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

H.R. 1, The One Big Beautiful Bill Act (OBBBA)Title VII - Committee on Finance; Subtitle B - Health Care: Issues pertaining to Medicaid, Medicare, Health tax, and Protecting Rural Hospitals and Providers; S. Amdt. 2554 to S. Amdt. 2360 to H.R.1, Scott, Crapo, Johnson, Lee, Lummis Amendment, 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. 786/ S. 1460, Preserving Patient Access to Accountable Care Act, all provisions; H.R. 5120, Hospitals As Naloxone Distribution Sites (HANDS) 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. 4470, The Removing Burdens from Organ Donations Act, all provisions; DRAFT, Issues pertaining to compounding of drugs; DRAFT, Legislation to provide relief for Long-Term Care Hospitals (LTCHs); DRAFT, Comments pertaining to legislative relief for independent rural hospitals; H.R.5081, Telehealth Modernization Act, all provisions; Centers for Medicare & Medicaid Services (CMS), RFI: Hospital Price Transparency Accuracy and Completeness Request for Information, Issues pertaining to the accuracy and completeness of hospitals machine-readable files; Centers for Medicare & Medicaid Services (CMS), Rural Health Transformation Fund implementation/revisions, Comments on the Rural Health Transformation Program application and award process; Centers for Medicare & Medicaid Services (CMS), Outpatient Prospective Payment System (OPPS) Proposed rule for Calendar Year (CY2026), Issues pertaining to outpatient and ambulatory surgery center prospective payment system, conditions of participation for maternal health; Centers for Medicare & Medicaid Services (CMS), "Calendar Year (CY) 2026 Home Health Prospective; Payment System (HH PPS) Rate Update", Issues pertaining to the CY26 Home Health Proposed Rule; Centers for Medicare & Medicaid Services (CMS), Physician fee schedule (PFS) proposed rule for calendar year (CY) 2026, Issues pertaining to physician fee schedule; Department of Health & Human Services (HHS) and Centers for Medicare & Medicaid Services, Health Insurer Commitment Prior Auth Process, Issues pertaining to insurer commitment to improved prior authorization processes; Medicaid Program, Issues pertaining to Medicaid program and how states finance programs, reimburse providers, and determine beneficiary eligibility; 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; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees, DSH cuts; Expiring Health Care Provisions, Issues pertaining to Telehealth, Hospital at Home, MDH/LVA, Medicaid DSH Program; Rural Health Transformation Fund, Issues pertaining to implementation and impact on rural hospitals.

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), Health & Human Services - Dept of (HHS)

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

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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. 1874Title 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; H.R. 5428, Medical Student Education Authorization Act, all provisions; S. 1929, SEPSIS Act, all provisions; H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions; S. 2062, Rolling Active Pharmaceutical Ingredient and Drug Reserve (RAPID) Reserve Act, all provisions; S. 921, Tyler's Law, all provisions; H.R. 3482, Veterans Community Care Scheduling Improvement Act, all provisions; HR 3483, Forcing Real Accountability for Unlawful Distributions Act (FRAUD) Act of 2025, all provisions; HR 3494, VA Hospital Inventory Management System Authorization Act, all provisions; H.R. 3413, Physician and Patient Safety Act, all provisions; H.R. 2936, Addressing Boarding and Crowding in the Emergency Department, all provisions; Department of Health & Human Services (HHS), AHRQ 2025-001 Request for Information; Ensuring Lawful Regulation and Unleashing Innovation to Make America Healthy Again, Comments on easing administrative burdens and encouraging innovation in health care; Health Resources & Services Administration (HRSA); Health Resources and Services Administration (HRSA), 340B Rebate Model Pilot Program, Comments pertaining to 340B Rebate Model Pilot Program; 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 and supporting health care workforce; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, cyberattacks, cybersecurity workforce, and securing supply chains; Price Transparency, Issues related to hospital price transparency; Post Acute Care, Issues pertaining to expanding patients' access and easy regulatory burdens to crucial services provided by Long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies; 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; Organ Procurement, Issues pertaining to organ procurement and transplantation.

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Health & Human Services - Dept of (HHS), Health Resources & Services Administration (HRSA)

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

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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. 1, The One Big Beautiful Bill Act (OBBBA)Title VII - Committee on Finance; Subtitle B - Health Care: Issues pertaining to Medicaid, Medicare, Health tax, and Protecting Rural Hospitals and Providers; Funding Priorities for Fiscal Year 2026, FY26 Appropriations Process, Strengthening the health care workforce, maternal and child health, rural health, disaster preparedness, behavioral health and medical research.

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES

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

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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

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

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

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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

Department of Homeland Security, H1-B Visa Program Changes, Issues pertaining to H1-B visa program changes; Department of Homeland Security, Duration of Status Proposed Rule, Issues pertaining to Duration of Status proposed rule for J-1 visas; Immigration, Issues pertaining to changes in immigration policy and impact on 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)

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

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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