Provider Reimbursement Stability Act of 2026

H.R. 8163: Provider Reimbursement Stability Act of 2026; provisions related to Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) budget neutrality H.R. 9693: Patients First Act of 2026; all provisions S. 5180: Provider Reimbursement Stability Act of 2026 ; all provisions CMS-1848-P: Medicare Physician Payment Rule; all provisions CMS-2449-P: Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments; all provisions CMS-2452-P: Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes; all provisions

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

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

H.R. 2484, Seniors Access to Critical Medications Act; Issues related to the extension of telehealth services; Issues related to site neutral payments; Issues related to 2024 Physician Fee Schedule and physician payment reform; H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act; Issues related to in-office dispensing of medication regulations; H.R. 8163/S. 5180, Provider Reimbursement Stability Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Physician Fee Schedule and physician payment reform; H.R. 879, Medicare Patient Access and Practice Stabilization Act; H.R. 3164/S. 2426, Equitable Community Access to Pharmacist Services Act; H.R. 8163/S. 5180, Provider Reimbursement Stability Act; Issues related to Provider Reimbursement Stability Act and Merit Based Incentive Payments System (MIPS) reform; Issues related to Senate Finance Dear Colleague process

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.879, Medicare Patient Access and Practice Stabilization Act of 2025. General provisions to address Medicare physician fee schedule payment policies and access to physician services. In general, policies impacting physician burden and sustaining the private practice physician model. H.R.3514/S.1816, Improving Seniors Timely Access to Care Act of 2025. Pub. L. No. 119-21, One Big Beautiful Bill Act, provisions regarding Medicare physicians payment increase, reform. H.R.9693, Patients First Act. H.R.8163/S.5180, Provider Reimbursement Stability Act. H.R.8375/S.4384, Medicare Advantage Improvement Act.

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

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

Policies in the 2027 Medicare Physician Fee Schedule Proposed Rule including Modifier 25 and orthopedic surgery cuts, Medicare physician payment reform including changes to budget neutrality and indexing the conversion factor to inflation, Provider Reimbursement Stability Act (H.R. 8163/S. 5180), Patients First Act (H.R. 9693), policies related to value-based care.

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

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

Policies in the 2027 Medicare Physician Fee Schedule Proposed Rule including Modifier 25 and orthopedic surgery cuts, Medicare physician payment reform including changes to budget neutrality and indexing the conversion factor to inflation, Provider Reimbursement Stability Act (H.R. 8163/S. 5180), and value-based care reform.

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

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

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

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

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

H.R. 1517/S.2225 - Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 2332/S.1101 - States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 4074 - Optimizing Postpartum Outcomes Act Expanded Telehealth Access Act - reintroduction H.R. 5621 - Physical Therapist Workforce and Patient Access Act Strengthening Medicare for Patients and Providers Act - reintroduction IDEA Act Medicare Payment Reform H.R. 1711/S. 2612 - Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 5081/S. 2709 - Telehealth Modernization Act H.R. 935 - Health Care Workforce Innovation Act H.R. 1614 - to expand eligible practitioners to furnish telehealth services S. 668/H.R. 3183 - SAFE Steps for Veterans Act H.R. 879 - Medicare Patient Access and Practice Stabilization Act H.R. 1 - One Big Beautiful Bill Act (Medicare provider payment section) H.R. 4204 - Medicare Patient Choice Act S.1816/H.R. 3514 - Improving Seniors' Timely Access to Care Act H.R. 8386 - the RECOVER Act (Repeal of Multiple Procedure Payment Reduction Policy) H.R. 6160 - Strengthening Medicare for Patients and Providers Act H.R. 8163/S. 5180 - Provider Reimbursement Stability Act H.R. 9693/S. 5672 - Patients First Act

Client expense: $312,662 · 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), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), White House Office

