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. 1261, CONNECT for Health Act, All provisions; H.R. 2191, To amend title XVII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals, All provisions; DRAFT Bill, Hospital Inpatient Services Modernization Act of 2025, all provisions; S. 335, Rural Hospital Support Act, all provisions; H.R. 1683, Protecting America's Seniors Access to Care Act, All provisions; DRAFT Bill, Clarifying that Rural Emergency Hospitals are eligible for Medicaid hospital reimbursement; Draft Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; DRAFT Bill, Resident Physician Shortage Reduction Act, All provisions; H.R. 1805, Assistance for Rural Community Hospitals (ARCH) Act, All provisions; H.R. 1924, Securing Access to Care for Seniors in Critical Condition Act of 2025, All provisions; H.R. 771, Rural Health Care Access Act of 2025, All provisions; DRAFT Bill, Supporting Healthy Moms and Babies Act, All provisions; S. 502, Rural Hospital Closure Relief Act of 2025, All provisions; Centers for Medicare & Medicaid Services (CMS), 2026 Medicare Advantage and Part D CY 2026 proposed rule, Insights on proposed policies that would increase oversight of Medicare Advantage plans and better align coverage and access under MA with Traditional Medicare; Medicare Payment Advisory Commission (MedPAC) January meeting, Inpatient and outpatient prospective payment systems (PPS), inpatient rehabilitation facilities (IRFs), hospital-based skilled nursing facilities
(SNFs), and home health (HH) agencies, and physician reimbursement; Medicare Payment Advisory Commission (MedPAC), Medicare beneficiary cost-sharing in rural facilities; Site Neutral Payments, Issues related to site neutral payment cuts; 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; 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; Physician Payments, Issues pertaining to alternative payment models, mental health of workforce, physician reimbursement cuts for 2025; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, REH's; Medicaid Program, Issues pertaining to Medicaid program.

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), 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

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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

DRAFTBill, the Safety from Violence for Healthcare Employees (SAVE) Act, all provisions; H.R.929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; DRAFT Bill, Mental Health Infrastructure Improvement Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; DRAFT Bill, Healthcare Workforce Resilience Act, all provisions; DRAFT Bill, 340B PATIENTS Act , all provisions; H.R. 1417, The Rural Health Care Technical Assistance Program Act, all provisions; S. 229, Drug-price Transparency for Consumers (DTC) Act, all provisions; H.R.330, Organ Donation Referral Improvement Act, Issues pertaining to organ donation referral process; S. 526, Pharmacy Benefit Manager Reform Act, Pharmacy benefit management services; Drug Enforcement Administration, DEAs proposed rule; Physician-Focused Payment Model Technical Advisory Committee, Population-based total cost-of-care; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Price Transparency, Issues related to hospital price transparency; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP); Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Nurse staffing mandate, workforce development programs; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, cyberattacks, and securing supply chains; Post-Acute Care, Issues pertaining to how Congress can better support patients' access to crucial services provided by Long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay; Hospital mergers and acquisitions, Issues pertaining to hospital consolidation, mergers an acquisition, physician practice acquisition, FTC premerger notification rules; Rural Emergency Hospital Designation, Issues pertaining to eligibility for the Rural Emergency Hospital designation and the expansion of physician-owned hospitals.

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), Homeland Security - Dept of (DHS), Drug Enforcement Administration (DEA)

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.Con.Res.14, Establishing the congressional budget for the United States Government for fiscal year 2025 and setting forth the appropriate budgetary levels for fiscal years 2026 through 2034, Title II - Reconciliation and Related Matters; H.R. 1968, The Full-Year Continuing Appropriations and Extensions Act, 2025, Division B / Title I - Public Health Extenders, Disaster Relief Funds, Ensuring hospitals are compensated for pandemic expenses.

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Federal Emergency Management Agency (FEMA)

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

White House, Tariffs on Canada, Mexico, and China, Tariff impact on supply chain for drugs and devices, Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax-exempt status and tax-exempt private activity bonds, Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits.

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, White House Office

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