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. 879, Medicare Patient Access and Practice Stabilization Act of 2025: payment rates
H.R. 1317 (2025-2026), I CAN Act: provision of service under Medicare
Medicare sequester, PAYGO
Medicare Advantage Upcoding
Medicare for All/Public Option
Historical Medicare payment undervaluation for anesthesiology services (33% problem)
Anesthesia Conversion Factor
Medicare Physician Fee Schedule Rule
Budget neutrality
Medicare Economic Index: Medicare inflationary increase
Medicaid
Bundled payments
H.R. 5454/S. 2879 Medicare Advantage Prompt Pay Act
WISeR Model

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), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO)

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

Graduate Medical Education
Certified Anesthesiologist Assistants
Anesthesia workforce shortages
HR 3890, Resident Physician Shortage Reduction Act of 2025: residency positions
S.709, Conrad State 30 and Physician Access Reauthorization Act: Foreign physician immigration status
S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act: physician shortages in rural areas
HR 2028; Resident Education Deferred Interest Act (REDI Act): Student loan relief
Anesthesia Research Funding
Scope of Practice
Merit-based Incentive Payment System, MIPS, MIPS Value Pathway
Quality Payment Program, QPP
Alternative Payment Model, APM
QCDR - Qualified Clinical Data Registry
Evaluation and Monitoring codes & cuts
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
Brain health
CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services
Conditions of Participation - Anesthesia services, opt-outs, supervision
CMS: Federal Independent Dispute Resolution (IDR) Process, Batching
H.R.27, HALT Fentanyl Act: fentanyl scheduling and registration requirements
H.R. 1227/S.475, Alternatives to PAIN Act of 2025: access to non-opioid pain management options
Pain Medicine
Prescription Drug Abuse
CDC Opioid Prescribing Guideline
H.R. 3595, Safe Prescribing Through Reporting Act of 2025: disclosure of certain records relating to substance use disorder medications to State prescription drug monitoring programs
Drug shortages
DEA Scheduling Propofol
FDA Safe Use Initiative
FDA Operating Room Fires
FDA Opioids
FDA Network of Experts
FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding)
USP - US Pharmacopeia
Compounding
NIH Interagency Pain Research Coordinating Committee
NIH: Funding, Indirect Costs, Indirect Grants, Overhead
Agency for Healthcare Research and Quality (AHRQ) funding
Long COVID research
21st Century Cures Initiative
Out of Network/Out of Network Payment
Network Adequacy
Pre-authorization; prior authorization
Insurance reform, shared savings, insurer accountability
Affordable Care Act reform efforts
Provider Nondiscrimination
Change Healthcare, Change Healthcare data breach
HR 292 Lorna Breen Reauthorization
H.R. 3178, SAVE Healthcare Workers Act: To protect hospital personnel from violence, and for other purposes
Maternal Mortality/Maternal Care Deserts
Blood management
42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care
S. 2759/H.R. 5283, the Healthcare Workforce Resilience Act,
Exemption for Physicians from New H-1B Visa Policy and $100,000 Fee
Medical journal fees
No Surprises Act (NSA) - H.R.4710 / S. 2420, the No Surprises Enforcement Act
H.R. 3164, the Ensuring Community Access to Pharmacist Services Act
Advance Premium Tax Credits (APTCs)
Federal regulation of commercial health insurance companies
One Big Beautiful Bill (OBBB)

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Food & Drug Administration (FDA), Justice - Dept of (DOJ), Health & Human Services - Dept of (HHS), Drug Enforcement Administration (DEA), Office of Management & Budget (OMB), Executive Office of the President (EOP), Defense - Dept of (DOD), Occupational Safety & Health Administration (OSHA), Federal Trade Commission (FTC), Veterans Affairs - Dept of (VA), Natl Institutes of Health (NIH), Centers For Medicare and Medicaid Services (CMS), White House Office, Centers For Disease Control & Prevention (CDC), Agency for Healthcare Research & Quality (AHRQ)

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 VET

16. Specific lobbying issues

Veterans Affairs Advance Practice Registered Nurses
HR 3944, Mil Con VA: Military Construction, Veterans Affairs, and Related Agencies Appropriations Act of 2026
VA Physician/Provider Hiring
Federal Supremacy Initiative (National Standards of Practice): reduction in patient safety standard
Defense Health Agency (DHA): Physician-led care and scope of practice
VHA Directive 1123, National Anesthesia Program/Safe Anesthesia Standards in the VA
Defense Health Agency anesthesia policy

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

Veterans Affairs - Dept of (VA), 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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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