STEVEN RIXEN

Hospital Medicare Reimbursement Rates - Urged the Centers for Medicare and Medicaid Services (CMS) to use their adjustment authority to increase Medicare reimbursement rates due to inflationary pressures that have not been fully captured in payment rules. Medicare Site-neutral Payment Policy (H.R. 3561) - Opposed inclusion of provisions to reduce Medicare payment rates for hospital outpatient department drug administration, and other services. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Also raised concerns about required use of payer-mandated pharmacy distribution using "white bagging" and "brown bagging" in Medicare Advantage. Medicare Home Infusion - Endorsed passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Supported passage of the SAVE Rural Hospitals Act (S. 803) and passage of the Rural Hospital Closure Relief Act (S. 1571)

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Hospital Financial Challenges - highlighted ongoing financial challenges facing hospitals with stagnant reimbursement, inflation and increased staffing costs. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Medicare Home Infusion - Supported efforts to improve the Medicare Home Infusion benefit and monitored the development of updated legislation. Medicare Reimbursement Reductions for 340B Drugs - Urged CMS to restore lost Medicare reimbursement for 340B drugs that was found unlawful by the Supreme Court without delay in a way that would not increase provider burden by requiring resubmission of previous claims.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Medicare Reimbursement Rates - Urged the Centers for Medicare and Medicaid Services (CMS) to use their adjustment authority to increase Medicare reimbursement rates due to inflationary pressures that have not been fully captured in payment rules. Medicare Site-neutral Payment Policy (H.R. 3561) - Opposed inclusion of provisions to reduce Medicare payment rates for hospital outpatient department drug administration, and other services. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Also raised concerns about required use of payer-mandated pharmacy distribution using "white bagging" and "brown bagging" in Medicare Advantage. Medicare Home Infusion - Endorsed passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Supported passage of the SAVE Rural Hospitals Act (S. 803) and passage of the Rural Hospital Closure Relief Act (S. 1571)

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Medicare Reimbursement Rates - Urged the Centers for Medicare and Medicaid Services (CMS) to use their adjustment authority to increase Medicare reimbursement rates due to inflationary pressures that have not been fully captured in payment rules. Medicare Site-neutral Payment Policy (H.R. 3561) - Opposed inclusion of provisions to reduce Medicare payment rates for hospital outpatient department drug administration, and other services. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Also raised concerns about required use of payer-mandated pharmacy distribution using "white bagging" and "brown bagging" in Medicare Advantage. Medicare Home Infusion - Endorsed passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Supported passage of the SAVE Rural Hospitals Act (S. 803) and passage of the Rural Hospital Closure Relief Act (S. 1571)

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Hospital Medicare Reimbursement Rates - Urged the Centers for Medicare and Medicaid Services (CMS) to use their adjustment authority to increase Medicare reimbursement rates due to inflationary pressures that have not been fully captured in payment rules. Medicare Site-neutral Payment Policy (H.R. 3561) - Opposed inclusion of provisions to reduce Medicare payment rates for hospital outpatient department drug administration, and other services. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Also raised concerns about required use of payer-mandated pharmacy distribution using "white bagging" and "brown bagging" in Medicare Advantage. Medicare Home Infusion - Endorsed passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Supported passage of the SAVE Rural Hospitals Act (S. 803) and passage of the Rural Hospital Closure Relief Act (S. 1571)

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Hospital Medicare Reimbursement Rates - Urged the Centers for Medicare and Medicaid Services (CMS) to use their adjustment authority to increase Medicare reimbursement rates due to inflationary pressures that have not been fully captured in payment rules. Medicare Site-neutral Payment Policy (H.R. 3561) - Opposed inclusion of provisions to reduce Medicare payment rates for hospital outpatient department drug administration, and other services. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Also raised concerns about required use of payer-mandated pharmacy distribution using "white bagging" and "brown bagging" in Medicare Advantage. Medicare Home Infusion - Endorsed passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Supported passage of the SAVE Rural Hospitals Act (S. 803) and passage of the Rural Hospital Closure Relief Act (S. 1571)

