GLOBAL MEDICAL RESPONSE

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Lobbying Spend

—

Filings

Firms Hired

Active Period

2025–2026

Lobbying Spend by Year

Client-reported lobbying expenses on LDA filings

Year	Lobbying Spend	Filings	Firms
2026	—	3	1
2025	—	5	1

Hired Firms

Lobbying firms retained by this client; amounts are client-reported expenses when available

Firm Name	Reported Spend	Filings
THE NICKLES GROUP, LLC	—	8

Government Bodies Lobbied

Government entities explicitly identified as targets in LDA filings

Government Body	Filings
HOUSE OF REPRESENTATIVES	7
Homeland Security, Dept of (DHS)	7
SENATE	7
Centers For Medicare and Medicaid Services (CMS)	6
Health & Human Services, Dept of (HHS)	6
Office of Management & Budget (OMB)	6
Medicare Payment Advisory Commission (MedPAC)	3

Top Issues

Most frequently reported lobbying issues

Issue Code	Description	Reports
Homeland Security	Homeland Security	8
Medicare/Medicaid	Medicare/Medicaid	8
Health Issues	Health Issues	1

Bills Explicitly Cited (1)

Bill numbers found in source-reported LDA specific issue text; broad topic matches are excluded

H.R. 1968119th Congress

Full-Year Continuing Appropriations and Extensions Act, 2025

2025 · first_quarter · Firm: THE NICKLES GROUP, LLC

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Cited source text and reported amounts

H.R. 1968 (P.L. 119-4), Full-Year Continuing Appropriations and Extensions Act, 2025, as it relates to add-on payments for ambulance services. Issues related to payment for Medicare ambulance services and modernizing the payment system. Issues related to access to ambulance services in Medicaid.

Client expense: — · Firm income: $50,000

Matched citations: H.R. 1968

Source: Senate LDA

GLOBAL MEDICAL RESPONSE — Lobbying Disclosure | Poliscope