Bipartisan Health Care Act

S. 891, the Bipartisan Health Care Act Part D Formulary Design and Generic Drug Tiering HR 4132 / S.2027 - Prescription Information Modernization Act Medicaid Generics Penalty Implementation of the Inflation Reduction Act Drug Shortages S. 2658, The Medication Affordability and Patent Integrity Act

Client expense: $450,000 · Firm income: Not reported

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

Issues related to the Medicare Physician Fee Schedule, including in S. 891, the Bipartisan Health Care Act. H.R. 879, the Medicare Patient Access and Practice Stabilization Act. Issues related to Medicare flexibilities during the COVID-19 Public Health Emergency. Education on Medicare and Medicaid policies in H.R. 1 (P.L. 119-21). H.R. 9693, the Patients First Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Physician Fee Schedule, including in S. 891, the Bipartisan Health Care Act. H.R. 879, the Medicare Patient Access and Practice Stabilization Act. Issues related to patient access. Issues related to telehealth and health IT. S. 1168/H.R. 2477, the Portable Ultrasound Reimbursement Equity Act of 2025. S. 1261/H.R. 4206, the CONNECT For Health Act of 2025. H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program. S. 1816/H.R. 3514, Improving Seniors' Timely Access to Care Act. H.R. 9693, the Patients First Act. H.R. 9844, the Connecting Health and Records Technology for Seniors (CHARTS) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 119-21 (H.R. 1): One Big Beautiful Bill Act; provisions related to Title VII, Subtitle B H.R. 946: Orphan CURES Act; all provisions H.R. 2214: DRUG Act; all provisions H.R. 4317: PBM Reform Act of 2025; all provisions H.R. 6703: Lower Health Care Premiums for All Americans Act; provisions related to Pharmacy Benefit Management (PBM) S. 864: HELP Copays Act; all provisions S. 882: Patients Before Middlemen Act; all provisions S. 891: Bipartisan Health Care Act; provisions related to Titles I, II, VIII, and IX S. 1862: Orphan CURES Act; all provisions S. 3345: PBM Price Transparency and Accountability Act; all provisions Executive Order #14216: Expanding Access to In Vitro Fertilization; all provisions of the order Executive Order #14297: Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients; all provisions of the order General discussions related to Pharmacy Benefit Manager (PBM) policy issues General discussions related to Healthcare supply chain policy issues General discussions related to Drug cost and pricing policy issues General discussions related to caregiving support and awareness policy issues

Client expense: $730,000 · Firm income: Not reported

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

P.L. 119-21 (H.R. 1): One Big Beautiful Bill Act; relating to Title VII, Subtitle B H.R. 1492: To amend title XI of the Social Security Act to equalize the negotiation period between small-molecule and biologic candidates under the Drug Price Negotiation Program.; all provisions S. 832: EPIC Act of 2025; all provisions S. 891: Bipartisan Health Care Act; provisions related to Titles I, II, VIII, and IX General discussions related to Drug cost and pricing policy issues