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Hospital Medicare Reimbursement Rates - Urged the Centers for Medicare and Medicaid Services (CMS) to use their adjustment authority to increase Medicare reimbursement rates due to inflationary pressures that have not been fully captured in payment rules. Medicare Site-neutral Payment Policy (H.R. 3561) - Opposed inclusion of provisions to reduce Medicare payment rates for hospital outpatient department drug administration, and other services. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Also raised concerns about required use of payer-mandated pharmacy distribution using "white bagging" and "brown bagging" in Medicare Advantage. Medicare Home Infusion - Endorsed passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Supported passage of the SAVE Rural Hospitals Act (S. 803) and passage of the Rural Hospital Closure Relief Act (S. 1571)

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Hospital Medicare Reimbursement Rates - Urged the Centers for Medicare and Medicaid Services (CMS) to use their adjustment authority to increase Medicare reimbursement rates due to inflationary pressures that have not been fully captured in payment rules. Medicare Site-neutral Payment Policy (H.R. 3561) - Opposed inclusion of provisions to reduce Medicare payment rates for hospital outpatient department drug administration, and other services. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Also raised concerns about required use of payer-mandated pharmacy distribution using "white bagging" and "brown bagging" in Medicare Advantage. Medicare Home Infusion - Endorsed passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Supported passage of the SAVE Rural Hospitals Act (S. 803) and passage of the Rural Hospital Closure Relief Act (S. 1571)

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Engaged to highlight how GPOs act to prevent and mitigate drug shortages. Urged greater transparency in the healthcare supply chain related to geographic locations for manufacturing, active pharmaceutical ingredients and other critical sources. Debt Ceiling Negotiations (H.R. 3746) - Opposed inclusion of work and community engagement requirements or further cuts in hospital reimbursement in debt ceiling negotiations. Pandemic and All Hazard Preparedness Act - Supported including provisions in the reauthorization of the Pandemic and All Hazards Preparedness Act that would provide greater authority to require reporting of geographic locations for sourcing of critical materials, active pharmaceutical ingredients, manufacturing, sterilization and finishing of critical medical products. Advocated for policies that would improve hospital and health system emergency preparedness. Supported improvements in transparency for the Strategic National Stockpile, greater government engagement with private sector stakeholders, automated reporting and reduced administrative burden for providers in emergencies and urged steps to support greater supply chain resilience. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers, and review of staffing agency activities during the COVID-19 pandemic. Children's Hospital Graduate Medical Education (CHGME) - Offered support for providing $738 million in funding the CHGME program. Urged Congress to reauthorize CHGME program (H.R. 3887). Telehealth - Endorsed passage of the CONNECT for Health Act(S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies that would extend flexibilities offered during the declared public health emergency and beyond the current 2024 expiration date. Medical Device Sterilization - conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Endorsed passage of the Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Endorsed passage of the Biologics Competition Act (H.R. 1790) Payer Mandated "white bagging" - Raised concerns about health plan restrictions requiring medications to be acquired through payer-affiliated pharmacies.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Drug shortages - Opposed provisions in House Energy and Commerce Committee discussion draft on drug shortages that would exempt sterile injectable products from the 340B Drug Pricing Program, and increase reporting obligations for hospitals as a and group purchasing organizations. Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Pandemic and All Hazard Preparedness Act (H.R. 4421 and H.R. 4420) - Supported timely passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. 340B Drug Pricing Program - Endorsed passage of the Protect 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Social Determinants of Health - Highlighted during congressional briefing how hospitals are investing in social determinants of health to support the health of their community. Highlighted the need for federal agencies to utilize a more comprehensive social needs index like the Vizient Vulnerability Index to identify community health needs and other social drivers of health. Healthcare Workforce - Urged passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768). Continued to highlight the need to improve healthcare staffing through investments and reauthorization of critical workforce programs, expanding access to unused visas for healthcare workers. Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840). Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Supported improved data standards and validation to improve accuracy of medical device information in the Global Unique Device Identification Database. Telehealth - Supported passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR)Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Payer-mandated White Bagging - Urged support for policy updates to place limits on payer-mandated white bagging for medications.

