Alternatives to PAIN Act

H.R. 929/S.266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S.475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S.779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1909/S.2621 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S.931 - COMPLETE Care Act H.R. 4206/S.1261 - CONNECT for Health Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 4619 - Medicare Mental Health Inpatient Equity Act S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2483/S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 3655 - STAR Plus Scholarship Act H.R. 3885/S.3989 - Community TEAMS Act H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505/S.5558 - Barriers to Suicide Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R. 5557 - Mental Health Services for Students Act H.R. 3514/S.1816 - Improving Seniors Timely Access to Care Act S. 3064 - Relief of Chronic Pain Act H.R.6672 - Mental Health Professionals Workforce Shortage Loan Repayment Act Conversations regarding mental health parity enforcement Communication with Congressional offices on SAMHSA grant terminations Input on Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) modernization Communication with Congressional offices on ghost networks H.R.7092 - RAYS Act Support of funding for gun violence prevention research at CDC, NIH and NIJ. S.4076 - Removing Medicare Mental Health Inpatient Limitations Act of 2026 Letter supporting funding for Maternal Mental Health and Substance Use Disorder Programs (MMHSUD) and National Maternal Mental Health Hotline. H.R. 5629 - To provide that the final rule of the Department of Health and Human Services titled Medications for the Treatment of Opioid Use Disorder except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect H.R. 7994 - The HERO Act H.R. 8124 - STOP Suicide Act H.R. 8201 - Expanding Community Access to Health Services Act Letter expressing concerns over H.R. 5629 and H.R. 5630 H.R. 9044 - Minority Fellowship Program Reauthorization Act of 2026 H.R. 8163 - Provider Reimbursement Stability Act H.R.8961 - Student Suicide Prevention Awareness Act H.Res.1329 - Expressing support for the designation of May 2026 as Mental Health Awareness Month H.R.8989 - Evidence-Based Youth Suicide Prevention Act of 2026 H.R.8122/ S.4640 - 9-8-8 Connect Act H.R.8811/S.4552 - Moms Matter Act H.R.9257 - Primary and Behavioral Health Care Access Act H.R.8487/S.3401 - Ensuring Excellence in Mental Health Act H.R. 9948 - Addictive Design Act H.R. 9551 - Mental Health Parity Enforcement and Funding Act H.R. 9693 - Patients First Act S.4916 - Aging with Artificial Intelligence Act of 2026 H.R.9538 - Residential Recovery for Seniors Act H.R.10216 - Public Transit Mental Health Awareness Act H.R. 8657 - Campus Lifeline Act H.R. 10349 - Emergency Responders Mental Health Training (EMT) Act H.R. 10210 - Doctors Not AI Act H.R. 8693/S.3062 - GUARD Act H.R.10280 - 9-8-8 Implementation Act of 2026 Letter supporting Project AWARE funding Letter urging prior authorization and step therapy reform National Health Service Corps extension Community Health Center funding extension H.R. 1 implementation impacts on Medicaid Conversation regarding vaccine recommendations and public health Response to HRSA RFI on the Safe Administration of Psychedelic Therapies

Client expense: $144,050 · Firm income: Not reported

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

Issues related to drug pricing; Issues related to H.R. 1227/S. 475 - Alternatives to PAIN Act; Issues related to H.R. 1518 - New Era of Preventing End-Stage Kidney Disease Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Unmet medical need in acute pain; H.R. 1227/S. 475 - The Alternatives to PAIN Act; Implementation of Public Law No: 117-328 sec. 4135 NO PAIN Act; Medically necessary fertility treatments for patients undergoing fully myeloablative conditioning; CMMI demo focusing on sickle cell disease; Drug Pricing Policies including Most Favored Nation policy proposals.

Client expense: $1,100,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Vice President of the U.S., White House Office

General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about non-opioid pain therapies.H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about the importance of access to non-opioid pain therapies for Medicare beneficiaries. H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.

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

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

ADHD treatment. Implementation of the Infrastructure Investment and Jobs Act (or bipartisan infrastructure law). Traffic safety (distracted and impaired driving). Issues related to FDA approval. Patient access to non-opioid pain medicines. NO PAIN Act implementation. H.R.1227 / S.475: Alternatives to PAIN Act. Most-Favored Nation (MFN) International reference pricing. Make America Healthy Again (MAHA) Commission. Proposed regulations. Global Benchmark for Efficient Drug Pricing (GLOBE) Model.

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

Government targets: HOUSE OF REPRESENTATIVES, 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

H.R. 1227/S. 475, Alternatives to PAIN Act and issues related to payment policies for non-opioid pain medication; Issues related to Most Favored Nation (MFN) drug pricing proposal; Issues related to Senate Finance Dear Colleague process; Kidney care issues; FY27 LHHS and Mil-Con appropriations report language

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 H.R. 5217 - Rural Behavioral Health Improvement Act of 2025 H.R. 3684 - Save Americas Rural Hospitals Act S. 1941 - Cure Hepatitis C Act of 2025 H.R. 5081/S. 2709 - Telehealth Modernization Act S. 1599/H.R. 6394 - Midwives for Maximizing Optimal Maternity Services (MOMS) Act S. 131/H.R. 392 - Providing Real-world Education and Clinical Experience by Precepting Tomorrows (PRECEPT) Nurses Act H.R. 4564 - Dillons Law H.R. 3108/S. 1535 - Rural Patient Monitoring Access Act H.R. 1616/S. 1805 - Promoting Access to Diabetic Shoes Act S. 717/H.R. 6894 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 1317/S. 575 - Improving Care and Access to Nurses (ICAN) Act H.R. 4773/S. 3350 - ACO Assignment Improvement Act of 2025 H.R. 6199/S. 3934 - Medical Nutrition Therapy Act of 2025 H.R. 2509/S. 931 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 2586 - Reentry Act of 2025 H.R. 929/S. 266 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 842/S. 339 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 683/H.R. 7324 - More Behavioral Health Providers Act S. 3435/H.R. 6607 - Future Advancement of Academic Nursing (FAAN) Act H.R. 1627 - Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 2319/S. 1157 - the Women and Lung Cancer Research and Preventive Services Act of 2025 S. 1261/H.R. 4206 - CONNECT for Health Act for 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act S. 1874/H.R. 3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2199/S. 1173 - Restore Protections for Dialysis Patients Act (Restore Act) H.Res. 389/S.Res. 206 - Supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2025. S. 1482/H.R. 4407 - National Nursing Workforce Center Act of 2025 H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 1300 - Prostate-Specific Antigen (PSA) Screening for High-risk Insured Men (HIM) Act H.R. 7106 - Enhancing Skilled Nursing Facilities Act H.R. 5629 - To provide that the final rule of the Department of Health and Human Services titled "Medications for the Treatment of Opioid Use Disorder", except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect. H.R. 7787 - Mental Health Workforce Act S. 4186/H.R. 8089 - Perinatal Workforce Act H.R. 7973 - Momnibus Act S. 3707/H.R. 7279 - Nurse Faculty Shortage Reduction Act. H.R. 7602 - State of Men's Health Act H.Res. 1264/S.Res. 709 - Supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2026. H.R. 8163 - the Provider Reimbursement Stability Act H.R. 8261 - Chronic Care Management Improvement Act Affordability of health insurance coverage Tobacco prevention Hospice certification and recertification Immunization policies H.R. 9257/S. 4754 - Primary and Behavioral Health Care Access Act Skilled nursing facility admitting examination and assessment requirements Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Health plan coverage and program requirements, including provider non-discrimination, network adequacy and prior authorization Nursing faculty and workforce shortage Nursing education Include nurses, APRNs, and nursing students in all national public health plans Rural health care issues, including rural workforce and reimbursement Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Medicaid reform Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Public health and nursing workforce infrastructure Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Site specific restrictions on providers under DEA controlled substances policy Telehealth, remote patient monitoring and other forms of health technology Primary care payment reform Documentation of medical records