Client expense: $730,000 · 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. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 843 - Prompt Approval of Safe Generic Drugs Act - Rep. Barragan, Nanette Diaz - Generic drugs applications and approvals H.R. 946 - ORPHAN Cures Act - Rep. Joyce, John - Medicare Drug Negotiation Program H.R. 950 - Saving Seniors Money on Prescriptions Act - Rep. Landsman, Greg - PBM reporting requirements for MA/Part D plans. H.R. 1117 - Responsibility in Drug Advertising Act - Rep. DeLauro, Rosa - Direct-to-consumer ads H.R. 1244 - Reducing Drug Prices for Seniors Act - Rep. Davis, Donald - Coinsurance for Part D drugs H.R. 2214 - DRUG Act - Rep. Miller-Meeks, Mariannette - PBM contracts H.R. 2450 - Prescription Drug Transparency and Affordability Act - Rep. McDonald Rivet, Kristen - PBM transparency H.R. 3493 - Global Fairness in Drug Pricing Act - Rep. Khanna, Ro - Prescription drug international reference pricing H.R. 3546 - Prescription Drug Price Relief Act - Rep. Khanna, Ro - Prescription drug patent reform H.R. 3775 - Fair Prescription Drug Prices for Americans Act - Rep. Van Drew, Jefferson - Prescription drug and biological product international reference pricing H.R. 3789 - DTC Act - Rep. Taylor, David - Direct-to-consumer prescription advertising transparency H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4231 - Treat and Reduce Obesity Act - Rep. Kelly, Mike - Medicare coverage of obesity drugs H.R. 4317 - PBM Reform Act - Rep. Carter, Earl L. "Buddy" - PBM contracting requirements and transparency H.R. 4605 - End Prescription Drug Ads Now Act - Rep. Nadler, Jerrold - Ban on DTC drug ads H.R. 4623 - Plain Prescription Prices Act - Rep. Williams, Nikema - Transparency requirements for DTC drug ads H.R. 5094 - Protect Patients from Costly Care Act - Rep. Pappas, Chris - Repeal of Medicaid cost sharing requirements for drugs; Orphan drug inclusion in Medicare Drug Price Negotiation Program H.R. 5197 - Protect Beneficiaries from Middlemen Act - Rep. Malliotakis, Nicole - Medicare cost-sharing limit for drugs H.R. 5526 - Biosimilar Red Tape Elimination Act - Rep. Pfluger, Austin - Biosimilars approval procedures H.R. 6255 - Affordable Insulin Now Act - Rep. Craig, Angie - require cost-sharing for certain insulin products H.R. 7837 - Most Favored Patient Act - Rep. Meuser, Daniel - MFN demonstration H.R. 8779 - PBM Act - Rep. Harshbarger, Diana - PBM ownership requirements H.R. 9661 - Expedited Access to Biosimilars Act - Rep. Langworthy, Nicholas - Biosimilar approval requirements H.R. 10227 - INSULIN Act - Rep. DeGette, Diana - Copay caps H.R. 10369 - Net Effective Cost Transparency and Prescription Drug Affordability Act - Rep. Mackenzie, Ryan - Requirements for PBMs S. 229 - DTC Act - Sen. Durbin, Richard - Drug advertising requirements S. 483 - Responsibility in Drug Advertising Act - Sen. King, Angus - Drug advertising requirements S. 526 - Pharmacy Benefit Manager Transparency Act of 2025 - Sen. Grassley, Chuck - PBM reporting requirements S. 529 - Capping Prescription Costs Act - Sen. Warnock, Raphael - Drug copay caps S. 652 - Protecting Patients from Deceptive Drugs Ads Act - Sen. Durbin, Richard - Drug advertising requirements S. 882 - Patients Before Middlemen Act - Sen. Blackburn, Marsha - PBM reforms S. 891 - Bipartisan Health Care Act - Sen. Wyden, Ron - PBM reforms and transparency S. 1040 - Drug Competition Enhanced Act - Sen. Cornyn, John - Drug patent reform S. 1041 - Affordable Prescriptions for Patients Act - Sen. Cornyn, John - Patent issues S. 1095 - Stop STALLING Act - Sen. Klobuchar, Amy - Drug patent reform S. 1096 - Preserve Access to Affordable Generics and Biosimilars Act - Sen. Klobuchar, Amy - Drug patent reform S. 1414 - Expedited Access to Biosimilars Act - Sen. Paul, Rand - Biosimilars assessment and approval S. 1587 - Fair Prescription Drug Prices for Americans Act - Sen. Hawley, Josh - Prescription drug international reference pricing S. 1753 - End Price Gouging for Medications Act - Sen. Merkley, Jeff - Prescription drug international reference pricing S. 1818 - Prescription Drug Price Relief Act - Sen. Sanders, Bernard - Prescription drug patent reform S. 1954 - Biosimilar Red Tape Elimination Act - Sen. Lee, Mike - Biological product assessment and approval S. 1973 - Treat and Reduce Obesity Act - Sen. Cassidy, Bill - Medicare coverage for obesity drugs S. 2345 - Short on Competition Act - Sen. Klobuchar, Amy - Expedited approval for generic drugs S. 2447 - Repealing the Trump Sick Tax Act - Sen. Welch, Peter - Repeal of Medicaid cost sharing requirements for drugs; Orphan drug inclusion in Medicare Drug Price Negotiation Program S. 2620 - REMEDY Act - Sen. Durbin, Richard - Expedited approvals for certain drug approvals S. 2658 - Medication Affordability and Patient Integrity Act - Sen. Hassan, Maggie - FDA and USPTO coordination S. 3014 - Ensuring Timely Access to Generics Act - Sen. Shaheen, Jeanne - Generic drug approval S. 4332 - Medication Competition Act - Sen. Hassan, Maggie - Pharmaceutical exclusivity periods S. 4355 - Drug Deal Disclosure Act - Sen. Wyden, Ron - Federal MFN agreement transparency S. 4509 - PBM Act - Sen. Warren, Elizabeth - PBM ownership requirements S. 5059 - A bill to amend the Public Health Service Act to streamline the review of biosimilar biological products. - Sen. Moody, Ashley - Biosimilar and biological product review process Issues related to the implementation of Inflation Reduction Act - Medicare negotiation; cost-sharing and coverage of weight loss drugs/GLP-1s; high priced drugs; patent reforms; generic approval; 340B; Most Favored Nation; Pharmacy Benefit Managers; PBM-related issues; step therapy; copay caps; insulin costs; and copay coupons.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1397/S. 1164 - Increasing Access to Dental Insurance Act; H.R. 1521: Dental and Optometric Care (DOC) Access Act; S. 5089 Medicare Dental Benefit Act of 2026; S. 891: Bipartisan Health Care Act; S. 2084: Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2025; H.R. 9833/S. 5088: Ensuring Kids Have Access to Medically Necessary Dental Care Act; H.R. 3277/S. 1677: Ensuring Lasting Smiles Act; H.R. 3069/S. 1506: Medicare for All Act; H.R. 2045/S. 939: Medicare Dental, Hearing, and Vision Expansion Act of 2025; H.R. 2041: Hidden Fee Disclosure Act of 2025; H.R. 1768: Lower Costs for Everyday Americans Act; H.R. 1219: Oral Health Products Inclusion Act; H.R. 1160: Health Care Provider Shortage Minimization Act of 2025; H.R. 935: Health Care Workforce Innovation Act of 2025; H.R. 210: Dental Care for Veterans Act; H.R. 9831 Medicaid Dental Benefit Act of 2026; H.R. 4556 Protect Our TEETH Act; H.R. 2001: Action for Dental Health Act; Issues pertaining to the Affordable Care Act (ACA) Enhanced Subsidies (no specific bills); Issues pertaining to Adult Dental Essential Health Benefits (EHB) (no specific bills); Issues pertaining to Medicare (no specific bills); Issues pertaining to Medicaid (no specific bills); Issues pertaining to Letter to Issuers (no specific bills); Issues pertaining to ERISA (no specific bills).

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

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

Issues related to health care, the Food and Drug Administration (FDA), influenza, 340B Program, drug pricing, importation of biopharmaceuticals, international pharmaceutical supply chain, TRICARE Pharmacy Program (FY2027 National Defense Authorization Act, H.R.8800/S.4784), insulin price cap, VICP Program, CICP Program, and PBM reform; vaccine schedule and vaccine safety; Type One Diabetes (T1D); Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; S.891, Bipartisan Health Care Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients Executive Order.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in H.R. 879 Medicare Patient and Practice Stabilization Act of 2025, S. 891 the Bipartisan Health Care Act of 2025 and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21, and related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, Medicare reimbursement for telemedicine, and extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations. H.R.8163 - Provider Reimbursement Stability Act of 2026. Issues related to modifier 25 in the 2027 physician fee schedule.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including related provisions in H.R. 879 - Medicare Patient and Practice Stabilization Act of 2025, S. 891 - Bipartisan Health Care Act, and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Issues related to adequate network coverage for dermatologic care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. H.R.8163 - Provider Reimbursement Stability Act of 2026. Issues related to modifier 25 in the 2027 physician fee schedule.

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

Government targets: 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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Pharmacy Benefit Manager (PBM) transparency and reform and continued implementation of the Medicare Drug Price Negotiation program; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to S. 927 - Protecting Pharmacies in Medicaid Act; Issues related to H.R. 4317 - PBM Reform Act of 2025; Issues related to H.R. 3164/S. 2426 - Equitable Community Access to Pharmacist Services Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Pharmacy Benefit Manager (PBM) transparency and reform and continued implementation of the Medicare Drug Price Negotiation program; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to S. 927 - Protecting Pharmacies in Medicaid Act; Issues related to H.R. 4317 - PBM Reform Act of 2025; Issues related to H.R. 3164/S. 2426 - Equitable Community Access to Pharmacist Services Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Pharmacy Benefit Manager (PBM) transparency and reform and continued implementation of the Medicare Drug Price Negotiation program; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to S. 927 - Protecting Pharmacies in Medicaid Act; Issues related to H.R. 4317 - PBM Reform Act of 2025; Issues related to H.R. 3164/S. 2426 - Equitable Community Access to Pharmacist Services Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to health care, the Food and Drug Administration (FDA), oncology coverage, mental health, opioid abuse, 340B Program, drug pricing, importation of biopharmaceuticals, international pharmaceutical supply chain, plasma therapy, step therapy, and PBM reform; Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; S.891, Bipartisan Health Care Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients Executive Order.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B drug discount program; drug pricing; importation of biopharmaceuticals; direct-to-consumer (DTC) advertising; transparency; international pharmaceutical supply chain; PBM reform; TRICARE Pharmacy Program (FY2027 National Defense Authorization Act, H.R.8800/S.4784); Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; S.891, Bipartisan Health Care Act; S.527, Prescription Pricing for the People Act of 2025; S.1040, Drug Competition Enhancement Act; S.1041, Affordable Prescriptions for Patients Act; S.1097, Interagency Patent Coordination and Improvement Act of 2025; S.1095, Stop STALLING Act; S.1096, Preserve Access to Affordable Generics and Biosimilars Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients; FY2027 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R.9260); FY2027 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act (H.R.8646); S.2658, Medication Affordability and Patent Integrity Act; S.3014, Ensuring Timely Access to Generics Act of 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to health care, the Food and Drug Administration (FDA), oncology coverage, 340B Program, drug pricing, importation of biopharmaceuticals, international pharmaceutical supply chain, TRICARE Pharmacy Program (FY2027 National Defense Authorization Act, H.R.8800/S.4784), antimicrobial resistance, VICP Program, PBM reform, vaccine schedule and vaccine safety; Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; S.891, Bipartisan Health Care Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients Executive Order.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Regulatory and legislative health care issues, including: Alzheimer's drug development; drug pricing; Pandemic and All-Hazards Preparedness Act (PAHPA) including reauthorizing priority review vouchers; pharmaceutical scheduling; TRICARE coverage issues in FY2027 National Defense Authorization Act (H.R.8800/S.4784); PBM reform; S.891, Bipartisan Health Care Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients Executive Order.

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

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

Legislative and regulatory issues related to emergency medicine, including issues such as surprise medical billing, Medicare payment reform, workforce issues, drug shortages and rural emergency hospitals. Support of S. 891 the Bipartisan Health Care Act, S.1974 the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act of 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage: Star Ratings, Risk Adjustment, Supplemental Benefits (H.R. 5746, H.R. 5243), No UPCODE Act (S. 1105), Medicare Prior Authorization and Electronic Prior Authorization (H.R. 3514, H.R. 8375), Provider Directories (S. 891), Telehealth Extending Flexibilities (H.R. 4206, S. 1261), Transparency & PBMs (S. 882; S. 891, S. 3345, H.R. 9392), Physician Fee Schedule, Site Neutrality (H.R. 7149), Broker/Agents (H.R. 9395), MLR (H.R. 9644).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

No Bill No. - Physician payment reform No Bill No. - Value based care No Bill No. - Kids Access to Primary Care Act No Bill No. - Medicaid Primary Care Improvement Act No Bill No. - Alleviating Barriers for Caregivers (ABC) Act No Bill No. - MA Prompt Pay No Bill No. - CY2027 Medicare Physician Fee Schedule (H.R. 879) - Medicare Patient Access and Practice Stabilization Act (H.R. 1510) - Due Process Continuity of Care Act (S. 891) - Bipartisan Health Care Act (H.R. 1735/S. 779) - EARLY Minds Act (H.R. 786) - Reserving Patient Access to Accountable Care Act (S.2671/H.R. 5269) - RESULTS Act (2. 2749) - Medicare Sequester Exemption Bill (H.R. 483) - Health Care Efficiency Through Flexibility Act (H.R. 6160) - Strengthening Medicare for Patients and Providers Act (H.R. 6210) - Senior Savings Protection Act (S. 3300) - Access to New Community Health Opportunities and Recovery (ANCHOR) Act (S. 3522) - No Red Tape for Addiction Treatment Act (H.R. 8735/ S. 4384) - Medicare Advantage Improvements Act (H.R. 8390) - National Food as Medicine Program Act of 2026 (H.R. 8425) - Strengthening the Vaccines for Children Program Act of 2026 (H.R. 9693) - Patients First Act (S. 5296) - Pay PCPs Act