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers. Endorsed passage of Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (H.R. 5819/S.1378). Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) and Preparedness and Response Reauthorization Act (H.R. 4420) - Supported passage of legislation to reauthorize the Pandemic and All Hazards Preparedness Act. Advocated for including provisions to increase transparency in the healthcare supply chain and improve hospital and health system emergency preparedness. Payer-mandated White Bagging - Urged support for policy updates related to payer-mandated white bagging for medications. Drug shortages -Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Endorsed passage of the Drug Origin Transparency Act (H.R. 3810). Endorsed passage of the Biosimilar Red Tape Elimination Act (S. 2305). Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act (S. 1355/H.R. 2940). Supported passage of the Biologics Competition Act (H.R. 1790). Endorsed passage of Biosimilar Red Tape Elimination Act (S.2305) 340B Drug Pricing Program - Continued to urge action to ensure covered entities have access to 340B discounted prices through contract pharmacies. Highlighted critical importance of the 340B program for hospitals. Endorsed passage of the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act (H.R. 2534). Opposed legislation (H.R. 3290/S. 1133) that would place cumbersome reporting obligations on 340B covered entities. Buffer inventory - Engagements with CMS on reimbursement for hospitals that stockpile buffer supplies of essential medicines Mental and Behavioral Health - Highlighted during congressional briefing how hospitals are providing mental and behavioral health treatment and support for their communities. Highlighted the need for legislation to address significant challenges to mental and behavioral health treatment, including increased demand for services, limited access to treatment, and clinician shortages. Healthcare Workforce - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389 / S. 1302), the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) and the Healthcare Workforce Resilience Act (H.R 6205/S. 3211); Monitored development and introduction of the Bipartisan Primary Care and Health Workforce Act (S.2840) Children's Hospital Graduate Medical Education (CHGME) - Urged Congress to reauthorize CHGME program through the Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887). Offered support for providing $738 million in funding the CHGME program. Unique Device Identification (UDI) - Continued engagement to improve data standards and validation and support opportunities for the improved use of unique device identification and the Global UDI database (GUDID). Telehealth - Continued supporting passage of the CONNECT for Health Act (S. 2016/H.R. 4189). Continued to advocate for the adoption of permanent telehealth policies to extend flexibilities beyond the current 2024 expiration date. Social Determinants of Health - Encouraged Congress and agencies to ensure tools like the Vizient Vulnerability Index are being utilized to understand and identify social drivers of health at the neighborhood level. Medical Device Sterilization - Conducted education and outreach on the potential negative impact on the healthcare supply chain of pending regulations limiting the use of Ethylene Oxide as a medical device sterilant. Issues related to pharmacy benefit managers

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Hospital Medicare Reimbursement Rates - Urged the Centers for Medicare and Medicaid Services (CMS) to use their adjustment authority to increase Medicare reimbursement rates due to inflationary pressures that have not been fully captured in payment rules. Medicare Site-neutral Payment Policy (H.R. 3561) - Opposed inclusion of provisions to reduce Medicare payment rates for hospital outpatient department drug administration, and other services. Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to take effect in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Medicare-supported Graduate Medical Education - Endorsed passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Advantage Prior Authorization - Raised concerns about the use of prior authorization and other utilization management techniques employed by Medicare Advantage organizations. Also raised concerns about required use of payer-mandated pharmacy distribution using "white bagging" and "brown bagging" in Medicare Advantage. Medicare Home Infusion - Endorsed passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Supported passage of the SAVE Rural Hospitals Act (S. 803) and passage of the Rural Hospital Closure Relief Act (S. 1571)

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 6363). Lower Costs, More Transparency Act (H.R. 5378) - Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Urged Congress to redirect its focus from site-neutral payment policies to reducing administrative burdens and increasing, rather than reducing, payments for care delivery in rural areas. The Medicare Dependent Hospital (MDH) program and the Low Volume Hospital Payment Adjustment (LVA) - Supported passage of The Rural Hospital Support Act (S. 1110) Medicare Area Wage Index - Supported passage of the Save Rural Hospitals Act (S. 803/H.R. 3635) Rural health care - Responded to House Ways and Means Committees Request for Information on ways to improve healthcare in rural and underserved areas. Urged Congress to consider utilizing the Vizient Vulnerability Index to help identify key challenges different rural communities face. Supported passage of the Rural Hospital Closure Relief Act (S. 1571) and the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation. Proposed Medicaid Managed Care Rule - Joined several other hospital advocacy organizations in signing a letter to CMS urging the agency not to finalize proposals related to provider-supported funding in the Medicaid Managed Care Proposed Rule. Supported CMSs proposal to establish the Average Commercial Rate (ACR) as the upper payment limit for inpatient and outpatient hospital services in the context of state directed payments. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Issues related to pharmacy benefit managers; monitoring the Modernizing and Ensuring PBM Accountability (MEPA) Act (S.2973) Issues related to hospital and provider payment

