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.5378, Lower Costs, More Transparency Act, Issues related to site neutral payment cuts, hospital price transparency, unique health identifier, 340B Program; H.R. 3173 / S. 4532, Improving Seniors' Timely Access to Care, all provisions; S.4350 / H.R. 8260, Hospital Inpatient Services Modernization Act of 2024, all provisions; Draft Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; S.4338, the Pay PCPs Act , Feedback to improve physician reimbursement and value-based primary care; S. 1110, the Rural Hospital Support Act, all provisions; H.R. 6430, Assistance for Rural Community Hospitals (ARCH)Act, all provisions; H.R. 7711, Advancing Access to Telehealth Act,all provisions; H.R. 3432, Telemental Health Care Access Act, all provisions; H.R. 3875, the Expanded Telehealth Access Act, all provisions; H.R. 5611, Helping Ensure Access to Local Telehealth (HEALTH) Act of 2023, all provisions; H.R. 6033, Supporting Patient Education and Knowledge (SPEAK) Act of 2023, all provisions; Draft Bill, To amend title XVIII of the Social Security Act to adjust long-term care hospital payment rates under the Medicare program, Issues related to LTCH payment policy reforms; S. 5236, A bill to amend titles XIX and XXI of the Social Security Act to enhance financial support for rural and safety net hospitals providing maternity, labor, and delivery services to vulnerable populations, and for other purposes, Reimbursements to rural and safety net hospitals providing maternity, labor, and delivery services; H.R. 7623, Telehealth Modernization Act, Issues pertaining to Telehealth, Hospital at Home, Unique Health Identifier; H. Jes Res 139 / S.J. Res 91, A joint resolution for congressional disapproval of a rule relating to "Medicare and Medicaid Programs, Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting", All provisions; S. 2016/ H.R. 4189, The CONNECT for Health Act of 2023, Specifically telehealth waivers, geographic restrictions, originating site requirements, in person requirement behavioral health, RHCs and FQHCs access; H.R. 1110, KEEP Telehealth Option Act, All provisions; H.R. 5541, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, All provisions; HR 2389/ S. 1302, Resident Physician Shortage Reduction Act of 2023, All provisions; H.R. 977/S. 470, Patient Access to Higher Quality Care Act, all provisions; Draft Bill, Obstetric care in Critical Access Hospitals (CAH); Centers for Medicare & Medicaid Services (CMS), Medicare Drug Price Negotiation Program Draft Guidance, Issues pertaining to the implementation of the Medicare drug price negotiation program; Centers for Medicare & Medicaid Services (CMS), Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model, Issues pertaining to Value Based Care and feedback on proposed IOTA model; Centers for Medicare & Medicaid Services (CMS), FY 2025 Inpatient Prospective Payment Systems for Acute Care Hospitals; Disproportionate Share Hospital Payments, Issues pertaining to the FY2025 Inpatient Prospective Payment Systems Rule and Disproportionate Share Hospital Payments Changes in FY25 IPPS Rule; Medicare Payment Advisory Commission (MedPAC), 2025 Priorities, Issues pertaining to 340B Drug Pricing Program, inpatient rehabilitation facility (IRF) payments, the physician fee schedule (PFS) and telehealth in the new cycle; Centers for Medicare & Medicaid Services (CMS), Calendar Year (CY) 2025 Home Health Prospective; Payment System (HH PPS) Rate Update, Issues pertaining to the CY25 Home Health Proposed Rule; Centers for Medicare & Medicaid Services (CMS), Physician fee schedule (PFS) proposed rule for calendar year (CY) 2025, Issues pertaining to physician fee schedule; Centers for Medicare & Medicaid Services (CMS), Outpatient Prospective Payment System (OPPS) Proposed rule for Calendar Year (CY2025), Issues pertaining to outpatient and ambulatory surgery center prospective payment system, conditions of participation for maternal health; Health & Human Services (HHS), Letter to HHS, Medicare Advantage Organizations' Use of Prior Authorization for Post-Acute Care; Centers for Medicare & Medicaid Services (CMS), Significant, Anomalous and Highly Suspect (SAHS) billing in Medicare Shared Savings Program (MSSP) in Calendar Year 2023, Issues pertaining to proposed rule to mitigate the impact of significant, anomalous and highly suspect (SAHS) billing activity within the Medicare Shared Savings Program (MSSP) in calendar year (CY) 2023; Site Neutral Payments, Issues related to site neutral payment cuts for drug administration; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees, DSH cuts; Medicaid Disproportionate Share Hospital (DSH) program, Medicaid DSH program; LTCH High Cost Outlier Threshold, SFC / W&M Meeting / CMS Meeting , Issues concerning High Cost Outlier in LTCH payment policy; National Provider Identifier (NPI), Included in E&C markup statement in September , Unique identifiers for off-campus Hospital Outpatient Departments (HOPDs); Access to inpatient rehabilitation care, Letter to CMS / Supported Hill Led Effort, Access to inpatient rehabilitation care for MA enrollees; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, and REHs; Physician Payments, Issues pertaining to proposed solutions to improve MACRA, alternative payment models, mental health of workforce; 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.