Client expense: $499,510 · Firm income: Not reported

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

Legislation and policies relating to: Potential changes in authorizations for nurse education, workforce, and research programs as a result of workforce reductions and reorganization of agencies and programs within the Department of Health and Human Services Cancellation of federal nursing workforce grants Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Use of provider-neutral and inclusive language in federal documents, forms, and surveys Implementation of 42 USC 300gg-5(a) regarding provider non-discrimination by health plans Policies affecting nurse practitioner education and workforce Mental health services and violence prevention Tobacco and vaping prevention and cessation Implementation of provisions of the One Big, Beautiful Bill Act (PL 119-21) H.R. 1197/S. 1562, PREEMIE Reauthorization Act H.R. 1735/S. 779, Early Action and Responsiveness Lifts Youth Minds (EARLY Minds) Act H.R. 2223, Building Capacity for Care Act H.R. 3333, Magnifying Opportunities to Recruit and Educate (MORE) Nurses Act H.R. 3884/S. 2011, Telemental Health Care Access Act H.R. 4262/S. 4110, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act H.R. 7092/S. 4061, Raising Awareness for Youth Suicide (RAYS) Prevention Act H.R. 7973, Momnibus Act H.R. 8089/S. 4186, Perinatal Workforce Act S. 266/H.R. 929, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. 891, Bipartisan Health Care Act S. 1482, National Nursing Workforce Center Act of 2025 S. 1599/H.R. 6394, Midwives for Maximizing Optimal Maternity Services (MOMS) Act of 2025 S. 1874/H.R. 3593, Title VIII Nursing Workforce Reauthorization Act of 2025

Client expense: Not reported · Firm income: $29,067

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

Legislation and policies relating to: Potential changes in authorizations for nurse education, workforce, and research programs as a result of workforce reductions and reorganization of agencies and programs within the Department of Health and Human Services Policies related to the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, child vaccine recommendations and schedule, the Vaccines For Children Program, and the Vaccine Injury Compensation Fund Cancellation of federal nursing workforce grants Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Use of provider-neutral and inclusive language in federal documents, forms, and surveys Reauthorization of the Child Nutrition Act Implementation of 42 USC 300gg-5(a) regarding provider non-discrimination by health plans Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Mental health services and violence prevention Tobacco and vaping prevention and cessation Implementation of provisions of the One Big, Beautiful Bill Act (PL 119-21) H.R. 1197/S. 1562, PREEMIE Reauthorization Act H.R. 1435/S. 3714, Family-to-Family Reauthorization Act of 2025 H.R. 1735/S. 779, Early Action and Responsiveness Lifts Youth Minds (EARLY Minds) Act H.R. 2472, Improving Newborns' Food and Nutrition Testing Safety (INFANTS) Act of 2025 H.R. 2493, Improving Care in Rural America Reauthorization Act of 2025 H.R. 3333, Magnifying Opportunities to Recruit and Educate (MORE) Nurses Act H.R. 3492, Protect Childrens Innocence Act H.R. 3624/S. 1924, Improving Mental Health Access for Students Act H.R. 3701, Family Vaccine Protection Act H.R. 3884/S. 2011, Telemental Health Care Access Act H.R. 4262/S. 4110, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act H.R. 4340/S. 921, Tyler's Law H.R. 4564, Dillons Law H.R. 4709, Newborn Screening Saves Lives Reauthorization Act of 2025 H.R. 4725, Transparency, Readability, Understandability, Truth, and Helpfulness (TRUTH) in Labeling Act H.R. 5145, Bipartisan Premium Tax Credit Extension Act H.R. 5434/S. 2826, 988 LGBTQ+ Youth Access Act of 2025 H.R. 5469/S. 2858, Stillbirth Health Improvement and Education (SHINE) for Autumn Act H.R. 5582, Patients Deserve Price Tags Act H.R. 6088/S. 3281, Restoring Food Security for Families & Farmers Act of 2025 H.R. 6121/S. 2303, Promoting Physical Activity for Americans Act H.R. 6252, Food Assurance and Security Act H.R. 6396, Kid Providing Resources for Optimal Outcomes against Fatalities (Kid PROOF) Act of 2025 H.R. 6561, PREVENT HPV Cancers Act of 2025 H.R. 6703, Lower Health Care Premiums for All Americans Act H.R. 6844, Tobacco TRACE Act H.R. 6845/S. 3569, S.T.O.P. Illegal Vaping Act H.R. 6945/S. 4242, Supporting Pregnant and Parenting Women and Families Act H.R. 7092/S. 4061, Raising Awareness for Youth Suicide (RAYS) Prevention Act H.R. 7567, Farm, Food, and National Security Act of 2026 H.R. 7757, Kids Internet and Digital Safety (KIDS) Act H.R. 7867, Infant Formula Safety Modernization Act of 2026 H.R. 7875, Providing Opportunities for Individuals in Need of Treatment and Support (POINTS) Act H.R. 7973, Momnibus Act H.R. 8081/S. 4202, Mental Health Access and Provider Support Act H.R. 8089/S. 4186, Perinatal Workforce Act H.R. 8163, Provider Reimbursement Stability Act H.R. 8201, Expanding Community Access to Health Services Act H.R. 8209, School-Based Health Centers Reauthorization Act of 2026 H.R. 8385, Food Labeling Modernization Act of 2026 H.R. 8425, Strengthening the Vaccines for Children Program Act of 2026 H.R. 8429, Baby Food Safety Act of 2026 H.R. 8521/S. 4387, Protect Moms from Domestic Violence Act H.R. 8657, Campus Lifeline Act H.R. 9257/S. 4754, Primary and Behavioral Health Care Access Act H.R. 9393, Lower Costs, More Transparency Act of 2026 S. 222/H.R. 649, Whole Milk for Healthy Kids Act of 2025 S. 266/H.R. 929, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. 272, Protect Infant Formula from Contamination Act S. 278, Kids Off Social Media Act S. 705, Innovations in Pediatric Drugs Act S. 836/H.R. 6291, Children and Teens Online Privacy Protection Act (COPPA 2.0) S. 891, Bipartisan Health Care Act S. 1157/H.R. 2319, Women and Lung Cancer Research and Preventive Services Act of 2025 S. 1885, Stop the Scroll Act S. 1482, National Nursing Workforce Center Act of 2025 S. 1599/H.R. 6394, Midwives for Maximizing Optimal Maternity Services (MOMS) Act of 2025 S. 1748/H.R. 6484, Kids Online Safety Act S. 1874/H.R. 3593, Title VIII Nursing Workforce Reauthorization Act of 2025 S. 2169, Rural Hospital Cybersecurity Enhancement Act S. 2857/H.R. 5448, Protecting Free Vaccines Act S. 2954, Health Care Workforce Expansion Act of 2025 S. 3199, 988 Lifeline Location Improvement Act of 2025 S. 3315, Health Care Cybersecurity and Resiliency Act of 2025 S. 3386, Health Care Freedom for Patients Act of 2025 S. 3402, Ensuring Excellence in Mental Health Act S. 3799, Healthy Start Reauthorization Act of 2026 S. 3853, End the Vaccine Carveout Act S. 4088, Welcome Back to the Health Care Workforce Act S. 4141, Rural Hospital Revitalization Act S. 4189, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act

