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LOBBYING REPORT |
Lobbying Disclosure Act of 1995 (Section 5) - All Filers Are Required to Complete This Page
2. Address
| Address1 | PO Box 96503 #72319 |
Address2 |
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| City | Washington |
State | DC |
Zip Code | 20090-6503 |
Country | USA |
3. Principal place of business (if different than line 2)
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5. Senate ID# 56018-12
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6. House ID# 351680000
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| TYPE OF REPORT | 8. Year | 2025 |
Q1 (1/1 - 3/31) | Q2 (4/1 - 6/30) | Q3 (7/1 - 9/30) | Q4 (10/1 - 12/31) |
9. Check if this filing amends a previously filed version of this report
| 10. Check if this is a Termination Report | Termination Date |
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11. No Lobbying Issue Activity |
| INCOME OR EXPENSES - YOU MUST complete either Line 12 or Line 13 | |||||||||
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| 12. Lobbying | 13. Organizations | ||||||||
| INCOME relating to lobbying activities for this reporting period was: | EXPENSE relating to lobbying activities for this reporting period were: | ||||||||
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| Provide a good faith estimate, rounded to the nearest $10,000, of all lobbying related income for the client (including all payments to the registrant by any other entity for lobbying activities on behalf of the client). | 14. REPORTING Check box to indicate expense accounting method. See instructions for description of options. | ||||||||
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Method A.
Reporting amounts using LDA definitions only
Method B. Reporting amounts under section 6033(b)(8) of the Internal Revenue Code Method C. Reporting amounts under section 162(e) of the Internal Revenue Code |
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| Signature | Digitally Signed By: TRISTAN NORTH |
Date | 10/10/2025 2:47:52 PM |
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
Lobbied on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2232, S.1643) to extend and raise the percentages of temporary increases in Medicare payments for ground ambulance services. Educated congressional offices and committees on mandatory past due changes in geographical designation of zip codes under the Medicare ambulance fee schedule following the 2020 Census.
Lobbied on the FY2025 Budget and Budget Reconciliation process on the One Big Beautiful Bill Act (H.R. 1) to mitigate the impact of changes to Medicaid enrollment policy on ground ambulance service organizations and to provider tax programs. Lobbied to increase the funding for the Rural Health Transformation Program and ensure that ground ambulance service providers and emergency medical services are eligible and covered for funding through inclusion in State plan program applications.
Lobbied on the Comprehensive Alternative Response for Emergencies Act of 2025 (H.R. 2538) to create a CMMI demonstration project on the reimbursement of ambulance response without transport, and the draft Emergency Medical Services Reimbursement for On-Scene Care and Support Act. Lobbied on the Community Paramedicine Act (H.R. 4011) to provide local governments and partners with funding to furnish mobile integrated healthcare.
Engaged with congressional offices on the Preserving Emergency Access in Key Sites Act (PEAKS Act) (H.R. 3378, S.1960).
Lobbied in support of reducing the amount of the copay for critical ambulance services for patients in Medicare Advantage plans.
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), White House Office
18. Name of each individual who acted as a lobbyist in this issue area
| First Name | Last Name | Suffix | Covered Official Position (if applicable) | New |
Tristan |
North |
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19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None
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
Educated congressional offices and committees on the local oversight and rate controls of ground ambulance service organizations and the requirements placed on such organizations as 9-1-1 emergency medical services as well first responders. Also educated on the challenges that ground ambulance service organizations, which are predominately small entities providing medical services to individual communities, face in receiving adequate reimbursement from payors. Lobbied in support of the final report of the Ground Ambulance and Patient Billing Advisory Committee.
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
| First Name | Last Name | Suffix | Covered Official Position (if applicable) | New |
Tristan |
North |
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19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None
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 LBR
16. Specific lobbying issues
Lobbied to raise the profile of the severe shortage of paramedics and emergency medical technicians (EMTs) in the U.S. and address the problem through emergency medical service training programs, and retaining current paramedics and EMTs through access to first responder benefits. Lobbied on the PARA-EMT Act (H.R. 2220), Apprenticeship Pathways Act of 2025 (S. 235), Homes for Every Local Protector, Educator, and Responder Act (S. 978, H.R. 2094), Pathways to Health Careers Act (H.R. 5370), draft Supporting our First Responders Act, and the Freedom to Invest in Tomorrow's Workforce Act (S. 756, H.R. 1151).
Lobbied on the National Defense Reauthorization Act of 2026 (S. 2296, H.R. 3838) to include language to facilitate the transition of medics leaving the armed forces to transition to the civilian healthcare workforce.
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), White House Office
18. Name of each individual who acted as a lobbyist in this issue area
| First Name | Last Name | Suffix | Covered Official Position (if applicable) | New |
Tristan |
North |
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19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None
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
Lobbied on the Senate and House FY2026 Labor, HHS, Education and Related Agencies Appropriations Bills (S. 2587, H.R. 5304) for funding for the Administration for Strategic Preparedness and Response for paramedic and EMT training grants to help address the emergency medical service workforce shortage to ensure sufficient EMS capabilities to address responses to national health emergencies and terrorism incidents.
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)
18. Name of each individual who acted as a lobbyist in this issue area
| First Name | Last Name | Suffix | Covered Official Position (if applicable) | New |
Tristan |
North |
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19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None
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 DIS
16. Specific lobbying issues
Lobbied in support of resources for ground ambulance service organizations in order to be prepared to respond to future public health emergencies, natural disasters and acts of terrorism.
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
| First Name | Last Name | Suffix | Covered Official Position (if applicable) | New |
Tristan |
North |
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19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None
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
Lobbied for provisions to support businesses, expand eligible training and education for 529 plan usage and inclusion of relief from the federal fuel excise tax for private ground ambulance service organizations as part of FY2025 Budget Reconciliation (H.R.1).
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
| First Name | Last Name | Suffix | Covered Official Position (if applicable) | New |
Tristan |
North |
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19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None
Information Update Page - Complete ONLY where registration information has changed.
20. Client new address
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21. Client new principal place of business (if different than line 20)
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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
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ISSUE UPDATE
24. General lobbying issue that no longer pertains
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AFFILIATED ORGANIZATIONS
25. Add the following affiliated organization(s)
Internet Address:
| Name | Address |
Principal Place of Business (city and state or country) |
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26. Name of each previously reported organization that is no longer affiliated with the registrant or client
| 1 | 2 | 3 |
FOREIGN ENTITIES
27. Add the following foreign entities:
| Name | Address |
Principal place of business (city and state or country) |
Amount of contribution for lobbying activities | Ownership percentage in client | ||||||||||
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28. Name of each previously reported foreign entity that no longer owns, or controls, or is affiliated with the registrant, client or affiliated organization
| 1 | 3 | 5 |
| 2 | 4 | 6 |
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?
| Lobbyist Name | Description of Offense(s) |