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act S.1816/H.R. 3514 - Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 4074 - Optimizing Postpartum Outcomes Act H.R. 1517/S.2225 - Prevent Interruptions in Physical Therapy Act Expanded Telehealth Access Act - reintroduction H.R. 5621 - Physical Therapist Workforce and Patient Access Act Strengthening Medicare for Patients and Providers Act - reintroduction IDEA Act H.R. 1711/S. 2612 - Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 5081/S.2709 - Telehealth Modernization Act H.R. 1614 - to expand eligible practitioners to furnish telehealth services H.R. 879 - Medicare Patient Access and Practice Stabilization Act Medicare Payment Reform H.R. 4202 - Medicare Patient Choice Act H.R. 8386 - the RECOVER Act (Repeal of Multiple Procedure Payment Reduction Policy) H.R. 1 - One Big Beautiful Bill Act H.R. 6160 Strengthening Medicare for Patients and Providers Act H.R. 8163/S. 5180 - Provider Reimbursement Stability Act H.R. 9693/S. 5672 - Patients First Act

Client expense: $312,662 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

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

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

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

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose provisions in the proposed 2027 Medicare Physician Fee Schedule: 1) a -2.5% efficiency adjustment to Work RVUs for non-time-based services; 2) a new methodology for calculating indirect practice expenses in facility settings that unfairly penalizes facility-based surgical services. Support for H.R. 6160, the Strengthening Medicare for Patients and Providers Act, which would provide an annual inflationary update for Medicare physician payment tied to the Medicare Economic Index (MEI). Support for The Efficiency Adjustment Delay Act (HR 7520), which would would delay the efficiency adjustment provision in the 2026 Medicare Physician Fee Schedule until January of 2030 and require CMS to submit a report to Congress within 2 years containing an assessment of whether it is necessary to apply a one-time, across-the-board adjustment to work relative value units, and to make corresponding updates to the intraservice portion of physician time inputs for non-time-based services, with respect to services that have not been revalued or reviewed within the 10-year period preceding the calendar year in which such one-time adjustment would be applied. Support for the Improving Seniors Timely Access to Care Act of 2025 (H.R. 3514/S. 1816) that would would streamline and standardize prior authorization requirements within the Medicare Advantage (MA) program. Support for H.R. 8163, the Provider Reimbursement Stability Act, urging Congress to take immediate steps to stabilize Medicare physician reimbursement and to modernize the Medicare payment system. Support for S. 5180, the Provider Reimbursement Stability Act that seeks to modernize and update the budget neutrality mechanism of the Medicare Physician Fee Schedule (MPFS) to improve stability for physician reimbursement and patient access.

Client expense: $78,800 · Firm income: Not reported

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACPs 2026 Third Quarter Lobbying Disclosure Report Medicare Payments to Physicians: Sent letter and met with legislators in support of the Patients First Act of 2026, (H.R. 9693) for a Medicare Economic Index inflationary updated to the physician fee schedule for physician practices, support for independent practices and replacement of MIPS with POINTS for quality measures. Supported and urged Congress to pass (H.R. 8163, S.5180), the Provider Reimbursement Stability Act, to enhance Medicare reimbursement stability for physicians by modernizing the Medicare Physician Fee Schedule. The Provider Reimbursement Stability Act of 2026. H.R. 8163 would raise the budget neutrality threshold from $20 million to $57.64 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every 5 years. ACP supported the Medicare Physician Data-Drive Performance Payment System Act of 2026, H.R. 8622. This critical legislation seeks to modernize Medicare payments by reducing administrative burdens, improving patient care, and supporting small/rural practices through a more practical, data-driven approach. Dr. William Fox, Chair Emeritus of ACPs Board of Regents, testified before the House Energy and Commerce Committees Health Subcommittee on policy reforms to improve the Medicare Physician Fee Schedule and the Medicare Access and CHIP Reauthorization Act (MACRA) on behalf of ACP. Dr. Rebecca Andrews, Past Chair of ACPs Board of Regents, testified before the House E&C Health Subcommittee in favor of each of the bills mentioned above. ACP supported Pay PCPs Act of 2026 (S. 5269), to inject $10 billion federal investment from fiscal year 2027 through 2031 to provide for the establishment of hybrid primary care payments under Medicare. Support Value-Based Care: Urged reintroduction and support of the Value in Health Care Act of 2024. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that expired at the end of 2024. ACP supported the Preserving Patient Access to Accountable Care Act which aligns with Colleges policy to support the transition to value-based payments through alternative payment models (APMs) that can accommodate a wide range of specialties, practice sizes, and unique patient populations. ACP supported this legislation as it would extend the incentive payments for qualifying physicians and other clinicians to participate in Medicare advanced APMs through payment year 2027 at an increased amount of 3.53 percent and would freeze the scheduled increase in qualifying thresholds. Pricing Transparency/Consolidation: Provided comments to the House Energy and Commerce Committees markup, which includes the Lower Cost, More Transparency Act, H.R. 9393, and the Improving Seniors Timely Access to Care Act, H.R. 3514. The two bills would enhance price transparency across health care entities and streamline unnecessary administrative burden, respectively. ACP also supported several policies included in bills slated for markup that would reform Medicare Advantage practices to ensure accountability and safeguard market competition. ACP strongly supports pricing transparency in health care. ACP supported the passage of the Lower Costs, More Transparency Act, which passed the House in the 118th Congress, and we continue to support its reintroduction and passage in this Congress under H.R. 9393. ACP supported provisions within the Medicare Advantage Cost Transparency Act, H.R. 9392, led by Ranking Member DeGette and Dr. Joyce, which would provide greater oversight by requiring that Medicare Advantage (MA) plans report to the Centers for Medicare & Medicaid Services (CMS) on encounter data, including the allowed amount that a plan agreed to pay for a service in total and the total out-of-pocket costs the patient pays for a service. The College has repeatedly voiced support for the Improving Seniors' Timely Access to Care Act, led by Reps. Kelly and DelBene, which would protect patients from unnecessary delays in care and reduce administrative burden on physicians by streamlining MAs prior authorization approval processes. We urge Congress to pass H.R. 3514 to ensure that our patients will get the care they need, when they need it most. FY2026 Appropriations/Agency Restructuring: For FY2027, ACP is urged appropriations committees that funding be either maintained or increased for the following proven programs: 1) Health Resources Services Administration (HRSA), $10.5 billion, including: 2) Health Workforce, National Health Service Corps (NHSC), $915.6 million in total program funding; 3) Primary Care Training and Enhancement (PCTE), $71 million; 4) Title X Family Planning Program, $390 million; 5) Agency for Healthcare Research and Quality (AHRQ), $500 million; 6) Centers for Disease Control and Prevention (CDC) Injury Prevention and Control, $11.6 billion, including: 7) Firearm Injury and Mortality Prevention Research, $35 million; 8) Chronic Disease Prevention and Health Promotion, Social Determinants of Health, $100 million; 9) National Institutes of Health (NIH), $51.3 billion, including: 10) Office of the Director, Firearms Research, $25 million; 11) Centers for Medicare and Medicaid Services (CMS) and Government Accountability Office (GAO); and 12) Report language to ensure primary care physicians are receiving Medicare physician