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

Draft Bill , 340B SUSTAIN Act, Issues pertaining to 340B Program access; H.R.9412 , Healthcare Cybersecurity Act of 2024, Issues pertaining to cyber security for health care field; Draft Bill , Strengthening Pathways to Healthcare Professions Act of 2024, Strengthening HRSA health workforce programs; H.R.8574, the 340B Affording Care for Communities and Ensuring a Strong Safety-net (340B ACCESS) Act, Issues pertaining to 340B Program access; H.R. 2584/ S. 2768, the Safety from Violence for Healthcare Employees (SAVE) Act, all provisions; S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, all provisions; S.665 / H.R. 4942, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S 3679 / H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; H.R. 7635, The 340B PATIENTS Act, all provisions; S. 4289, Medical Debt Cancellation Act , all provisions; H.R. 3120, Healthy Competition for Better Care Act, all provisions; H.R. 9457, Transparent Telehealth Bills Act of 2024, all provisions; S. 3770/ H.R. 7266, The Future Advancement of Academic Nursing (FAAN Act), all provisions; S. 1176 / H.R. 2663 , Workplace Violence Prevention for Health Care and Social Service Workers Act, all provisions; S. 5025 , the SEPSIS Act , all provisions; Draft Bill , Rural 340B Access Act, Issues pertaining 340B Program access; Draft Bill , Draft Bill , Freestanding Emergency Departments; Cybersecurity and Infrastructure Security Agency (CISA) - Dept. Homeland Sec., Cyber Incident Reporting for Critical Infrastructure Act (CIRCIA) Reporting Requirements, Feedback on reporting requirements for cybersecurity incidents under CIRCIA; Occupational Safety and Health Administration (OSHA)Occupational Safety and Health Administrations (OSHA) proposed emergency response standard, Feedback to strengthen OSHA's emergency response standard for hospitals and health systems and their workforce; Health Resources Services Administration (HRSA), J&J Rebate Model for 340B Program, Feedback on Johnson & Johnson rebate model for 340B Program; Medical Debt, Issues specific to medical debt incurred by patients and hospital billing and collection practices; Price Transparency, STMT to Committee on Aging, Issues related to hospital price transparency; Cyber Security, Issues pertaining to ongoing cyber risks to the health care field. Change Health Care cyber-attack, breach notifications CrowdStrike, OneBlood, health records; Rural Health Care Access, Issues to protect access to rural health care; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status; Maternal Health and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP) and impact of recent payment rules; Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay; Drug Prices, Included in Cost of Healthcare Hearing , Issues related to prescription drug prices; Physician Owned Hospitals, Hill meetings, Physician-owned hospitals; 340B Program, Hill Letter, Johnson and Johnson 340B Proposal; DEA Telehealth Waivers, Telemedicine prescribing of controlled substances; Workforce, nurse staffing mandate, workforce development programs; Health Professions Diversity, National health service corps; centers of excellence; health careers opportunity programs; Hospital mergers and acquisitions, Issues pertaining to hospital consolidation, mergers an acquisitions, physician practice acquisition; Supply Chain Issues, HHS Calls, Issues pertaining to supply chain issues for medical devices and blood shortages; Rural 340B Access Act , Hill visit, Hill discussion about the Rural 340B Access Act (House and Senate); Outstanding COVID reimbursement for hospitals, Check in with FEMA, FEMA outreach about outstanding COVID reimbursement for 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), Health Resources & Services Administration (HRSA), Labor - Dept of (DOL), Homeland Security - Dept of (DHS), Occupational Safety & Health Administration (OSHA), Drug Enforcement Administration (DEA), White House Office, Justice - Dept of (DOJ)

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

FEMA Disaster Relief Funding, additional funding for FEMAs Disaster Relief Fund (DRF).

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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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