Client expense: Not reported · Firm income: $24,000

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

Issues related to the Medicare Physician Fee Schedule, including in S. 891, the Bipartisan Health Care Act. H.R. 879, the Medicare Patient Access and Practice Stabilization Act. Issues related to Medicare flexibilities during the COVID-19 Public Health Emergency. Education on Medicare and Medicaid policies in H.R. 1 (P.L. 119-21).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Physician Fee Schedule, including in S. 891, the Bipartisan Health Care Act. H.R. 879, the Medicare Patient Access and Practice Stabilization Act. Issues related to patient access. Issues related to telehealth and health IT. S. 1168/H.R. 2477, the Portable Ultrasound Reimbursement Equity Act of 2025. S. 1261/H.R. 4206, the CONNECT For Health Act of 2025. H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program. S. 1816/H.R. 3514, Improving Seniors' Timely Access to Care Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 119-21 (H.R. 1): One Big Beautiful Bill Act; relating to Title VII, Subtitle B H.R. 1492: To amend title XI of the Social Security Act to equalize the negotiation period between small-molecule and biologic candidates under the Drug Price Negotiation Program.; all provisions S. 832: EPIC Act of 2025; all provisions S. 891: Bipartisan Health Care Act; provisions related to Titles I, II, VIII, and IX General discussions related to Drug cost and pricing policy issues

Client expense: $700,000 · 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

P.L. 119-21 (H.R. 1): One Big Beautiful Bill Act; provisions related to Title VII, Subtitle B H.R. 946: Orphan CURES Act; all provisions H.R. 2214: DRUG Act; all provisions H.R. 4317: PBM Reform Act of 2025; all provisions H.R. 6703: Lower Health Care Premiums for All Americans Act; provisions related to Pharmacy Benefit Management (PBM) S. 864: HELP Copays Act; all provisions S. 882: Patients Before Middlemen Act; all provisions S. 891: Bipartisan Health Care Act; provisions related to Titles I, II, VIII, and IX S. 1862: Orphan CURES Act; all provisions S. 3345: PBM Price Transparency and Accountability Act; all provisions Executive Order: Expanding Access to In Vitro Fertilization; all provisions of the order Executive Order: Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients; all provisions of the order General discussions related to Pharmacy Benefit Manager (PBM) policy issues General discussions related to Healthcare supply chain policy issues General discussions related to Drug cost and pricing policy issues General discussions related to caregiving support and awareness policy issues

Client expense: $700,000 · Firm income: Not reported

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

S. 891, the Bipartisan Health Care Act Part D Formulary Design and Generic Drug Tiering HR 4132 / S.2027 - Prescription Information Modernization Act Medicaid Generics Penalty Implementation of the Inflation Reduction Act Drug Shortages S. 2658, The Medication Affordability and Patent Integrity Act