Client expense: $400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 H.R. 5217 - Rural Behavioral Health Improvement Act of 2025 H.R. 3684 - Save Americas Rural Hospitals Act S. 1941 - Cure Hepatitis C Act of 2025 H.R. 5081/S. 2709 - Telehealth Modernization Act H.R. 3108/S. 1535 - Rural Patient Monitoring Access Act H.R. 1616/S. 1805 - Promoting Access to Diabetic Shoes Act S. 717/H.R. 6894 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 1317/S. 575 - Improving Care and Access to Nurses (ICAN) Act H.R. 4773/S. 3350 - ACO Assignment Improvement Act of 2025 H.R. 6199/S. 3934 - Medical Nutrition Therapy Act of 2025 H.R. 2509/S. 931 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 2586 - Reentry Act of 2025 H.R. 842/S. 339 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 683/H.R. 7324 - More Behavioral Health Providers Act S. 1261/H.R. 4206 - CONNECT for Health Act of 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 7787 - Mental Health Workforce Act H.R. 7106 - Enhancing Skilled Nursing Facilities Act H.R. 7973 - Momnibus Act H.R. 8163 - the Provider Reimbursement Stability Act Hospice certification and recertification Skilled nursing facility admitting examination and assessment requirements Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Medicaid reform Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Public health and nursing workforce infrastructure Telehealth, remote patient monitoring and other forms of health technology Primary care payment reform Documentation of medical records Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic

Client expense: $400,000 · Firm income: Not reported

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

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

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

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

Access to innovative non-opioid medicines; Alternatives to PAIN, H.R. 1227; Alternatives to PAIN, S. 475.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to drug pricing; Issues related to H.R. 1227/S. 475 - Alternatives to PAIN Act; Issues related to H.R. 1518 - New Era of Preventing End-Stage Kidney Disease Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about the importance of access to non-opioid pain therapies for Medicare beneficiaries. H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.

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

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

General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about non-opioid pain therapies.H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Unmet medical need in acute pain; H.R. 1227/S. 475 - The Alternatives to PAIN Act; Implementation of Public Law No: 117-328 sec. 4135 NO PAIN Act; Medically necessary fertility treatments for patients undergoing fully myeloablative conditioning; CMMI demo focusing on sickle cell disease; Drug Pricing Policies including Most Favored Nation policy proposals.

Client expense: $1,200,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Vice President of the U.S., White House Office

Issues related to pain management, including S.475/H.R. 1227 - Alternatives to PAIN Act. Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169), and implementation of Executive Order 14273, Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients. Issues related to FDA regulation of pharmaceuticals.

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

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

ADHD treatment. Implementation of the Infrastructure Investment and Jobs Act (or bipartisan infrastructure law). Traffic safety (distracted and impaired driving). Issues related to FDA approval. Patient access to non-opioid pain medicines. NO PAIN Act implementation. H.R.1227 / S.475: Alternatives to PAIN Act. Most-Favored Nation (MFN) International reference pricing. Make America Healthy Again (MAHA) Commission.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access to innovative non-opioid medicines; Alternatives to PAIN, H.R. 1227; Alternatives to PAIN, S. 475.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1227/S. 475, Alternatives to PAIN Act and issues related to payment policies for non-opioid pain medication; Issues related to Most Favored Nation (MFN) drug pricing proposal; Issues related to Senate Finance Dear Colleague process