revaluations. We urged Congress to include report language in the FY2026 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language and hope Congress will pass the FY26 Labor HHS bills. Also urged Congress to include report language in the FY2027 Labor HHS appropriations bill directing a study on extent G2211 add on codes and increases in fee schedule for primary care are being retained by hiring entities (hospitals, ACOs, private equity) versus the physicians. ACP urged appropriators to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. Primary Care and the Physician Workforce: ACP urged Congress to support the Resident Physician Shortage Reduction Act of 2025 (S. 2439/ H.R. 4731), which would increase the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years. ACP supported the Conrad State 30 and Physician Access Reauthorization Act, S. 709 and H.R. 1585, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement. We supported the Resident Education Deferred Interest (REDI) Act (S 942/HR 2028) that, if passed, will allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program. ACP supported legislation for the H-1Bs for Physicians and Healthcare Workforce Act, H.R. 7961. The bill's primary goal is to exempt healthcare professionals from a $100,000 H-1B visa filing fee. ACP supported H.R. 8765, the Prioritizing Primary Care Act. This legislation would mandate an annual report on federal spending on primary care as well as establish a working group to study and make recommendations on how each federal agency addresses the issue. Scope of Practice: ACP provided comments urging the House Ways and Means Committee during markup to oppose the Equitable Community Access to Pharmacist Services Act, which would expand Medicare coverage to permanently include select services provided by a pharmacist. ACP advocated before Senate offices against the marked-up bill coming out of House Ways and Means and renamed the Main Street Pharmacy Access Act enabling pharmacists to bill certain Medicare codes and to diagnose and treat flu, strep throat and other respiratory infections. Expand Patient Access: We urged Congress to reintroduce and pass the Chronic Care Management Improvement Act. This legislation would have removed the cost sharing requirement for patients to access chronic care management services. We also support allowing the physician that performs chronic care management services to waive the requirement that the patient pay the 20 percent coinsurance fee associated with this service. We urged Congress to protect the public health infrastructure, recognize evidence-based science and preserve healthcare agency staffing to inform and protect the public from infectious disease and other health emergencies. Incidences of previously well-controlled, vaccine-preventable diseases, such as pertussis (whooping cough) and measles, are increasing in the United States. Vaccines are vital to our ability to prevent diseases that threaten public health, including novel diseases and future pandemics. We urged Congress to utilize the best possible scientific evidence to guide public health legislation. It is critical that public health leaders support evidence-based medicine, including the use of vaccines and other effective public health strategies that protect the public. ACP conducted a Hill Briefing on using scientifically driven, evidenced-based vaccines. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Prescription Drug Reform: Supported the Capping Prescription Costs Act, introduced by Senator Raphael Warnock. The legislation would lower prescription drug costs for millions of Americans by placing annual caps on out-of-pocket costs for prescription drugs at $2,000 for individuals and $4,000 for families with private insurance. Supported bipartisan Drug-price Transparency for Consumers (DTC) Act, a bill that would require price disclosures on advertisements for prescription drugs in order to empower patients and reduce Americans colossal spending on medications. The bill was introduced by Senators Dick Durbin and Chuck Grassley. ACP also supported the Saving Seniors Money on Prescriptions Act, H.R. 950, which aims to drive down the rising costs of prescription drugs for patients on Medicare by improving price transparency in Pharmacy Benefit Managers (PBMs) business practices. Urged Congress to reintroduce and pass: 1) the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029; 2) the Medicare PBM Accountability Act, legislation aimed at lowering the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans; 3) the Increasing Access to Biosimilars Act of 2023, legislation which would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B; 4) the Cutting Copays Act, legislation which would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs; and the Drug Shortage Prevention Act of 2023, which would require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. ACP supported legislation, Drug-Price Transparency for Consumers (DTC) Act, by Senators. Durbin and Grassley that requires Direct-to-Consumer advertisements for prescription drugs and biological products paid for by Medicare and Medicaid to include the list price or Wholesale Acquisition Cost (WAC) for a 30-month supply-which is the price set by manufacturers (and which is paid by uninsured patients, as well as the 50 percent of patients with high-deductible plans).

Client expense: $86,880 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

ACPSs 2026 Third Quarter Lobbying Disclosure Report Medicare Payments to Physicians: Sent letter and met with legislators in support of the Patients First Act of 2026, (H.R. 9693) for a Medicare Economic Index inflationary updated to the physician fee schedule for physician practices, support for independent practices and replacement of MIPS with POINTS for quality measures. Supported and urged Congress to pass (H.R. 8163, S.5180), the Provider Reimbursement Stability Act, to enhance Medicare reimbursement stability for physicians by modernizing the Medicare Physician Fee Schedule. The Provider Reimbursement Stability Act of 2026. H.R. 8163 would raise the budget neutrality threshold from $20 million to $57.64 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every 5 years. ACP supported the Medicare Physician Data-Drive Performance Payment System Act of 2026, H.R. 8622. This critical legislation seeks to modernize Medicare payments by reducing administrative burdens, improving patient care, and supporting small/rural practices through a more practical, data-driven approach. Dr. William Fox, Chair Emeritus of ACPs Board of Regents, testified before the House Energy and Commerce Committees Health Subcommittee on policy reforms to improve the Medicare Physician Fee Schedule and the Medicare Access and CHIP Reauthorization Act (MACRA) on behalf of ACP. Dr. Rebecca Andrews, Past Chair of ACPs Board of Regents, testified before the House E&C Health Subcommittee in favor of each of the bills mentioned above. ACP supported Pay PCPs Act of 2026 (S. 5269), to inject $10 billion federal investment from fiscal year 2027 through 2031 to provide for the establishment of hybrid primary care payments under Medicare. Support Value-Based Care: Urged reintroduction and support of the Value in Health Care Act of 2024. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that expired at the end of 2024. ACP supported the Preserving Patient Access to Accountable Care Act which aligns with Colleges policy to support the transition to value-based payments through alternative payment models (APMs) that can accommodate a wide range of specialties, practice sizes, and unique patient populations. ACP supported this legislation as it would extend the incentive payments for qualifying physicians and other clinicians to participate in Medicare advanced APMs through payment year 2027 at an increased amount of 3.53 percent and would freeze the scheduled increase in qualifying thresholds. Pricing Transparency/Consolidation: Provided comments to the House Energy and Commerce Committees markup, which includes the Lower Cost, More Transparency Act, H.R. 9393, and the Improving Seniors Timely Access to Care Act, H.R. 3514. The two bills would enhance price transparency across health care entities and streamline unnecessary administrative burden, respectively. ACP also supported several policies included in bills slated for markup that would reform Medicare Advantage practices to ensure accountability and safeguard market competition. ACP strongly supports pricing transparency in health care. ACP supported the passage of the Lower Costs, More Transparency Act, which passed the House in the 118th Congress, and we continue to support its reintroduction and passage in this Congress under H.R. 9393. ACP supported provisions within the Medicare Advantage Cost Transparency Act, H.R. 9392, led by Ranking Member DeGette and Dr. Joyce, which would provide greater oversight by requiring that Medicare Advantage (MA) plans report to the Centers for Medicare & Medicaid Services (CMS) on encounter data, including the allowed amount that a plan agreed to pay for a service in total and the total out-of-pocket costs the patient pays for a service. The College has repeatedly voiced support for the Improving Seniors' Timely Access to Care Act, led by Reps. Kelly and DelBene, which would protect patients from unnecessary delays in care and reduce administrative burden on physicians by streamlining MAs prior authorization approval processes. We urge Congress to pass H.R. 3514 to ensure that our patients will get the care they need, when they need it most. FY2026 Appropriations/Agency Restructuring: For FY2027, ACP is urged appropriations committees that funding be either maintained or increased for the following proven programs: 1) Health Resources Services Administration (HRSA), $10.5 billion, including: 2) Health Workforce, National Health Service Corps (NHSC), $915.6 million in total program funding; 3) Primary Care Training and Enhancement (PCTE), $71 million; 4) Title X Family Planning Program, $390 million; 5) Agency for Healthcare Research and Quality (AHRQ), $500 million; 6) Centers for Disease Control and Prevention (CDC) Injury Prevention and Control, $11.6 billion, including: 7) Firearm Injury and Mortality Prevention Research, $35 million; 8) Chronic Disease Prevention and Health Promotion, Social Determinants of Health, $100 million; 9) National Institutes of Health (NIH), $51.3 billion, including: 10) Office of the Director, Firearms Research, $25 million; 11) Centers for Medicare and Medicaid Services (CMS) and Government Accountability Office (GAO); and 12) Report language to ensure primary care physicians are receiving Medicare physician revaluations. We urged Congress to include report language in the FY2026 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language and hope Congress will pass the FY26 Labor HHS bills. Also urged Congress to include report language in the FY2027 Labor HHS appropriations bill directing a study on extent G2211 add on codes and increases in fee schedule for primary care are being retained by hiring entities (hospitals, ACOs, private equity) versus the physicians. ACP urged appropriators to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. Primary Care and the Physician Workforce: ACP urged Congress to support the Resident Physician Shortage Reduction Act of 2025 (S. 2439/ H.R. 4731), which would increase the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years. ACP supported the Conrad State 30 and Physician Access Reauthorization Act, S. 709 and H.R. 1585, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement. We supported the Resident Education Deferred Interest (REDI) Act (S 942/HR 2028) that, if passed, will allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program. ACP supported legislation for the H-1Bs for Physicians and Healthcare Workforce Act, H.R. 7961. The bill's primary goal is to exempt healthcare professionals from a $100,000 H-1B visa filing fee. ACP supported H.R. 8765, the Prioritizing Primary Care Act. This legislation would mandate an annual report on federal spending on primary care as well as establish a working group to study and make recommendations on how each federal agency addresses the issue. Scope of Practice: ACP provided comments urging the House Ways and Means Committee during markup to oppose the Equitable Community Access to Pharmacist Services Act, which would expand Medicare coverage to permanently include select services provided by a pharmacist. ACP advocated before Senate offices against the marked-up bill coming out of House Ways and Means and renamed the Main Street Pharmacy Access Act enabling pharmacists to bill certain Medicare codes and to diagnose and treat flu, strep throat and other respiratory infections. Expand Patient Access: We urged Congress to reintroduce and pass the Chronic Care Management Improvement Act. This legislation would have removed the cost sharing requirement for patients to access chronic care management services. We also support allowing the physician that performs chronic care management services to waive the requirement that the patient pay the 20 percent coinsurance fee associated with this service. We urged Congress to protect the public health infrastructure, recognize evidence-based science and preserve healthcare agency staffing to inform and protect the public from infectious disease and other health emergencies. Incidences of previously well-controlled, vaccine-preventable diseases, such as pertussis (whooping cough) and measles, are increasing in the United States. Vaccines are vital to our ability to prevent diseases that threaten public health, including novel diseases and future pandemics. We urged Congress to utilize the best possible scientific evidence to guide public health legislation. It is critical that public health leaders support evidence-based medicine, including the use of vaccines and other effective public health strategies that protect the public. ACP conducted a Hill Briefing on using scientifically driven, evidenced-based vaccines. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Prescription Drug Reform: Supported the Capping Prescription Costs Act, introduced by Senator Raphael Warnock. The legislation would lower prescription drug costs for millions of Americans by placing annual caps on out-of-pocket costs for prescription drugs at $2,000 for individuals and $4,000 for families with private insurance. Supported bipartisan Drug-price Transparency for Consumers (DTC) Act, a bill that would require price disclosures on advertisements for prescription drugs in order to empower patients and reduce Americans colossal spending on medications. The bill was introduced by Senators Dick Durbin and Chuck Grassley. ACP also supported the Saving Seniors Money on Prescriptions Act, H.R. 950, which aims to drive down the rising costs of prescription drugs for patients on Medicare by improving price transparency in Pharmacy Benefit Managers (PBMs) business practices. Urged Congress to reintroduce and pass: 1) the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029; 2) the Medicare PBM Accountability Act, legislation aimed at lowering the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans; 3) the Increasing Access to Biosimilars Act of 2023, legislation which would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B; 4) the Cutting Copays Act, legislation which would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs; and the Drug Shortage Prevention Act of 2023, which would require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. ACP supported legislation, Drug-Price Transparency for Consumers (DTC) Act, by Senators. Durbin and Grassley that requires Direct-to-Consumer advertisements for prescription drugs and biological products paid for by Medicare and Medicaid to include the list price or Wholesale Acquisition Cost (WAC) for a 30-month supply-which is the price set by manufacturers (and which is paid by uninsured patients, as well as the 50 percent of patients with high-deductible plans).

Client expense: $119,057 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

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

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

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