Client expense: $360,000 · Firm income: Not reported

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Pharmacy Benefit Manager (PBM) transparency and reform and continued implementation of the Medicare Drug Price Negotiation program; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to S. 927 - Protecting Pharmacies in Medicaid Act; Issues related to H.R. 4317 - PBM Reform Act of 2025; Issues related to S. 2426 - Equitable Community Access to Pharmacist Services Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Pharmacy Benefit Manager (PBM) transparency and reform and continued implementation of the Medicare Drug Price Negotiation program; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to S. 927 - Protecting Pharmacies in Medicaid Act; Issues related to H.R. 4317 - PBM Reform Act of 2025; Issues related to S. 2426 - Equitable Community Access to Pharmacist Services Act; Issues related to H.R. 3164 - Main Street Pharmacy Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Pharmacy Benefit Manager (PBM) transparency and reform and continued implementation of the Medicare Drug Price Negotiation program; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to S. 927 - Protecting Pharmacies in Medicaid Act; Issues related to H.R. 4317 - PBM Reform Act of 2025; Issues related to S. 2426 - Equitable Community Access to Pharmacist Services Act; Issues related to H.R. 3164 - Main Street Pharmacy Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Draft, the Expedited Access to Biosimilars Act (no bill number) - Rep. Langworthy, Nick - Biosimilar approval requirements H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 843 - Prompt Approval of Safe Generic Drugs Act - Rep. Barragan, Nanette Diaz - Generic drugs applications and approvals H.R. 946 - ORPHAN Cures Act - Rep. Joyce, John - Medicare Drug Negotiation Program H.R. 950 - Saving Seniors Money on Prescriptions Act - Rep. Landsman, Greg - PBM reporting requirements for MA/Part D plans. H.R. 1117 - Responsibility in Drug Advertising Act - Rep. DeLauro, Rosa - Direct-to-consumer ads H.R. 1244 - Reducing Drug Prices for Seniors Act - Rep. Davis, Donald - Coinsurance for Part D drugs H.R. 2214 - DRUG Act - Rep. Miller-Meeks, Mariannette - PBM contracts H.R. 2450 - Prescription Drug Transparency and Affordability Act - Rep. McDonald Rivet, Kristen - PBM transparency H.R. 3493 - Global Fairness in Drug Pricing Act - Rep. Khanna, Ro - Prescription drug international reference pricing H.R. 3546 - Prescription Drug Price Relief Act - Rep. Khanna, Ro - Prescription drug patent reform H.R. 3775 - Fair Prescription Drug Prices for Americans Act - Rep. Van Drew, Jefferson - Prescription drug and biological product international reference pricing H.R. 3789 - DTC Act - Rep. Taylor, David - Direct-to-consumer prescription advertising transparency H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4231 - Treat and Reduce Obesity Act - Rep. Kelly, Mike - Medicare coverage of obesity drugs H.R. 4317 - PBM Reform Act - Rep. Carter, Earl L. Buddy - PBM contracting requirements and transparency H.R. 4605 - End Prescription Drug Ads Now Act - Rep. Nadler, Jerrold - Ban on DTC drug ads H.R. 4623 - Plain Prescription Prices Act - Rep. Williams, Nikema - Transparency requirements for DTC drug ads H.R. 5094 - Protect Patients from Costly Care Act - Rep. Pappas, Chris - Repeal of Medicaid cost sharing requirements for drugs; Orphan drug inclusion in Medicare Drug Price Negotiation Program H.R. 5197 - Protect Beneficiaries from Middlemen Act - Rep. Malliotakis, Nicole - Medicare cost-sharing limit for drugs H.R. 5526 - Biosimilar Red Tape Elimination Act - Rep. Pfluger, Austin - Biosimilars approval procedures H.R. 6255 - Affordable Insulin Now Act - Rep. Craig, Angie - require cost-sharing for certain insulin products H.R. 7837 - Most Favored Patient Act - Rep. Meuser, Daniel - MFN demonstration H.R. 8779 - PBM Act - Rep. Harshbarger, Diana - PBM ownership requirements S. 229 - DTC Act - Sen. Durbin, Richard - Drug advertising requirements S. 483 - Responsibility in Drug Advertising Act - Sen. King, Angus - Drug advertising requirements S. 526 - Pharmacy Benefit Manager Transparency Act of 2025 - Sen. Grassley, Chuck - PBM reporting requirements S. 529 - Capping Prescription Costs Act - Sen. Warnock, Raphael - Drug copay caps S. 652 - Protecting Patients from Deceptive Drugs Ads Act - Sen. Durbin, Richard - Drug advertising requirements S. 882 - Patients Before Middlemen Act - Sen. Blackburn, Marsha - PBM reforms S. 891 - Bipartisan Health Care Act - Sen. Wyden, Ron - PBM reforms and transparency S. 1040 - Drug Competition Enhanced Act - Sen. Cornyn, John - Drug patent reform S. 1041 - Affordable Prescriptions for Patients Act - Sen. Cornyn, John - Patent issues S. 1095 - Stop STALLING Act - Sen. Klobuchar, Amy - Drug patent reform S. 1096 - Preserve Access to Affordable Generics and Biosimilars Act - Sen. Klobuchar, Amy - Drug patent reform S. 1414 - Expedited Access to Biosimilars Act - Sen. Paul, Rand - Biosimilars assessment and approval S. 1587 - Fair Prescription Drug Prices for Americans Act - Sen. Hawley, Josh - Prescription drug international reference pricing S. 1753 - End Price Gouging for Medications Act - Sen. Merkley, Jeff - Prescription drug international reference pricing S. 1818 - Prescription Drug Price Relief Act - Sen. Sanders, Bernard - Prescription drug patent reform S. 1954 - Biosimilar Red Tape Elimination Act - Sen. Lee, Mike - Biological product assessment and approval S. 1973 - Treat and Reduce Obesity Act - Sen. Cassidy, Bill - Medicare coverage for obesity drugs S. 2345 - Short on Competition Act - Sen. Klobuchar, Amy - Expedited approval for generic drugs S. 2447 - Repealing the Trump Sick Tax Act - Sen. Welch, Peter - Repeal of Medicaid cost sharing requirements for drugs; Orphan drug inclusion in Medicare Drug Price Negotiation Program S. 2620 - REMEDY Act - Sen. Durbin, Richard - Expedited approvals for certain drug approvals S. 2658 - Medication Affordability and Patient Integrity Act - Sen. Hassan, Margaret - FDA and USPTO coordination S. 3014 - Ensuring Timely Access to Generics Act - Sen. Shaheen, Jeanne - Generic drug approval S. 4332 - Medication Competition Act - Sen. Hassan, Maggie - Pharmaceutical exclusivity periods S. 4355 - Drug Deal Disclosure Act - Sen. Wyden, Ron - Federal MFN agreement transparency S. 4509 - PBM Act - Sen. Warren, Elizabeth - PBM ownership requirements Issues related to the implementation of Inflation Reduction Act - Medicare negotiation; cost-sharing and coverage of weight loss drugs/GLP-1s; high priced drugs; patent reforms; generic approval; Pharmacy Benefit Managers; PBM-related issues; step therapy; copay caps; insulin costs; and copay coupons.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Tracking -a federal district court vacated a Health Resources and Services Administration (HRSA) policy restricting 340B disproportionate share hospitals (DSHs) from using group purchasing organizations (GPOs) alongside replenishment models for outpatient drugs, concluding the agency failed to provide adequate justification under the Administrative Procedure Act. share hospitals (DSHs) from using group purchasing organizations (GPOs) alongside replenishment models for outpatient drugs, concluding the agency failed to provide adequate justification under the Administrative Procedure Act. Tracking Bills - S. 3206 Transgender Health Care Access Act, S. 2709 and HR 5081 Telehealth Modernization Act, HR 6468 Rural Residency Placement & Development Act of 2025 - the area is challenged with med students match with this region which challenges the ability to recruit new health care professionals to remain in the area. HR5821 - Rural Hospital Fairness Act, S891 - Bipartisan Health Act, S526 PBM Transparency Act - provides for full transparency in drug pricing to ensure any savings go back to patients - the Federal Trade Commission will complete a 6(b) study examining the effects of consolidation on pricing in the PBM industry, as well as other potentially abusive behavior by PBMs. The bill instructs the FTC to provide policy recommendations to Congress to improve competition and protect consumers. The hospital supports any mechanism for drug price transparency for patients. S527 - Prescription Pricing for People Act of 2025 - A study by FTC to study role of intermediaries (PBMs) in pharm. supply chain and provide recommendations for improvement of costs to patients. S927 Protecing Pharmacies in Medicaid Act - PBMs charge Medicaid more than they pay pharmacies for a particular drug, increases corporate profits while driving up costs for Medicaid. PBMs use of spread pricing has also been linked to the increasing failure rate for independent pharmacies, which provide a critical source of health care and community for rural communities. HR267 Health Care Transparency Act - statutory authority for requirements for hospitals and health insurance plans to disclose certain information about the costs for items and services. We need to ensure requirements are within appropriate information to be disclosed - challenged with varied reimbursement rates. HR 2214 - DRUG Act. The bill is impacting prescription drug costs, access, and manufacturing practices. These include the Inflation Reduction Act's provisions for Medicare Part D, amendments to the Federal Sentencing Guidelines, and potential changes related to PBMs and direct-to-consumer advertising. Supporting best and most affordable care for patients. Tracking House Bills on price transaparency, drug controls, community care H.R. 9393 - Lower Costs, More Transparency Act of 2026 (Guthrie, Pallone): Codifies existing price transparency rules for hospitals and health plans American Hospital Association. H.R. 9390 - Prices on the Wall Act of 2026 (Miller-Meeks): Requires hospitals to post service pricing physically on their walls American Hospital Association. H.R. 9397 - Premium Transparency Act (Pfluger, Moran): Mandates insurers to disclose how much of premiums go toward healthcare costs subscriber.politicopro.com. H.R. 9396 - Prior Authorization Accountability Act (Goldman-TX): Improves transparency and consistency in prior authorization for Medicare Advantage plans American Hospital Association. H.R. 5243 - Medicare Advantage Data Transparency Amendment: Increases data transparency for supplemental benefits under Medicare Advantage House Committee on Energy and Commerce. H.R. 9395 - Transparency in Medicare Advantage Steering Act (Ocasio-Cortez): Enhances oversight and transparency in Medicare Advantage steering House Committee on Energy and Commerce. Access to Care & Community Health H.R. 8201 - Expanding Community Access to Health Services Act (Lee-NV): Requires community health centers to provide behavioral health and substance use disorder services, with related funding AACOM. H.R. 9389 - Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 (Harshbarger): Expands nutrition education and chronic disease prevention services at Federally Qualified Health Centers AACOM. H.R. 3514 - Improving Seniors Timely Access to Care Act of 2025 (Kelly, DelBene): Reduces variation in prior authorization methods for Medicare Advantage plans American Hospital Association. Illicit Drug Control H.R. 1266 - Combatting Illicit Xylazine Act (Panetta, Pfluger): Places xylazine on the controlled substances list subscriber.politicopro.com. H.R. 7970 - STOP Nitazenes Act (Latta): Places nitazenes on the controlled substances list subscriber.politicopro.com. H.R. 2004 - Tylers Law (Lieu, Latta): Expands naloxone access and overdose prevention measures House Committee on Energy and Commerce. H.R. 1561 - ALERT Communities Act (Crockett, Gooden): Supports community-based overdose prevention and response House Committee on Energy and Commerce. H.R. 7994 - HERO Act (Ruiz): Enhances harm reduction and overdose prevention services House Committee on Energy and Commerce. H.R. 5880 - Fight Illicit Pill Presses Act (Hageman, Stansbury) & H.R. 8005 - Stop Pills That Kill Act (Evans): Target illicit drug manufacturing and distribution House Committee on Energy and Commerce. H.R. 7184 - PRESS Act (McDowell): Addresses illicit drug production and distribution