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 H.R. 5217 - Rural Behavioral Health Improvement Act of 2025 H.R. 3684 - Save Americas Rural Hospitals Act S. 1941 - Cure Hepatitis C Act of 2025 H.R. 5081/S. 2709 - Telehealth Modernization Act S. 1599 - Midwives for Maximizing Optimal Maternity Services (MOMS) Act S. 131/H.R. 392 - Providing Real-world Education and Clinical Experience by Precepting Tomorrows (PRECEPT) Nurses Act H.R. 4564 - Dillons Law H.R. 3108/S. 1535 - Rural Patient Monitoring Access Act H.R. 1616/S. 1805 - Promoting Access to Diabetic Shoes Act S. 717/H.R. 6894 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 1317/S. 575 - Improving Care and Access to Nurses (ICAN) Act H.R. 4773/S. 3350 - ACO Assignment Improvement Act of 2025 H.R. 6199/S. 3934 - Medical Nutrition Therapy Act of 2025 H.R. 2509/S. 931 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 2586 - Reentry Act of 2025 H.R. 929/S. 266 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 842/S. 339 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 683/H.R. 7324 - More Behavioral Health Providers Act S. 3435/H.R. 6607 - Future Advancement of Academic Nursing (FAAN) Act H.R. 1627 - Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 2319/S. 1157 - the Women and Lung Cancer Research and Preventive Services Act of 2025 S. 1261/H.R. 4206 - CONNECT for Health Act for 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act S. 1874/H.R. 3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2199/S. 1173 - Restore Protections for Dialysis Patients Act (Restore Act) H.Res. 389/S.Res. 206 - Supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2025. S. 1482 - National Nursing Workforce Center Act of 2025 H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 1300 - Prostate-Specific Antigen (PSA) Screening for High-risk Insured Men (HIM) Act H.R. 7106 - Enhancing Skilled Nursing Facilities Act H.R. 5629 - To provide that the final rule of the Department of Health and Human Services titled "Medications for the Treatment of Opioid Use Disorder", except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect. H.R. 7787 - Mental Health Workforce Act S. 4186/H.R. 8089 - Perinatal Workforce Act H.R. 7973 - Momnibus Act S. 3707/H.R. 7279 - Nurse Faculty Shortage Reduction Act. H.R. 7602 - State of Men's Health Act Chronic Care Management Improvement Act Affordability of health insurance coverage Tobacco prevention Hospice certification and recertification Immunization policies Primary and Behavioral Health Care Access Act Skilled nursing facility admitting examination and assessment requirements Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Health plan coverage and program requirements, including provider non-discrimination, network adequacy and prior authorization Nursing faculty and workforce shortage Nursing education Include nurses, APRNs, and nursing students in all national public health plans Rural health care issues, including rural workforce and reimbursement Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Medicaid reform Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Public health and nursing workforce infrastructure Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Site specific restrictions on providers under DEA controlled substances policy Telehealth, remote patient monitoring and other forms of health technology Primary care payment reform Documentation of medical records

Client expense: $400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 H.R. 5217 - Rural Behavioral Health Improvement Act of 2025 H.R. 3684 - Save Americas Rural Hospitals Act S. 1941 - Cure Hepatitis C Act of 2025 H.R. 5081/S. 2709 - Telehealth Modernization Act H.R. 3108/S. 1535 - Rural Patient Monitoring Access Act H.R. 1616/S. 1805 - Promoting Access to Diabetic Shoes Act S. 717/H.R. 6894 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 1317/S. 575 - Improving Care and Access to Nurses (ICAN) Act H.R. 4773/S. 3350 - ACO Assignment Improvement Act of 2025 H.R. 6199/S. 3934 - Medical Nutrition Therapy Act of 2025 H.R. 2509/S. 931 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 2586 - Reentry Act of 2025 H.R. 842/S. 339 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 683/H.R. 7324 - More Behavioral Health Providers Act S. 1261/H.R. 4206 - CONNECT for Health Act of 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 7787 - Mental Health Workforce Act H.R. 7106 - Enhancing Skilled Nursing Facilities Act H.R. 7973 - Momnibus Act Hospice certification and recertification Skilled nursing facility admitting examination and assessment requirements Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Medicaid reform Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Public health and nursing workforce infrastructure Telehealth, remote patient monitoring and other forms of health technology Primary care payment reform Documentation of medical records Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic

Client expense: $400,000 · Firm income: Not reported

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

General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about the importance of access to non-opioid pain therapies for Medicare beneficiaries. H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.

