FAIR Act of 2025

Medicare-funded Graduate Medical Education; Osteopathic Funding and Representation; H.R.2314/S.2715, FAIR Act; H.R.3885/S.3989, Community TEAMS Act of 2025; FY2027 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R.9260); FY2027 National Defense Authorization Act (H.R.8800/S.4784).

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

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

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 2314 / S. 2715) and the TEAMS Act (H.R. 7258/ S. 3968).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support the Medicare and Medicaid Beneficiaries Access to Timely Care Act of 2026. Applies prior auth reforms to Part D, CHIP, Medicaid. Not introduced in the 2nd Quarter Support the Fair Access in Residency (FAIR) Act (H.R. 2314 and S. 2715) to require equal recognition of the Comprehensive Osteopathic Medical Licensing Exam (COMLEX) Support the Improving Seniors' Timely Access to Care Act (H.R. 3514 / S. 1816)

Client expense: Not reported · Firm income: $21,600

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4731 and S. 2439: Resident Physician Shortage Reduction Act of 2025 A bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes (ALL). H.R. 2314 and S. 2715: Fair Access in Residency (FAIR) Act A bill to amend title XVIII of the Social Security Act to require hospitals with approved medical residency training programs to submit to the Secretary of Health and Human Services certain information regarding osteopathic and allopathic candidates for such programs (ALL).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Fair Access In Residency Act (H.R. 2314, S.2715) Teaching Health Center Graduate Medical Education National Institutes of Health Research Expanding Medical Education Act (H.R. 2106, S. 975) Community TEAMS Act (H.R. 3885, S.3989) Post GRAD Act (H.R. 3711) Rural Health Transformation Program Healthcare Advisory Council Resident Physician Shortage Reduction Act (H.R.4731/S.2439) Medical Student Education Authorization Act (H.R.5248) Resident Education Deferred Interest (REDI Act) (H.R. 2028, S. 942) Rural Residency Planning and Development Act of 2025 (H.R. 6468) PSLF Payment Completion Fairness Act (H.R. 3267, S.3487) Foreign Medical School Accountability Fairness Act (S. 3757) Nutrition Education Community Academic Health Systems Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 (H.R. 9389)

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

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

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

Medicare-funded Graduate Medical Education; Osteopathic Funding and Representation; H.R.2314/S.2715, FAIR Act; H.R.3885/S.3989, Community TEAMS Act of 2025; FY2027 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R.9260); FY2027 National Defense Authorization Act (H.R.8800/S.4784).

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

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res. 14 Fiscal Year 2026 Budget Reconciliation Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the need to delay, undo, or revise pending new restrictions on to provider taxes and state-directed payments, along with implement strategies to mitigate coverage losses due to the OBBBAs work requirements and more frequent eligibility redeterminations for the ACA expansion population. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.7409 - Defend Rural Health Act Issue: Oppose efforts to repeal or curtail the ability of urban hospitals to become rural referral centers or reclassify for the purposes of their wage index. Issue: Educate Congress and policymakers on the role academic health systems, teaching hospitals, medical schools, and faculty practices play in caring for rural patients and communities, training providers to practice in rural communities, and ensuring access to critical health care services not otherwise available. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: CAA, 2021 Sec. 131 extension and RTP thresholds Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. H.R.5582/S.2355 - Patients Deserve Price Tags Act H.R.9393 - Lower Costs, More Transparency Act of 2026 H.R.9390 - Prices on the Wall Act of 2026 Issue: Oppose efforts to increase administrative burden on hospitals through expanded reporting measures. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. H.R.9504 - Tax Exempt Hospital Transparency Act Issue: Oppose efforts that increase duplicative and burdensome reporting requirements on tax exempt hospitals through expanded IRS reporting measures. H.R.3514/ S.1816 - Improving Seniors' Timely Access to Care Act of 2025 Issue: Support efforts to decrease the burden of prior authorization in Medicare Advantage plans Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. H.R.8163 - Provider Reimbursement Stability Act of 2026 Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R.4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761/H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 2314 / S. 2715) and the TEAMS Act (H.R. 7258/ S. 3968).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support the Fair Access in Residency (FAIR) Act (S. 2715 / H.R. 2314) to facilitate training of osteopathic medical students Support the Community Training, Education, and Access for Medical Students Act (H.R. 3885 / S. 3989)

Client expense: Not reported · Firm income: $21,600

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4731 and S. 2439: Resident Physician Shortage Reduction Act of 2025 A bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes (ALL). H.R. 2314 and S. 2715: Fair Access in Residency (FAIR) Act A bill to amend title XVIII of the Social Security Act to require hospitals with approved medical residency training programs to submit to the Secretary of Health and Human Services certain information regarding osteopathic and allopathic candidates for such programs (ALL).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

Medicare-funded Graduate Medical Education; Osteopathic Funding and Representation; H.R.2314/S.2715, FAIR Act; H.R.3885/S.3989, Community TEAMS Act of 2025; FY2027 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations; FY2027 National Defense Authorization Act.

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

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res. 14 Fiscal Year 2026 Budget Reconciliation Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the need to delay, undo, or revise pending new restrictions on to provider taxes and state-directed payments, along with strategies to mitigate coverage losses in light of the implementation of work requirements and more frequent eligibility redeterminations for the ACA expansion population. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.7409 - Defend Rural Health Act Issue: Oppose efforts to repeal or curtail the ability of urban hospitals to become rural referral centers or reclassify for the purposes of their wage index. Issue: Educate Congress and policymakers on the role academic health systems, teaching hospitals, medical schools, and faculty practices play in caring for rural patients and communities, training providers to practice in rural communities, and ensuring access to critical health care services not otherwise available. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: CAA, 2021 Sec. 131 extension and RTP thresholds Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. S.2355 - Patients Deserve Price Tags Act Issue: Oppose efforts to increase administrative burden on hospitals through expanded reporting measures. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R.4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761/H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 2314 / S. 2715) and the TEAMS Act (H.R. 7258/ S. 3968).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare-funded Graduate Medical Education; Osteopathic Funding and Representation; H.R.2314/S.2715, FAIR Act; H.R.3885, Community TEAMS Act of 2025; FY2026 National Defense Authorization Act (S.2296/H.R.3838/P.L.119-60); FY2026 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R.5304/S.2587); FY2026 Department of Defense Appropriations Act (H.R.4016/S.2572); H.R.1, One Big Beautiful Bill Act (P.L.119-21), higher education accountability provisions.

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

Support the Fair Access in Residency (FAIR) Act (S. 2715 / H.R. 2314) to facilitate training of osteopathic medical students Support the Community Training, Education, and Access for Medical Students Act (H.R. 3885)

Client expense: Not reported · Firm income: $21,600

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 768, Need-Based Educational Aid Act of 2001, all provisions H.R. 2028, Resident Education Deferred Interest (REDI) Act, all provisions S. 942, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 2314, Fair Access In Residency (FAIR) Act, all provisions S. 2715, Fair Access In Residency (FAIR) Act, all provisions S. 632, IHS Workforce Parity Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act (PL 119-21), provisions relating to Graduate Medical Education, and student loans H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 681, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions

Client expense: $5,480,000 · Firm income: Not reported

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res. 14 Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their disproportionate share hospital (DSH) cap. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R. 4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761 / H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

Medicare-funded Graduate Medical Education; Osteopathic Funding and Representation; H.R.2314/S.2715, FAIR Act; H.R.3885, Community TEAMS Act of 2025; FY2026 National Defense Authorization Act (S.2296/H.R.3838/P.L.119-60); FY2026 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R.5304/S.2587); FY2026 Department of Defense Appropriations Act (H.R.4016/S.2572); H.R.1, One Big Beautiful Bill Act (P.L.119-21), higher education accountability provisions.

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

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Rural Health Innovation Act of 2025 (H.R.1480) Fair Access In Residency Act (H.R. 2314/S.2715) Teaching Health Center Graduate Medical Education National Institutes of Health Research Pathways to Health Professions Act (H.R. 593) Bipartisan Rural America Health Corps Act (H.R. 1127) Expanding Medical Education Act (H.R. 2106, S. 975) Community TEAMS Act (H.R. 3885) Specialty Physicians Advancing Rural Care Act (S. 1380) Post GRAD Act (H.R. 3711) Physician and Patient Safety Act (H.R. 3413, S. 1767) IHS Workforce Production Act ( S.632) Rural Health Focus Act (S.403) Rural Health Transformation Program Healthcare Advisory Council Resident Physician Shortage Reduction Act (H.R.4731/S.2439) Medical Student Education Authorization Act (H.R.5248) Palliative Care and Hospice Education and Training Act (S.2287) Improving Care in Rural America Reauthorization Act (S.2301) Health Care Workforce Expansion Act (S.2954) Resident Education Deferred Interest (REDI Act) (H.R. 2028,S. 942) Save Americas Rural Hospitals Act (H.R. 3684) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R. 4262) Train More Primary Care Doctors Act of 2025 (H.R. 958) Rural Hospital Flexibility Act (S. 3250) Rural Behavioral Health Improvement Act (H.R.5217)

Client expense: $100,000 · Firm income: Not reported

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 2314 / S. 2715) and the TEAMS Act (H.R. 7258/ S. 3968).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support the Fair Access in Residency (FAIR) Act (S. 2715 / H.R. 2314)

Client expense: Not reported · Firm income: $21,600

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2028, Resident Education Deferred Interest (REDI) Act, all provisions S. 942, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 2314, Fair Access In Residency (FAIR) Act, all provisions S. 2715, Fair Access In Residency (FAIR) Act of 2025, all provisions S. 632, IHS Workforce Parity Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions relating to Graduate Medical Education, student loans H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4681, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions H.R. 3885, Community TEAMS Act of 2025, all provisions H.R. 5428, Medical Student Education Authorization Act of 2025, all provisions Health Resources and Services Administration (HRSA) Title VII and Title VIII Programs/reauthorization