Medicaid Disproportionate Hospital (DSH) payment cuts - Urged Congress to avoid Medicaid Disproportionate Share Hospital (DSH) payment cuts scheduled to begin in FY 2024. Urged passage of Supporting Safety Net Hospitals Act (H.R. 2665). Supported temporary delay of Medicaid DSH cuts in continuing resolution (H.R. 5860). Lower Costs, More Transparency Act (H.R. 5378) - Supported inclusion of provision to delay Medicaid DSH payment cuts and provisions similar to those in the Improving Seniors Timely Access to Care Act to update requirements for the use of prior authorization by Medicare Advantage organizations. Opposed adoption of site-neutral payment policies for drug administration and increased fines related to price transparency requirements for hospitals. Medicare-supported Graduate Medical Education - Supported passage of the Resident Physician Shortage Reduction Act (H.R. 2389/S. 1302). Medicare Home Infusion - Supported passage of the Preserving Patient Access to Home Infusion Act (S. 1976/H.R. 4104). Rural health care - Developed and provided feedback to the House Ways and Means Committee RFI related to improving care access in rural and underserved areas. Supported passage of the SAVE Rural Hospitals Act (S. 803/H.R. 3635); the Rural Hospital Closure Relief Act (S. 1571); the Rural Hospital Support Act (S. 1110); the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4924/S. 665). Urged further changes to Rural Emergency Hospital designation.

Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Urged additional pandemic financial support for hospitals. Advocated for investments for hospitals and health care providers, including physical structure improvements, workforce and graduate medical education support. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth -Supported provisions in the Consolidated Appropriations Act, 2022 (H.R. 2471) to temporarily extend certain flexibilities after the end of the public health emergency. Supported passage of the CONNECT for Health Act (S. 1512/H.R. 2903) to make telehealth flexibilities permanent. Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored introduction of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). Provider Relief Fund - Urged HHS and Congress to offer greater flexibility and extend deadlines for hospitals to utilize PRF funding and provide clear guidance on reporting expectations. Supported Provider Relief Deadline Extension Act (S. 2493) and Provider Relief Fund Improvement Act (H.R. 5963/S.3611). Drug Pricing - Reviewed options to further support modifications to the unapproved drugs initiative that would prevent or limit price increases for older, unapproved drugs. Supported changes to the 340B program and urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Advocated for HHS to offer additional 340B Drug Pricing Program eligibility flexibility for hospitals that have had patient mix changed during the COVID-19 public health emergency (S. 773). Supported inclusion of provisions in Consolidated Appropriations Act, 2022 (H.R. 2471) that would extend eligibility for covered entities that may have lost eligibility during the public health emergency. Medical Device User Fee Amendments - Urged greater authorities for the FDA to promote supply chain transparency. Generic Drug User Fee Amendments - Supported rapid adoption of generic drug user fee amendments, and urged inclusion of clarifying language related to the Unapproved Drugs Initiative and the PASTUER Act (S.2076). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Supported adoption of effort to reduce greenhouse gas emissions and environmentally preferred sourcing for health care supplies. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (S. 1512/H.R. 2903) and encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored Senate Committee adoption of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Food and Drug Administration User Fees (S. 4348, H.R.7667) - Urged inclusion of provisions in FDA user fee legislation to provide greater authorities for the FDA to promote supply chain transparency, clarifying language related to the Unapproved Drugs Initiative, the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