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

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

General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about non-opioid pain therapies.H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Issues related to drug pricing; Issues related to H.R. 1227/S. 475 - Alternatives to PAIN Act; Issues related to H.R. 1518 - New Era of Preventing End-Stage Kidney Disease Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Unmet medical need in acute pain; H.R. 1227/S. 475 - The Alternatives to PAIN Act; Implementation of Public Law No: 117-328 sec. 4135 NO PAIN Act; Medically necessary fertility treatments for patients undergoing fully myeloablative conditioning; CMMI demo focusing on sickle cell disease; Drug Pricing Policies including Most Favored Nation policy proposals.

Client expense: $1,140,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Vice President of the U.S., White House Office

Issues related to pain management, including S.475/H.R. 1227 - Alternatives to PAIN Act. Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169), and implementation of Executive Order 14273, Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients.

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

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

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

Client expense: $219,480 · 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

ADHD treatment. Implementation of the Infrastructure Investment and Jobs Act (or bipartisan infrastructure law). Traffic safety (distracted and impaired driving). Issues related to FDA approval. Patient access to non-opioid pain medicines. NO PAIN Act implementation. H.R.1227 / S.475: Alternatives to PAIN Act. Most-Favored Nation (MFN) International reference pricing. Make America Healthy Again (MAHA) Commission.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access to innovative non-opioid medicines; Alternatives to PAIN, H.R. 1227; Alternatives to PAIN, S. 475.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1227/S. 475, Alternatives to PAIN Act and issues related to payment policies for non-opioid pain medication; Issues related to Most Favored Nation (MFN) drug pricing proposal