Client expense: Not reported · Firm income: $24,000

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

Medicare Advantage: Star Ratings, Risk Adjustment, Supplemental Benefits (H.R. 5746, H.R. 5243), No UPCODE Act (S. 1105), Medicare Prior Authorization and Electronic Prior Authorization (H.R. 3514, H.R. 8375), Provider Directories (S. 891), Telehealth Extending Flexibilities (H.R. 4206, S. 1261), Transparency & PBMs (S. 882; S. 891, S. 3345), Physician Fee Schedule, Site Neutrality (H.R. 7149, H.R. 3417 from 118th), Broker/Agents (H.R. 9395).

Client expense: $700,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act and Extending Enhanced APTCs (H.R. 247; S. 46), 2026 Proposed NBPP/Individual Market/ACA exchanges; Fraudulent Enrollments in Qualified Health Plans (S. 976, HR 2079), Behavioral Health, Employer-Provided Health Coverage; Surprise Billing (S. 2420, H.R. 4710); Cybersecurity; Health IT, Health Care Innovation, Transparency & PBMs (S. 891, H.R. 6703), PBM Compensation (H.R. 7895), Prescription Drugs (S. 1954, S. 1096, S. 1096, S.1040) Price Transparency (S. 2355, H.R. 9393, H.R. 9397), Prior Authorization (H.R. 9396), 340B.