Healthcare Supply Chain - Highlighted the important role played by hospital group purchasing organizations in promoting resiliency and value in healthcare purchasing. Provided information on ongoing efforts to reduce greenhouse gas emissions and support environmentally preferred sourcing for healthcare supplies. Engaged to support policies to ensure greater transparency and mitigate or limit shortages of prescription drugs. Supported policies that would expedite critical cargo, including cargo necessary for medical care, during a public health emergency or disaster. Food and Drug Administration User Fee Amendments - Supported passage of legislation to extend user-fee authorities ((S. 4348, H.R.7667, H.R. 6833). Advocated for greater transparency in the health care supply chain for drugs and medical devices. Supported updating language related to the Unapproved Drugs Initiative, and incorporating the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084) in final passage. Inflation Reduction Act (H.R. 5376) - Supported extension of enhanced subsidies through the health insurance marketplace. Supported provisions that would increase reimbursement for biosimilar medications and monitored impact of other policies impacting prices of prescription drugs. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (S. 1512/H.R. 2903) and the Extending Telehealth Beyond COVID-19 Act (H.R. 4040). Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored PREVENT Pandemics Act and supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493). Supported passage of the Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053).

Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Supported adoption of effort to reduce greenhouse gas emissions and environmentally preferred sourcing for health care supplies. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (S. 1512/H.R. 2903) and encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored Senate Committee adoption of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Food and Drug Administration User Fees (S. 4348, H.R.7667) - Urged inclusion of provisions in FDA user fee legislation to provide greater authorities for the FDA to promote supply chain transparency, clarifying language related to the Unapproved Drugs Initiative, the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

Healthcare Supply Chain - Highlighted the important role played by hospital group purchasing organizations in promoting resiliency and value in healthcare purchasing. Engaged to support policies to ensure greater transparency and mitigate or limit shortages of prescription drugs. Supported policies that would expedite critical cargo, including cargo necessary for medical care, during a public health emergency or disaster. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Supported updating language related to the Unapproved Drugs Initiative, and incorporating the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084) in omnibus legislation (H.R. 2617). Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (H.R. 2617 S. 1512/H.R. 2903) and the Extending Telehealth Beyond COVID-19 Act (H.R. 4040). Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255). Urged administration to examine practices of health care staffing agencies and supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799; H.R 2617) - monitored PREVENT Pandemics Act and supported inclusion of provisions to improve supply chain transparency, enhance cybersecurity of medical devices and extend shelf life of prescription drugs in omnibus legislation. 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortages Shelf Life Extension Act (S. 3493). Supported passage of the Biologics Competition Act (H.R. 8877).

Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Urged additional pandemic financial support for hospitals. Advocated for investments for hospitals and health care providers, including physical structure improvements, workforce and graduate medical education support. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth -Supported provisions in the Consolidated Appropriations Act, 2022 (H.R. 2471) to temporarily extend certain flexibilities after the end of the public health emergency. Supported passage of the CONNECT for Health Act (S. 1512/H.R. 2903) to make telehealth flexibilities permanent. Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored introduction of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). Provider Relief Fund - Urged HHS and Congress to offer greater flexibility and extend deadlines for hospitals to utilize PRF funding and provide clear guidance on reporting expectations. Supported Provider Relief Deadline Extension Act (S. 2493) and Provider Relief Fund Improvement Act (H.R. 5963/S.3611). Drug Pricing - Reviewed options to further support modifications to the unapproved drugs initiative that would prevent or limit price increases for older, unapproved drugs. Supported changes to the 340B program and urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Advocated for HHS to offer additional 340B Drug Pricing Program eligibility flexibility for hospitals that have had patient mix changed during the COVID-19 public health emergency (S. 773). Supported inclusion of provisions in Consolidated Appropriations Act, 2022 (H.R. 2471) that would extend eligibility for covered entities that may have lost eligibility during the public health emergency. Medical Device User Fee Amendments - Urged greater authorities for the FDA to promote supply chain transparency. Generic Drug User Fee Amendments - Supported rapid adoption of generic drug user fee amendments, and urged inclusion of clarifying language related to the Unapproved Drugs Initiative and the PASTUER Act (S.2076). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

Build Back Better Act (H.R. 5376) - Supported inclusion of 4,000 Medicare-supported Graduate Medical Education slots as part of Build Back Better Act. Supported policies to encourage health care coverage and close the Medicaid coverage gap. Medicare Sequestration - Urged Congress to avoid full resumption of Medicare sequestration payment reductions and act to prevent sequestration cuts due to statutory PAYGO requirements. Health Care Workforce - Supported legislation (S.834/H.R. 2256; S. 1438) to increase the number of Medicare-supported Graduate Medical Education slots. Supported the Opioid Workforce Act (S. 1438/H.R. 3441). Advocated for increased funding for Children's Hospital Graduate Medical Education funding. Supported passage of legislation - Strengthen Kids Mental Health Now Act (H.R. 7236). Telehealth - Advocated for Congress to extend or make permanent flexibilities related to distant site and geographic limitations, expanding the provider types and services available to be reimbursed by Medicare. Supported provisions in the Consolidated Appropriations Act, 2022 (H.R. 2471) to temporarily extend certain flexibilities after the end of the public health emergency. Urged passage of the CONNECT for Health Act (S. 1512/H.R. 2903). Social Determinants of Health and Health Equity - Engaged and offered feedback on proposals from CMS to provide resources and context to better assess patient obstacles to accessing health care and their impact on health care outcomes. Supported passage of the Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053). Supported passage of the Preserving Access to Home Infusion Act (H.R. 5067).

Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Urged additional pandemic financial support for hospitals. Advocated for investments for hospitals and health care providers, including physical structure improvements, workforce and graduate medical education support. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth -Supported provisions in the Consolidated Appropriations Act, 2022 (H.R. 2471) to temporarily extend certain flexibilities after the end of the public health emergency. Supported passage of the CONNECT for Health Act (S. 1512/H.R. 2903) to make telehealth flexibilities permanent. Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored introduction of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). Provider Relief Fund - Urged HHS and Congress to offer greater flexibility and extend deadlines for hospitals to utilize PRF funding and provide clear guidance on reporting expectations. Supported Provider Relief Deadline Extension Act (S. 2493) and Provider Relief Fund Improvement Act (H.R. 5963/S.3611). Drug Pricing - Reviewed options to further support modifications to the unapproved drugs initiative that would prevent or limit price increases for older, unapproved drugs. Supported changes to the 340B program and urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Advocated for HHS to offer additional 340B Drug Pricing Program eligibility flexibility for hospitals that have had patient mix changed during the COVID-19 public health emergency (S. 773). Supported inclusion of provisions in Consolidated Appropriations Act, 2022 (H.R. 2471) that would extend eligibility for covered entities that may have lost eligibility during the public health emergency. Medical Device User Fee Amendments - Urged greater authorities for the FDA to promote supply chain transparency. Generic Drug User Fee Amendments - Supported rapid adoption of generic drug user fee amendments, and urged inclusion of clarifying language related to the Unapproved Drugs Initiative and the PASTUER Act (S.2076). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Supported adoption of effort to reduce greenhouse gas emissions and environmentally preferred sourcing for health care supplies. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (S. 1512/H.R. 2903) and encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored Senate Committee adoption of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Food and Drug Administration User Fees (S. 4348, H.R.7667) - Urged inclusion of provisions in FDA user fee legislation to provide greater authorities for the FDA to promote supply chain transparency, clarifying language related to the Unapproved Drugs Initiative, the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

Medicare PAYGO Sequestration - (H.R 2617) - Supported inclusion of provisions in the Consolidated Appropriations Act to prevent 4% Medicare payment reductions due to sequestration required by statutory PAYGO requirements. Medicare Physician Reimbursement (H.R. 2617; H.R. 8800) - Supported legislation that would ease pending reimbursement cuts through the physician fee schedule conversion factor. Health Care Workforce (S.834/H.R. 2256; S. 1438/H.R. 3441; H.R. 2617) - Supported legislation to increase the number of Medicare-supported Graduate Medical Education slots. Advanced Alternative Payment Model (APM) Bonus Payment (H.R. 4587; H.R. 2617) - Supported passage of legislation to extend the APM bonus payments. Telehealth (H.R. 2617; H.R. 4040; S. 1512/H.R. 2903)- Advocated for Congress to extend or make permanent flexibilities related to distant site and geographic limitations, expanding the provider types and services available to be reimbursed by Medicare. Acute Hospital Care at Home Model (H.R. 2617; S. 3792/H.R. 7053) Supported passage of legislation to extend the Acute Hospital Care at Home Model beyond the end of the declared Public Health Emergency. Rural Health Care Extenders (H.R. 2617) - Supported extension of Medicare Dependent Hospital program and Medicare Low-Volume Adjustment. Mental and Behavioral Health (S. 4747; H.R. 7236; H.R. 2617) - Supported passage of legislation to better support access to mental and behavioral health needs for children and adults. Supported passage of the Improving Seniors' Timely Access to Care Act (S.3018/ H.R.3173). Supported passage of the Preserving Access to Home Infusion Act (H.R. 5067/S. 2652).