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 21/S. 6 - Born-Alive Abortion Survivors Protection Act H.R.1096 - HOPE and Mental Wellbeing Act of 2025 H.R. 929/S. 266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S. 475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S. 779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585/S. 709 - Conrad State 30 and Physician Access Reauthorization Act H.R. 1909/S. 2621 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S. 931 - COMPLETE Care Act H.R. 4206/S. 1261 - CONNECT for Health Act H.R. 1305 - Improving Measurements for Loneliness and Isolation Act H.R. 1902 - Helping Emergency Responders Overcome (HERO) Act H.R. 2223 - Building Capacity for Care Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 3266/S.1673 - Mental Health Infrastructure Improvement Act of 2025 Mental Health Matters Act H.R. 4619 - Medicare Mental Health Inpatient Equity Act Letter to Congress in support of the Prevention and Public Health Fund Letter to Congress to extend telehealth flexibilities Letter to Congress for funding for public health research into firearm morbidity and mortality prevention at CDC, NIH and NIJ. Letter to Congress on Agency for Healthcare Research and Quality (AHRQ) funding Letter to Congress on funding for FDAs Neurology Drug Program in FY26 Letter to Congress on funding for the BRAIN Initiative in FY26 Letter to Congress regarding school-based Medicaid programs Letters to Congress in support of Medicaid Letter to NIH regarding indirect cost caps for NIH grants Letter to HHS in response to the draft Make American Healthy Again Commission Assessment. S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2587 - Youth Mental Health Research Act H.R. 2483/S. 2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 539/S. 106 - Chiropractic Medicare Coverage Modernization Act of 2025 H.R. 2630 - Youth Suicide Prevention Research Act H.R. 3655 - STAR Plus Scholarship Act Letter to Congress in support of NIH neuroscience research Letter to Congress to protect federal funding of maternal health programs Letter to Congress supporting the Pediatric Mental Health Care Access (PMHCA) program Letter to Congress in support of funding for the Children's Hospital Graduate Medical Education (CHGME) program Letter to Congress in support of school mental health workforce grants Communication with Congressional offices on CCBHC funding Letter to Congress to include report language in FY26 appropriations for the 988 Suicide and Crisis Lifeline and Garrett Lee Smith Youth Suicide Prevention Campus Grants Letter to Congress concerning funding for 988 lifeline LGBTQ+ youth specialized services H.R. 3890/S. 2439 - Resident Physician Shortage Reduction Act of 2025 H.R. 3885 - Community TEAMS Act H.R. 3658 - 911 Community Crisis Responders Act H.R. 4745/S. 2410 - Medicaid Bump Act H.R. 3758 - Workers' Disability Benefits Parity Act H.R. 4744/S. 2445 - Community Mental Wellness and Resilience Act H.R. 1867 - To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology H.R 4641 - Keep Kids Covered Act Letter opposing H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act Letter to Congress to support the integrity of the United States Preventive Services Task Force (USPSTF) Letter in response to FDA panel review of SSRIs and pregnancy Letter to HHS in response to proposed change to its interpretation of federal public benefit to include 13 additional programs as restricted Federal public benefits Letter to SAMHSA regarding reports on the redirection of FY25 funds H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 4723/S. 2446 - Mental Health for Latinos Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505 - Barriers to Suicide Act H.R. 5454/S.2879 - Medicare Advantage Prompt Pay Act Letters to Congress to extend the enhanced premium tax credits H.R.6249 - Addressing Addiction After Disasters Act Mental Health Emergency Needs in Disasters (MEND) Act Mental Health Career Promotion Act H.R. 5074 - Protecting Young Minds Online Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R.5553 - CTE Student Mental Health and Wellness Act H.R. 5557 - Mental Health Services for Students Act H.R.1197 - PREEMIE Reauthorization Act of 2025 H.R. 3514/S.1816 - Improving Seniors Timely Access to Care Act Draft legislation on expedited FDA approval pathways for addiction therapeutics Mental Health Emergency Package: Youth Mental Health Day and Suicide Prevention Day Resolution, Mental Health Crisis Response Act, and Mental Health Emergency Responder Act S. 3064 - Relief of Chronic Pain Act H.R. 6226 - Latino Youth Mental Health Empowerment Act H.R. 5482 - Prevent Youth Suicide Act H.R.6672 - Mental Health Professionals Workforce Shortage Loan Repayment Act Letter to Letter to Department of Labor, Department of Health and Human Services, and Department of Treasury regarding mental health parity enforcement. H.R. 3492 - Protect Children's Innocence Act H.R. 498 - Do No Harm in Medicaid Act H.R. 6817/ S. 1056 - Home-Based Telemental Health Care Act Letters and a presentation to the FDA digital health advisory panel regarding generative AI enabled mental health medical devices

Client expense: $391,974 · Firm income: Not reported

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

H.R. 5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 H.R. 5217 - Rural Behavioral Health Improvement Act of 2025 H.R. 3684 - Save Americas Rural Hospitals Act S. 1941 - Cure Hepatitis C Act of 2025 H.R. 5081/S. 2709 - Telehealth Modernization Act S. 1599 - Midwives for Maximizing Optimal Maternity Services (MOMS) Act S. 131/H.R. 392 - Providing Real-world Education and Clinical Experience by Precepting Tomorrows (PRECEPT) Nurses Act H.R. 4564 - Dillons Law H.R. 3108/S. 1535 - Rural Patient Monitoring Access Act H.R. 1616/S. 1805 - Promoting Access to Diabetic Shoes Act S. 717/H.R. 6894 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 1317/S. 575 - Improving Care and Access to Nurses (ICAN) Act H.R. 4773/S. 3350 - ACO Assignment Improvement Act of 2025 H.R. 6199 - Medical Nutrition Therapy Act of 2025 H.R. 2509/S. 931 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 2586 - Reentry Act of 2025 H.R. 929/S. 266 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 842/S. 339 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 683 - More Behavioral Health Providers Act S. 3435/H.R. 6607 - Future Advancement of Academic Nursing (FAAN) Act H.R. 1627 - Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 2319/S. 1157 - the Women and Lung Cancer Research and Preventive Services Act of 2025 S. 1261/H.R. 4206 - CONNECT for Health Act for 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act S. 1874/H.R. 3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2199/S. 1173 - Restore Protections for Dialysis Patients Act (Restore Act) H.Res. 389/S.Res. 206 - Supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2025. S. 1482 - National Nursing Workforce Center Act of 2025 H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 1300 - Prostate-Specific Antigen (PSA) Screening for High-risk Insured Men (HIM) Act Affordability of health insurance coverage Tobacco prevention Hospice certification and recertification Immunization policies Primary and Behavioral Health Care Access Act Skilled nursing facility admitting examination and assessment requirements Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Health plan coverage and program requirements, including provider non-discrimination, network adequacy and prior authorization Nursing faculty and workforce shortage Nursing education Include nurses, APRNs, and nursing students in all national public health plans Rural health care issues, including rural workforce and reimbursement Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Medicaid reform Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Public health and nursing workforce infrastructure Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Site specific restrictions on providers under DEA controlled substances policy Telehealth, remote patient monitoring and other forms of health technology Primary care payment reform Documentation of medical records

Client expense: $550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 H.R. 5217 - Rural Behavioral Health Improvement Act of 2025 H.R. 3684 - Save Americas Rural Hospitals Act S. 1941 - Cure Hepatitis C Act of 2025 H.R. 5081/S. 2709 - Telehealth Modernization Act H.R. 3108/S. 1535 - Rural Patient Monitoring Access Act H.R. 1616/S. 1805 - Promoting Access to Diabetic Shoes Act S. 717/H.R. 6894 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 1317/S. 575 - Improving Care and Access to Nurses (ICAN) Act H.R. 4773/S. 3350 - ACO Assignment Improvement Act of 2025 H.R. 6199 - Medical Nutrition Therapy Act of 2025 H.R. 2509/S. 931 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 2586 - Reentry Act of 2025 H.R. 842/S. 339 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 683 - More Behavioral Health Providers Act S. 1261/H.R. 4206 - CONNECT for Health Act of 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social Service Workers Act Hospice certification and recertification Skilled nursing facility admitting examination and assessment requirements Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Medicaid reform Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Public health and nursing workforce infrastructure Telehealth, remote patient monitoring and other forms of health technology Primary care payment reform Documentation of medical records Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic

Client expense: $550,000 · Firm income: Not reported

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

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

Client expense: $226,393 · 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

General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about non-opioid pain therapies.H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about the importance of access to non-opioid pain therapies for Medicare beneficiaries. H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.

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

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

Issues related to drug pricing; Issues related to H.R. 1227/S. 475 - Alternatives to PAIN Act.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Issues related to pain management, including S.475/H.R. 1227 - Alternatives to PAIN Act.

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

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

Unmet medical need in acute pain; H.R. 1227/S. 475 - The Alternatives to PAIN Act; Implementation of Public Law No: 117-328 sec. 4135 NO PAIN Act; Medically necessary fertility treatments for patients undergoing fully myeloablative conditioning; CMMI demo focusing on sickle cell disease; Drug Pricing Policies including Most Favored Nation policy proposals.

Client expense: $1,110,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Vice President of the U.S., White House Office

ADHD treatment. Implementation of the Infrastructure Investment and Jobs Act (or bipartisan infrastructure law). Traffic safety (distracted and impaired driving). Issues related to FDA approval. Patient access to non-opioid pain medicines. NO PAIN Act implementation. H.R.1227 / S.475: Alternatives to PAIN Act. Most-Favored Nation (MFN) International reference pricing. Make America Healthy Again (MAHA) Commission.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1227/S. 475, Alternatives to PAIN Act and issues related to payment policies for non-opioid pain medication; Issues related to Most Favored Nation (MFN) drug pricing proposal

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access to innovative non-opioid medicines; Alternatives to PAIN, H.R. 1227; Alternatives to PAIN, S. 475.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE