Lobbying Disclosure Act of 1995 (Section 5) - All Filers Are Required to Complete This Page

9. Check if this filing amends a previously filed version of this report

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code MMM

16. Specific lobbying issues

S. 2761 / H.R. 5269, the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act, all provisions; H.R. 5142, The Home Health Stabilization Act, all provisions; H.R. 4313 / S. 2237, Hospital Inpatient Services Modernization Act of 2025, all provisions; S. 1261 / H.R. 4206, CONNECT for Health Act of 2025, all provisions; H.R. 1805, Assistance for Rural Community Hospitals (ARCH) Act, all provisions; H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions; S. 335, Rural Hospital Support Act, all provisions; S.1816 / H.R.3514, Improving Seniors Timely Access to Care Act, all provisions; S. 502, Rural Hospital Closure Relief Act, all provisions; S. 2439 / H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions; H.R. 4002, Patient Access to Higher Quality Health Care Act, all provisions; S.2011/ HR 3884, Telemental Health Care Access Act, all provisions; S. 2279, Protect Medicaid and Rural Hospitals Act, all provisions; H.R. 4619, Medicare Mental Health Inpatient Equity Act, all provisions; H.R. 5454/S. 2879, the Medicare Advantage Prompt Pay Act, all provisions; S. S. 2793, Ensuring Access to Essential Providers, all provisions; H.R. 6240, Rural Hospital Closure Relief Act of 2025, all provisions; DRAFT, Issues related to prior-authorization and employer-sponsored plans; HR 5467, Patient Access to Autoimmune Treatments Act, all provisions; H.R. 6148, Patients Over Paperwork Act, all provisions; Medicare Payment Advisory Commission (MedPAC), Letter to Medicare Payment Advisory Commission, Comments on the Medicare Payment Advisory Commissions (MedPACs) preliminary analysis of the association between Medicare Advantage (MA) enrollment changes and hospital finances; Centers for Medicare and Medicaid Services (CMS), Wasteful and Inappropriate Services Reduction (WISeR) model, Issues pertaining to the Wasteful and Inappropriate Services Reduction (WISeR) model; Centers for Medicare and Medicaid Services (CMS), Medicaid state-directed payments, Comments on implementation of changes to state directed payment provisions; Centers for Medicare and Medicaid Services (CMS), Provider Tax Preliminary Implementation Guidance, Comments pertaining to preliminary guidance on the implementation of sections 71115 and 71117 of H.R. 1 and impact on hospitals and health systems; Medicaid Program, Issues pertaining to Medicaid program and how states finance programs, reimburse providers, and determine beneficiary eligibility, and implementation of H.R. 1 provisions related to state directed payments and provider taxes; Site Neutral Payments, Issues related to site neutral payment cuts; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, REH's, implementation of Rural Health Transformation Program; Physician Payments, Issues pertaining to alternative payment models, mental health of workforce, physician reimbursement cuts for 2025; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay and cost-based reimbursement for critical access hospitals under Medicare Advantage, Wasteful and Inappropriate Services Reduction (WISeR) model; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees, DSH cuts; Expired Health Care Provisions, Issues pertaining to Telehealth, Hospital at Home, MDH/LVA, Medicaid DSH Program; Post Acute Care, Issues pertaining to expanding patients' access to crucial services provided by Long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies; Rural Community Hospital Demonstration Project, Issues related to ending the Rural Community Hospital Demonstration Project.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Centers For Medicare and Medicaid Services (CMS), Medicare Payment Advisory Commission (MedPAC)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

​

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code HCR

16. Specific lobbying issues

H.R. 4581 / S.2372, 340B PATIENTS Act, all provisions; H.R. 3178 / S. 1600, The Save Healthcare Workers Act, all provisions; H.R. 929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 1874, Title VIII Nursing Workforce Reauthorization Act, all provisions; S. 1784 / H.R. 4191, The Mapping America's Pharmaceutical Supply (MAPS) Act, all provisions; H.R. 5283 / S. 2759, Healthcare Workforce Resilience Act, all provisions; S. 2062, The Rolling Active Pharmaceutical Ingredient and Drug Reserve (RAPID Reserve) Act, all provisions; H.R. 5256, 340B Access Act, all provisions; S. 1929, SEPSIS Act, all provisions; S. 2355 / H.R. 5582, Patients Deserve Price Tags Act, all provisions; S. 1868, the Critical Access for Veterans Care Act, all provisions; S. 3435 / H.R. 6607, The Future Advancement of Academic Nursing, all provisions; DRAFT, Right to Re-Enroll Act of 2026, Issues related to the right of patients to use a special enrollment period if their providers are no longer in-network during the plan year; DRAFT, Issues related to how the Rural Health Transformation Fund allocates funding; S. 3097, Health Information Privacy Reform Act, all provisions; S. 2834 / H.R. 5439, Medically Tailored Home-Delivered Meals Program Pilot Act, all provisions; DRAFT, Issues pertaining to nursing school faculty workforce development; DRAFT, WELLS Act, Issues pertaining to maternal health; S. 3033, Improving Access to Care for Rural Veterans Act , all provisions; H.R. 6445/S. 3364, Fast Track Healthcare Apprenticeships Act, all provisions; H.R. 6010, The Fix it Act, all provisions; H.R. 6538 / S. 3264, The More Affordable Care Act, all provisions; Federal Trade Commission, Employer noncompete agreements- RFI, Comments on employer noncompete agreements; Office of Science and Technology Policy (OSTP) [White House], RFI regarding regulatory reform on artificial intelligence, Comments on regulatory reform on artificial intelligence; U.S Food & Drug Administration (FDA), RFI on artificial intelligence-enabled medical devices, Comments on artificial intelligence - enabled medical devices; U.S. Department of Education, Forthcoming Implementation of the One Big Beautiful Bill Acts (OBBBA) Definition of Professional Degree Programs, Comments pertaining to the changing definition of professional degree programs and impact to health care workforce; U.S. Department of Commerce, Section 232, Investigation on Medical Devices, Comments on impact of future tariffs on medical devices, PPE and other medical goods and impact to hospitals and health systems; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program, including 340B Rebate Model Pilot Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP), funding priorities; Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Issues pertaining to workforce development grants, supporting health care workforce, changing definitions of professional degree programs; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay, No Surprises Act Independent Dispute Resolution process; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, cyberattacks, cybersecurity workforce, and securing supply chains; Price Transparency, Issues related to hospital price transparency; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce; AI in Healthcare, Issues pertaining to the use of AI in healthcare; Organ procurement and transplantation, Issues pertaining to organ procurement hearings; Veterans affairs issues, Issue pertaining to sterile processing in VA clinics.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Federal Trade Commission (FTC), Food & Drug Administration (FDA), Office of Science & Technology Policy (OSTP), Education - Dept of

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

​

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code BUD

16. Specific lobbying issues

H.R. 5371, The Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act of 2026, Section 2, Division F - Health Extenders; Centers for Medicare and Medicaid Services (CMS), Impact of various expired health care waivers during government shutdown; Medicare Sequestration, Statutory PAYGO Requirements.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Centers For Medicare and Medicaid Services (CMS)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

​

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code TAX

16. Specific lobbying issues

DRAFT,Issues pertaining to FICA tax exemption for F-1 students; U.S. Department of Commerce, Section 232 Investigation on Medical Devices, Comments on impact of future tariffs on medical devices, PPE and other medical goods and impact to hospitals and health systems; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Tariffs, Issues pertaining to impact of tariffs on hospitals and health systems.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Commerce - Dept of (DOC)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

​

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code IMM

16. Specific lobbying issues

H.R. 4393, The Dignity Act, all provisions; S. 2941, Visa Cap Enforcement Act, all provisions; Department of Homeland Security (DHS), H-1B Visa Selection Process, Issues pertaining to H-1B visa weighted selection process and impact on health care workforce; U.S. Citizenship and Immigration Services (USCIS), Proposed Rule for Public Charge Ground of Inadmissibility, Comments pertaining to proposed rule regarding the Public Charge Ground of Inadmissibility and impact to hospitals and health systems; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Homeland Security - Dept of (DHS), U.S. Citizenship & Immigration Services (USCIS)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

​

Information Update Page - Complete ONLY where registration information has changed.

20. Client new address

21. Client new principal place of business (if different than line 20)

22. New General description of client’s business or activities

LOBBYIST UPDATE

23. Name of each previously reported individual who is no longer expected to act as a lobbyist for the client

ISSUE UPDATE

24. General lobbying issue that no longer pertains

AFFILIATED ORGANIZATIONS

25. Add the following affiliated organization(s)

Internet Address:

26. Name of each previously reported organization that is no longer affiliated with the registrant or client

FOREIGN ENTITIES

27. Add the following foreign entities:

28. Name of each previously reported foreign entity that no longer owns, or controls, or is affiliated with the registrant, client or affiliated organization

CONVICTIONS DISCLOSURE

29. Have any of the lobbyists listed on this report been convicted in a Federal or State Court of an offense involving bribery, extortion, embezzlement, an illegal kickback, tax evasion, fraud, a conflict of interest, making a false statement, perjury, or money laundering?
No Yes