027 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Husted, Jon [R-OH] H.R.6248 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.2493 - Improving Care in Rural America Reauthorization Act of 2025 This bill reauthorizes through FY2030 grant programs administered by the Health Resources and Services Administration (HRSA) that provide funding to health care service providers and related entities in rural areas. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.3419 - To amend the Public Health Service Act to reauthorize the telehealth network and telehealth resource centers grant programs. To amend the Public Health Service Act to reauthorize the telehealth network and telehealth resource centers grant programs. Sponsor: Rep. Valadao, David G. [R-CA-22] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9117 - Clear Healthcare Expense Cost Knowledge Act (CHECK Act) To promote the availability of certain healthcare information, and for other purposes. Sponsor: Rep. Langworthy, Nicholas A. [R-NY-23] H.R.9390 - Prices on the Wall Act of 2026 To amend title XXVII of the Public Health Service Act to require certain facilities to post prices on the walls. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R.2041 - Hidden Fee Disclosure Act of 2025 To amend the Employee Retirement Income Security Act of 1974 to clarify and strengthen the application of certain employer-sponsored health plan disclosure requirements. Sponsor: Rep. Courtney, Joe [D-CT-2] H.R. 8209 - School Based-Health Centers Reauthorization Act To amend the Public Health Service Act to reauthorize the school-based health centers grant program. Sponsor: Rep. Tonko, Paul [D-NY-20] H.R.9389 - Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 To amend the Public Health Service Act to authorize funding for nutrition education and chronic disease prevention at federally qualified health centers, and for other purposes. Sponsor: Rep. Harshbarger, Diana [R-TN-1] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3] S.380 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.1254 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Rep. Kelly, Robin L. [D-IL-2] H.R.3302 - Healthy Start Reauthorization Act of 2025 To amend the Public Health Service Act to reauthorize the Healthy Start Initiative. Sponsor: Rep. Ocasio-Cortez, Alexandria [D-NY-14] S.3799 - Healthy Start Reauthorization Act of 2026 To amend the Public Health Service Act to reauthorize the Healthy Start Initiative. Sponsor: Sen. Marshall, Roger [R-KS] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14] S.4694 - Maternal Health for Veterans Act To amend title 38, United States Code, to require the Secretary of Veterans Affairs to carry out a maternity care coordination program, and for other purposes. Sponsor: Sen. Duckworth, Tammy [D-IL]

Client expense: $80,000 · 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), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

S 1173/HR 2199 - Restore Protections for Dialysis Patients Act including issues related to Medicare secondary payer issues; S 2420/HR 4710 - No Surprises Act Enforcement Act including issues related to independent dispute resolution abuse

Client expense: $4,180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3164: Ensuring Community Access to Pharmacist Services Act; all provisions H.R. 4710: No Surprises Act Enforcement Act; all provisions H.R. 7945: Nitrous Oxide Safety Act of 2026; all provisions S. 2420: No Surprise Act Enforcement Act; all provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE