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

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff.
Discuss with Congressional staff opposition to Medicaid proposals 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, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule, cost-sharing for Medicaid beneficiaries, reductions to retroactive coverage, elimination of reasonable opportunity window, reductions in coverage for immigrants.
Oppose changes to Affordable Care Act in H.R.1: limitations on premium tax credit eligibility, limitations on basic health program eligibility, reductions to special enrollment period.
Discuss opposition to Medicare site-neutral payment policies with Congressional staff.
Educate Congressional staff on hospital price transparency federal rule (84 FR 65602).
Oppose changes to national provider identifier (NPI)s for hospital outpatient departments (118th: H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822).
Discuss with Congressional staff S.891, Bipartisan Health Care Act, and comment on following provisions: support for delay of Medicaid DSH cut, codification and expansion of Federal price transparency rule, oppose NPI requirements for hospital outpatient departments, support reauthorization of Community Health Centers, support reauthorization of National Health Service Corps, support reauthorization of Teaching Health Center Graduate Medical Education funding, support PAHPA reauthorization, support SUPPORT Act reauthorization.
Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comments on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals.
Discuss legislative proposals with Congressional staff to 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.
Discuss Medicare Graduate Medical Education (GME) provisions in the Consolidated Appropriations Act (CAA), 2021 and CAA, 2023 with HHS staff.
Discuss with Congressional staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855); concerns on Rural Physician Workforce Preservation Act and opposition to modifications to ongoing slot distribution; Senate Finance Committee draft proposals to increase GME slots.
Discuss with HHS staff and Congressional staff 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 passage of the 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.
Support health extenders in H.R. 1968 (Full-Year Continuing Appropriations and Extensions Act, 2025): extend COVID-19 Medicare-covered telehealth flexibilities, Acute Hospital Care at Home waiver, Medicaid DSH cut delay; discuss with Congressional staff and HHS staff.
Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff.
Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702).
Discuss Congressional activity on antitrust exemptions for medical residencies with Congressional staff.
Support SEPSIS Act (S.1929).
Support Streamline Emergency Care Act (H.R. 3980).
Provide health care deregulation suggestions to OMB, HHS: make CMMI models voluntary, repeal certain reporting mandates, ease telehealth restrictions, urge nonenforcement of laboratory developed tests final rule.

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, White House Office, Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Health Resources & Services Administration (HRSA), Health & Human Services - Dept of (HHS), 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 MMM

16. Specific lobbying issues

Discuss with Congressional staff and HHS staff support for Medicare GME expansion and changes to 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; concerns on Rural Physician Workforce Preservation Act; Senate Finance Committee proposals to increase GME slots.
Discuss with Congressional staff opposition to Medicaid proposals 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, sunsetting uniform tax waivers, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule, reductions to retroactive coverage, reduction of reasonable opportunity window.
Discuss technical amendment to CAA, 2021, Sec. 131 pertaining to Medicare GME with Congressional staff.
Discuss with Congressional staff distribution methodology for Medicare GME slots created in the CAA, 2021.
Discuss expiring COVID-19 Public Health Emergency (PHE) Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to extend PHE telehealth flexibilities and Acute Hospital Care at Home Waiver.
Support extension of Medicare Dependent Hospital and Low-Volume Adjustment programs.
Discuss opposition to Medicare site-neutral payment policies with Congressional staff.
Oppose changes to NPIs for hospital outpatient departments (118th Congress: H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822).
Discuss FY 2024 IPPS comments with Congressional, HHS staff: to increase payment update to hospitals, Transforming Episodic Accountability Model, AHEAD Model, and CAA, 2023 Sec 4122 GME slot distribution methodology.
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.
Support certain changes to Medicaid DSH payments: support two-year elimination of Medicaid DSH cut scheduled for January 1, 2025; support Save Our Safety Net Hospitals Act to restore pre-CAA, 2021 DSH cap calculation methodology and include dual-eligible patients in state DSH cap calculation.
Discuss Medicaid waiver with Congressional staff and HHS.
Discuss CMMI initiatives on global budgets and primary care in NYS Medicaid waiver.
Discuss Medicaid IMD exclusion policies with Congressional staff.
Support legislation to increase Medicaid payment rates for labor and delivery services for certain hospitals (118th Congress: S.5236).
Oppose CMS final rule to establish minimum nurse staffing in Medicare- and Medicaid-certified long-term care facilities (89 FR 40876) and support legislative efforts to repeal rule.
Support Medicare Advantage prior authorization reforms - Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816).
Discuss wage index issues with Congressional staff: H.R. 8561 to address MA local area growth under projection, FY 2025 IPPS/LTCH interim final rule, indirect medical education (IME) payments to hospitals.
Meet with CMS leadership to discuss Medicare and Medicaid issues: prior authorization and MA insurance denials, concerns on mandatory participation for AHEAD and TEAM models, Medicare support for health care workforce; support for telehealth flexibilities and Acute Hospital Care at Home waiver extension.
Discuss Medicare wage index issues with CMS.
Discuss Medicaid Section 1332 waiver with Congressional staff.
Urge delayed enforcement of CMS final rule prohibiting nurses from performing glucose tests using high-complexity devices in point-of-care situations.

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

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.
Discuss disaster relief funding and health and hospital provisions in CAA, 2024 (H.R. 4366); Further Consolidated Appropriations Act, 2024 (H.R. 2882), Further Continuing Appropriations and Disaster Relief Supplemental Act, 2025 (H.R. 10445); American Relief Act, 2025; Full-Year Continuing Appropriations and Extensions Act, 2025 (H.R. 1968).
Support health extenders in H.R. 1968: extend COVID-19 Medicare-covered telehealth flexibilities, Acute Hospital Care at Home waiver, Medicaid DSH cut delay; discuss with Congressional staff and HHS staff.

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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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