Build Back Better Act (H.R. 5376) - Supported inclusion of 4,000 Medicare-supported Graduate Medical Education slots as part of Build Back Better Act. Supported policies to encourage health care coverage and close the Medicaid coverage gap. Medicare Sequestration - Urged Congress to continue delay of Medicare sequestration payment reductions and act to prevent sequestration cuts due to statutory PAYGO requirements. Health Care Workforce - Supported legislation (S.834/H.R. 2256; S. 1438) to increase the number of Medicare-supported Graduate Medical Education (GME) slots. Supported the Opioid Workforce Act (S. 1438/H.R. 3441). Telehealth - Advocated for Congress to extend or make permanent flexibilities related to distant site and geographic limitations, expanding the provider types and services available to be reimbursed by Medicare. Supported provisions in the Consolidated Appropriations Act, 2022 (H.R. 2471) to temporarily extend certain flexibilities after the end of the public health emergency. Urged passage of the CONNECT for Health Act (S. 1512/H.R. 2903). Social Determinants of Health and Health Equity - Engaged and offered feedback on proposals from CMS to provide resources and context to better assess patient obstacles to accessing health care and their impact on health care outcomes. Supported passage of the Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053). Supported passage of the Preserving Access to Home Infusion Act (H.R. 5067). Advanced and Accelerated Payments Program - Urged Congress to act to provide further flexibility for repayment of advanced payments under the Medicare Advanced and Accelerated Payments Program.

Healthcare Supply Chain - Highlighted the important role played by hospital group purchasing organizations in promoting resiliency and value in healthcare purchasing. Provided information on ongoing efforts to reduce greenhouse gas emissions and support environmentally preferred sourcing for healthcare supplies. Engaged to support policies to ensure greater transparency and mitigate or limit shortages of prescription drugs. Supported policies that would expedite critical cargo, including cargo necessary for medical care, during a public health emergency or disaster. Food and Drug Administration User Fee Amendments - Supported passage of legislation to extend user-fee authorities ((S. 4348, H.R.7667, H.R. 6833). Advocated for greater transparency in the health care supply chain for drugs and medical devices. Supported updating language related to the Unapproved Drugs Initiative, and incorporating the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084) in final passage. Inflation Reduction Act (H.R. 5376) - Supported extension of enhanced subsidies through the health insurance marketplace. Supported provisions that would increase reimbursement for biosimilar medications and monitored impact of other policies impacting prices of prescription drugs. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (S. 1512/H.R. 2903) and the Extending Telehealth Beyond COVID-19 Act (H.R. 4040). Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored PREVENT Pandemics Act and supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493). Supported passage of the Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053).

Inflation Reduction Act (H.R. 5376) - Supported inclusion of 4,000 Medicare-supported Graduate Medical Education slots as part of the Inflation Reduction Act. Supported policies to encourage health care coverage and close the Medicaid coverage gap. Monitored impact of Medicare reimbursement provisions for prescription drugs in final legislation. Medicare Provider Reimbursement - Raised concerns about adequacy of payment updates through annual payment rules and urged Congress to provide additional support. Advocated for Congress to extend Medicare sequestration relief through the end of the COVID-19 Public Health Emergency and act to prevent sequestration cuts beginning in 2023 due to statutory PAYGO requirements. Medicare Physician Reimbursement - Supported passage of Supporting Medicare Providers Act (H.R. 8800) to ease pending reimbursement cuts through the physician fee schedule conversion factor. Health Care Workforce - Supported legislation (S.834/H.R. 2256; S. 1438) to increase the number of Medicare-supported Graduate Medical Education slots. Supported the Opioid Workforce Act (S. 1438 /H.R. 3441). Advanced Alternative Payment Model (APMs) Bonus Payment - Supported passage of the Value in Healthcare Act (H.R. 4587) to extend the APM bonus payments. Strengthen Kids Mental Health Now Act (H.R. 7236). Telehealth - Advocated for Congress to extend or make permanent flexibilities related to distant site and geographic limitations, expanding the provider types and services available to be reimbursed by Medicare. Urged passage of the CONNECT for Health Act (S. 1512/H.R. 2903). Supported passage of Advancing Telehealth Beyond COVID-19 Act (H.R. 4040). Social Determinants of Health and Health Equity - Engaged and offered feedback on proposals from CMS to provide resources and context to better assess patient obstacles to accessing health care and their impact on health care outcomes. Supported passage of the Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053). Supported passage of the Improving Seniors' Timely Access to Care Act (S.3018/ H.R.3173). Supported passage of the Preserving Access to Home Infusion Act (H.R. 5067/S. 2652).

Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Urged additional pandemic financial support for hospitals. Advocated for investments for hospitals and health care providers, including physical structure improvements, workforce and graduate medical education support. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth -Supported provisions in the Consolidated Appropriations Act, 2022 (H.R. 2471) to temporarily extend certain flexibilities after the end of the public health emergency. Supported passage of the CONNECT for Health Act (S. 1512/H.R. 2903) to make telehealth flexibilities permanent. Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored introduction of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). Provider Relief Fund - Urged HHS and Congress to offer greater flexibility and extend deadlines for hospitals to utilize PRF funding and provide clear guidance on reporting expectations. Supported Provider Relief Deadline Extension Act (S. 2493) and Provider Relief Fund Improvement Act (H.R. 5963/S.3611). Drug Pricing - Reviewed options to further support modifications to the unapproved drugs initiative that would prevent or limit price increases for older, unapproved drugs. Supported changes to the 340B program and urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Advocated for HHS to offer additional 340B Drug Pricing Program eligibility flexibility for hospitals that have had patient mix changed during the COVID-19 public health emergency (S. 773). Supported inclusion of provisions in Consolidated Appropriations Act, 2022 (H.R. 2471) that would extend eligibility for covered entities that may have lost eligibility during the public health emergency. Medical Device User Fee Amendments - Urged greater authorities for the FDA to promote supply chain transparency. Generic Drug User Fee Amendments - Supported rapid adoption of generic drug user fee amendments, and urged inclusion of clarifying language related to the Unapproved Drugs Initiative and the PASTUER Act (S.2076). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

Build Back Better Act (H.R. 5376) - Supported inclusion of 4,000 Medicare-supported Graduate Medical Education slots as part of Build Back Better Act. Supported policies to encourage health care coverage and close the Medicaid coverage gap. Medicare Sequestration - Urged Congress to avoid full resumption of Medicare sequestration payment reductions and act to prevent sequestration cuts due to statutory PAYGO requirements. Health Care Workforce - Supported legislation (S.834/H.R. 2256; S. 1438) to increase the number of Medicare-supported Graduate Medical Education slots. Supported the Opioid Workforce Act (S. 1438/H.R. 3441). Advocated for increased funding for Children's Hospital Graduate Medical Education funding. Supported passage of legislation - Strengthen Kids Mental Health Now Act (H.R. 7236). Telehealth - Advocated for Congress to extend or make permanent flexibilities related to distant site and geographic limitations, expanding the provider types and services available to be reimbursed by Medicare. Supported provisions in the Consolidated Appropriations Act, 2022 (H.R. 2471) to temporarily extend certain flexibilities after the end of the public health emergency. Urged passage of the CONNECT for Health Act (S. 1512/H.R. 2903). Social Determinants of Health and Health Equity - Engaged and offered feedback on proposals from CMS to provide resources and context to better assess patient obstacles to accessing health care and their impact on health care outcomes. Supported passage of the Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053). Supported passage of the Preserving Access to Home Infusion Act (H.R. 5067).