Client expense: $700,000 · Firm income: Not reported

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

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

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

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

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

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

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

Issues related to health care, the Food and Drug Administration (FDA), influenza, 340B Program, drug pricing, importation of biopharmaceuticals, international pharmaceutical supply chain, TRICARE Pharmacy Program (FY2027 National Defense Authorization Act, H.R.8800/S.4784), insulin price cap, VICP Program, CICP Program, and PBM reform; vaccine schedule and vaccine safety; Type One Diabetes (T1D) and military healthcare; Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; S.891, Bipartisan Health Care Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients Executive Order.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B drug discount program; drug pricing; importation of biopharmaceuticals; direct-to-consumer (DTC) advertising; transparency; international pharmaceutical supply chain; PBM reform; TRICARE Pharmacy Program (FY2027 National Defense Authorization Act, H.R.8800/S.4784); Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; S.891, Bipartisan Health Care Act; S.527, Prescription Pricing for the People Act of 2025; S.1040, Drug Competition Enhancement Act; S.1041, Affordable Prescriptions for Patients Act; S.1097, Interagency Patent Coordination and Improvement Act of 2025; S.1095, Stop STALLING Act; S.1096, Preserve Access to Affordable Generics and Biosimilars Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients; FY2027 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R.9260); FY2027 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act (H.R.8646); S.2658, Medication Affordability and Patent Integrity Act; S.3014, Ensuring Timely Access to Generics Act of 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to health care, the Food and Drug Administration (FDA), oncology coverage, mental health, opioid abuse, 340B Program, drug pricing, importation of biopharmaceuticals, international pharmaceutical supply chain, plasma therapy, step therapy, and PBM reform; Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; S.891, Bipartisan Health Care Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients Executive Order.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.891, the Bipartisan Health Care Act; S.882, the Patients Before Middlemen Act; S.927, the Protecting Pharmacies in Medicaid Act; H.R.3164/S.2426, the Mainstreet Pharmacy Access Act/the Ensuring Community Access to Pharmacist Services Act; H.R.2428, the Ensuring Access to Lower-Cost Medicines for Seniors Act; Comments to CMS on the implementation of Medicare Part D Medicare Drug Price Negotiation implementation under the Inflation Reduction Act (IRA; P.L. 117-169); Long-Term Care Pharmacy at Home Services in Medicare; Comments to CMS for its "Dispensing Entity-CMS Agreement and Dispensing Entity-MTF Data Module Contractor Agreement" (IRA; P.L.117-169)' H.R.1, the One Big Beautiful Bill Act Comments to CMS on "Re: Draft Guidance for IPAY 2028 and Manufacturer Effectuation of the MFP for 2026, 2027, and 2028 for the Medicare Drug Price Negotiation Program"; Comments to CMS on "Re: Medicare Transaction Facilitator DRAFT Standard Companion Guide Health Care Claim Payment/Advice (835)" Comments to CMS on "Re: Agency Information Collection Activities: Proposed Collection; Comment Request [Docket No. CMS-10912] - CMS-10912 Medicare Transaction Facilitator for 2026 and 2027 under Sections 11001 and 11002 of the Inflation Reduction Act (IRA) - Drug Price Negotiation Program MTF DM Dispensing Entity and Third-Party Support Enrollment Form"; H.Con.Res.14, Establishing the congressional budget for the United States Government for fiscal year 2025 and setting forth the appropriate budgetary levels for fiscal years 2026 through 2034; H.R.4317, the PBM Reform Act; H.R.5031/S.3159, the Preserving Patient Access to Long-Term Care Pharmacies Act; Comments to CMS on "RE:Re: Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices Model [CMS-1830-P]"; Comments to CMS on "Re: Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies [CMS-1828-P]"; Comments to CMS on "RE:Re: 340B Program Notice: Application Process for the 340B Rebate Model Pilot Program [HRSA2025 and HRSA-2025-14619]"; Comments to CMS on "Re: Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program [CMS-1832-P]"; H.R.5256, the 340B ACCESS Act; S.2800, the Pharmacy and Medically Underserved Areas Enhancement Act; S.3345, the PBM Price Transparency and Accountability Act; H.R. 6609, Pharmacists Fight Back in Medicare and Medicaid Act; Grassley-Lujan Request-for-Information on Pharmacists Providing Chronic Care; CMMI Potential reimbursement model for CMS coverage of GLP-1 drugs; H.R.7148, the Consolidated Appropriations Act, 2026; Comments to CMS on Proposed Rule "Re: Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program"; Implementation of "reasonable and relevant" contract terms in the Medicare Part D Program; Comments to CMS on "Re: 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, Childrens Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges [CMS-0062-P]"; Comments to CMS on "Re: Medicare GLP-1 Bridge Program - Improper Restriction of the $5.00 LTC Dispensing Fee to Nursing Facility and ICF/IID Residents; Conflict with 42 C.F.R. 423.120, Chapter 5, Section 20.7 of the Medicare Prescription Drug Benefit Manual, and CMSs December 15, 2021 Guidance on LTC Pharmacy Access";

Client expense: $270,000 · 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

Issues related to health care, the Food and Drug Administration (FDA), oncology coverage, 340B Program, drug pricing, importation of biopharmaceuticals, international pharmaceutical supply chain, TRICARE Pharmacy Program (FY2027 National Defense Authorization Act, H.R.8800/S.4784), antimicrobial resistance, VICP Program, PBM reform, vaccine schedule and vaccine safety; Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization; S.891, Bipartisan Health Care Act; Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients Executive Order.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE