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 HCR

16. Specific lobbying issues

Oppose H.R. 1 limitations on premium tax credit eligibility and support legislatively delaying implementation.
Support permanently extending Affordable Care Act enhanced premium tax credits.
Support 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act, support PATIENTS Act, oppose HRSA back-end rebate models.
Support recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training sites, and immigration reforms that expedite entry for foreign health care workers.
Support SAVE Healthcare Workers Act (H.R. 3178/S. 1600).
Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875.
Discuss FEMA COVID-19 Public Assistance payouts to hospitals with Congressional staff.
Support SEPSIS Act (S.1929).
Discuss New York State application for Section 1331 Basic Health Plan waiver with Congressional staff and CMS staff.
Discuss Section 1332 State Innovation Waiver with Congressional staff.
Discuss legislative proposals to regulate the use of artificial intelligence in health care settings with Congressional staff.
Discuss non-profit tax-exempt status of hospitals and examples of community benefit for IRS purposes.
Discuss 2026 New York City nurses strike with Congressional staff.
Discuss commercial insurance reform with Congressional staff.

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), 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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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

Support Medicare graduate medical education (GME) expansion and legislative proposals to expand Medicare GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act, additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act.
Discuss technical amendment to CAA, 2021, Sec. 131 to address artificially low GME caps with Congressional staff.
Discuss with Congressional staff distribution methodology for Medicare GME slots created in the CAA, 2021.
Discuss rural reclassification for Medicare wage index and Medicare GME purposes with Congressional staff.
Discuss COVID-19 Public Health Emergency (PHE) Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to permanently extend PHE telehealth flexibilities and two-year extension of Acute Hospital Care at Home Waiver.
Oppose Medicare site-neutral payment policies.
Oppose unique national provider identifier (NPI) requirement for hospital outpatient departments and discuss implementation - H.R. 7148-Sec. 6225.
Discuss CY 2026 OPPS final rule with Congressional staff: 340B drug acquisition survey, opposition to site-neutral cuts for drug administration services.
Support Medicare Advantage reforms - Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816), MA Prompt Pay Act (H.R. 5454/S.2879).
Discuss Medicare wage index issues with CMS.
Discuss proposals that stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support), make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities.
Oppose Medicaid program and financing in H.R.1: work requirements as a condition of coverage, changes to state-directed payments, reductions to Federal matching funds, reductions to the safe harbor threshold for provider taxes, sunset of broad-based and uniform provider tax waivers, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule, reductions to retroactive coverage.
Discuss H.R. 1 phase-out of non-broad-based and uniform Medicaid provider tax waivers and support maximum phase-out period.
Support certain changes to Medicaid DSH payments: support two-year elimination of Medicaid DSH cut; support Save Our Safety Net Hospitals Act (H.R. 5064) to restore pre-CAA, 2021 DSH cap calculation methodology and include dual-eligible patients in state DSH cap calculation.
Discuss Medicaid Section 1115 waiver with Congressional staff and HHS.
Oppose proposed rule - Medicare and Medicaid Conditions of Participation: Limiting Participation Based on the Performance of Sex Trait Modification Procedures on Children with Congressional staff.
Discuss nursing and allied health cost report issues.
Discuss uncompensated care.

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), White House Office, Executive Office of the President (EOP)

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

Discuss Medicare GME funding in CAA, 2021 and CAA, 2023 with Congressional staff and HHS staff.
Support health extenders in H.R. 7148, Consolidated Appropriations Act of 2026: extend COVID-19 Medicare-covered telehealth flexibilities, Acute Hospital Care at Home waiver, Medicaid DSH cut elimination; Medicaid DSH cap calculation changes; discuss with Congressional staff and HHS staff.
Support increased funding for Hospital Preparedness 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)

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

Oppose September 19 Presidential Proclamation imposing $100,000 fee on employers petitioning for new H-1B visas; discuss opposition with Congressional staff and DHS; support health care sector exemption - H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961).

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