Client expense: $4,620,000 · Firm income: Not reported

H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 891, Bipartisan Health Care Act, provisions related to Medicare and Medicaid H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R. 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No Unreasonable Payments, Coding, Or Diagnoses for the Elderly (No UPCODE) Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 1, One Big Beautiful Bill Act, provisions relating to Medicare and Medicaid physician payments, work requirements, per capita taxes, provider taxes, APMs, FMAP changes, PBM transparency H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 2314, Fair Access In Residency (FAIR) Act, all provisions S. 2715, Fair Access In Residency (FAIR) Act of 2025, all provisions H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions relating to APMs H.R. 4206, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025, all provisions S. 1261, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services (ECAPS) Act, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, al provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 1399, Health Tech Investment Act, all provisions H.R. 4559, Prompt and Fair Pay Act, all provisions H.R. 5454, Medicare Advantage Prompt Pay Act, all provisions S. 2879, Medicare Advantage Prompt Pay Act, all provisions H.R. 4313, Hospital Inpatient Services Modernization Act, all provisions S. 2237, Hospital Inpatient Services Modernization Act, all provisions H.R. 4752, Reducing Hereditary Cancer Act, all provisions S. 2760, Reducing Hereditary Cancer Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to Medicaid S.J.Res.8, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Market Integrity and Affordability," all provisions H.R. 5343, Ensuring Patient Access to Critical Breakthrough Products Act, all provisions S. 1717, Ensuring Patient Access to Critical Breakthrough Products Act of 2025, all provisions H.R. 842, Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, all provisions H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4464, Preventive Health Savings Act, all provisions H.R. 2509, Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act, all provisions S. 931, Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act, all provisions Draft legislation to reform the MACRA/MIPS program Value in Health Care Act/draft GOLD CARD Act/drafts Medicare program: 21st Century Cures Act/implementation Medicare program: Medicare Economic Index (MEI) inflationary updates Medicare program: Merit-based Incentive Payment System (MIPS)/cost, quality, improvement activities, and interoperability Medicare program: MIPS Value Pathways (MVPs) reforms Medicare program: Medicare Physician Fee Schedule/efficiency adjustment, and indirect practice-expense Medicare program: Physician payment/budget neutrality Medicare program: Physician payment reform Medicare program: Kidney care models Medicare program: Coding Medicare program: G2211 Inherent Complexity Code Medicare program: Prior authorization Medicare program: Site neutral payment Medicare program: Accountable Care Organizations (ACOs)/Alternative Payment Model (APM) flexibilities Medicare program: APMs/Wasteful and Inappropriate Service Reduction (WISeR) Medicare program: APMs/Ambulatory Specialty Model (ASM) Medicare program: APM Bonus Extension Medicare program: Medicare acceptance rates, private practice issues/benchmark survey Medicare program: Relative Value Scale Update Committee (RUC) processes Medicare program: Wearables Medicare program: Local and National Coverage Determination processes Medicare program: Value-based care Medicare program: Postoperative visits Medicare program: Medicare Advantage (MA)/utilization management Medicare program: MA/prior authorization Medicare program: Promoting Interoperability (PI) Program Medicare program: Health IT/physician burdens Medicare program: Data privacy and cybersecurity Medicare program: HIPAA/electronic records Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Center for Medicare & Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: Telehealth flexibilities Medicaid: Access to care/advance premium tax credit

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H. Con. Res. 14 Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, reductions in wage index. Oppose cuts to federal Medicaid funding, including through reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Issue: Support codification of Rural Residency Planning and Development grants. Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/ S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/ S.2600 Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the continued move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their disproportionate share hospital (DSH) cap. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Medicare-funded Graduate Medical Education; NIH Osteopathic Funding and Representation; H.R.2314/S.2715, FAIR Act; H.R.3885, Community TEAMS Act of 2025; FY2026 National Defense Authorization Act (S.2296/H.R.3838); FY2026 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R.5304/S.2587); FY2026 Department of Defense Appropriations Act (H.R.4016/S.2572); H.R.1, One Big Beautiful Bill Act (P.L.119-21), higher education accountability provisions.

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

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Rural Health Innovation Act of 2025 (H.R.1480) Fair Access In Residency Act (H.R. 2314/S.2715) Teaching Health Center Graduate Medical Education National Institutes of Health Research Pathways to Health Professions Act (H.R. 593) Bipartisan Rural America Health Corps Act (H.R. 1127) Expanding Medical Education Act (H.R. 2106, S. 975) Community TEAMS Act (H.R. 3885) Specialty Physicians Advancing Rural Care Act (S. 1380) Post GRAD Act (H.R. 3711) Physician and Patient Safety Act (H.R. 3413, S. 1767) IHS Workforce Production Act ( S.632) Rural Health Focus Act (S.403) Rural Health Transformation Program Healthcare Advisory Council Resident Physician Shortage Reduction Act (H.R.4731/S.2439) Medical Student Education Authorization Act (H.R.5248) Palliative Care and Hospice Education and Training Act (S.2287) Improving Care in Rural America Reauthorization Act (S.2301) Health Care Workforce Expansion Act (S.2954) Resident Education Deferred Interest (REDI Act) (H.R. 2028,S. 942) Save Americas Rural Hospitals Act (H.R. 3684) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R. 4262) Train More Primary Care Doctors Act of 2025 (H.R. 958)

Client expense: $160,000 · Firm income: Not reported

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 2314 / S. 2715) and the TEAMS Act (H.R. 7258/ S. 3968).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE