To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility.

Medical necessity and therapy caps extension issues (H.R. 1459): Preserving Access to Inpatient Rehabilitation Act and S. 543: Tim Johnson Inpatient Rehabilitation Preservation Act); H.R. 4105: Medicare Recovery Audit Contractor Program Moratorium Act; Implementation of Medicare, Medicaid, and SCHIP Extension Act (PL 110-173);Therapy cap exceptions extension; Medical Necessity and RAC audit issues; HR 6331 Medicare Improvements for Patients and Providers Act of 2008 (PL 110-275) and S. 3101.

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 1459: Inpatient Rehabilitation Preservation Act of 2007; S. 543: "Tim Johnson Inpatient Rehabilitation Preservation Act of 2007" - medical necessity and therapy caps extension issues; H.R. 4105: "Medicare Recovery Audit Contractor Program Moratorium Act of 2007"; Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 (Pub. L. No.: 110-173).

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA), White House Office

S 3230, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2009, health care information technology funding and projects, HRSA critical and specialty care and continuing education and rural emergency services. CONTINUED ON NEXT PAGE Promote regional electronic health record demonstration and telehealth. HR 2043, to provide for a Medicaid demonstration project for chronic disease management. HR 1459, to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. S 1455, to provide for the establishment of a health information technology and privacy system. HR 6947 and S 3181, DHS Appropriations for FY-09 (became PL 110-329), critical healthcare infrastructure and regional disease surveillance.

Client expense: Not reported · Firm income: $60,000

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), SENATE

P.L. 108-173, Medicare Prescription Drug Modernization act of 2003, implementation of provisions for dual eligibles. P.L. 108-171, Deficit Reduction Act of 2005, implementation of provisions dealing with Medicaid, TANF, other human services. Implemetation of the Health Insurance Flexibilityi and Accountability Waiver. Implementation of Family Caregivers Support Act. Family Support Act of 2007, provisions dealing with buying into Medicaid. Funding for Lifespan Respite Care Act, provisions that address respite care services for family caregivers of individuals with special needs. H.Con.Res 99 and S.Con.Res.21, FY 2008 Budget Resolution, provisions dealing with reserve funds for SCHIP and the reabilitation option. H.R. 1459 and S. 543, Preserving Access to In Patient Rehabilitation Hospital Act of 2007. S. 1050 and H.R. 3294, Promoting Wellness for Individuals with Disabilities Act of 2007. Legislative proposals to reauthorize the State Children's Health Insurance Program (SCHIP). S. 558. Mental Health Parity Act of 2007. S. 634 and H.R. 1634, Newborn Screening Saves Lives Act. Moratorium for Medicaid's regulations on rehabilitation, school-based administration and transportationi services, and case management.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Election Assistance Commission (EAC), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

P.L. 108-171, Deficit Reduction Acto f 2005, implementation of provisions dealing with Medicaid, TANF, other human services. Implementation of Family Caregivers Support Act. Family Support Act of 2007, provisions dealing with buying into Medicaid. Funding for Lifespan Respite Care Act, provisions that address respite care services for family caregivers of individuals with special needs. H.R. 1459 and S. 543, Preserving Access to In Patient Rehabilitation Hospital Act of 2007. S. 1050 and H.R. 3294, Promoting Wellness for Individuals with Disabilities Act of 2007. S. 558. Mental Health Parity Act of 2007. Moratorium for Medicaid's regulations on outpatient rules. Increase Federal Medical Assistance Percentage (FMAP). Health Care Reform.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Election Assistance Commission (EAC), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

H.R. 1809, Medicare Independent Living Act of 2007; H.R. 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007; Ending the Two-Year Wating Period for Individuals with Disabilities to Qualify for Medicare

Client expense: Not reported · Firm income: $40,000

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R. 4105 - To impose a moratorium on the use of recovery audit contrators under the Medicare Integrity Program. H.R. 976 - An act to amend title XXI of the Social Sercurity Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R. 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold to determine whether a hospital or unit is an impatient rehabilitation facility. H.R. 562 - To amend title XVIII of teh Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. H.R. 3162 - To amend titles XVII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes. H.R. 1621 - To amnd title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. H.R. 1536 - To amend part D of title XVII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. H.R. 4541 - To amend title XVIII of the Social Security Act to provide for patient protections under the Medicare prescription drug program for residents of long term care facilities. H.R.3963 - To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.5604 - To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009, and for other purposes. H.R.6331 - To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. H.R.5480 - To respond to a Medicare funding warning. S.2662 - A bill to respond to a medicare funding warning. S.543 - A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S.1107 - A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S. 2819 - A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn, and for other purposes. S. 3101 - A bill to amend titles XVII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care sub rural areas, including pharmacy access, and for other purposes. S.1893 - An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. S.338 - A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program. S.2499 - A bill to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. S.2396 - A bill to amend title XI of the Social Security Act to modernize the quality improvement organization (QIO) program. S. 2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and firect care workers dedicated to providing quality care to the growing population of older Americans. S. 2705 - A bill to authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. S. 2786 - A bill to amend title XVIII of the Social Security Act to improve access to health care under teh Medicare program for beneficiaries residing in rural areas. H.R.5480 - To respond to a Medicare funding warning.

Client expense: $460,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 3162, Children's Health and Medicare Protection (CHAMP) Act; S. 450/H.R. 749, Medicare Access to Rehabilitation Services Act; H.R. 1459, To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility; S. 543, A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program.

Client expense: Not reported · Firm income: $20,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424), War Supplemental Appropriations Act (HR 2642), and wherever proposed support HR 1459/S. 543 related to the 75% Rule

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424) and wherever proposed support HR 1459/S. 543 related to the 75% Rule

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 108-173, Medicare Prescription Drug Modernization act of 2003, implementation of provisions for dual eligibles. P.L. 108-171, Deficit Reduction Act of 2005, implementation of provisions dealing with Medicaid, TANF, other human services. Implementation of Family Caregivers Support Act. Family Support Act of 2007, provisions dealing with buying into Medicaid. Funding for Lifespan Respite Care Act, provisions that address respite care services for family caregivers of individuals with special needs. H.Con.Res 99 and S.Con.Res.21, FY 2008 Budget Resolution, provisions dealing with reserve funds for SCHIP and the reabilitation option. H.R. 1459 and S. 543, Preserving Access to In Patient Rehabilitation Hospital Act of 2007. S. 1050 and H.R. 3294, Promoting Wellness for Individuals with Disabilities Act of 2007. S. 558. Mental Health Parity Act of 2007. Moratorium for Medicaid's regulations on outpatient rules. Increase Federal Medical Assistance Percentage (FMAP). H.R. 6331, Medicare Improvements for Patients and Providers Act.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Election Assistance Commission (EAC), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), Treasury, Dept of, White House Office

H.R. 1459/S. 543, H.R. 477/S. 999, H.R. 2384, H.R. 2621, H.R. 2201, S. 1349, H.R. 2199, S. 1233, S.793/H.R. 1418, H.R. 2179, H.R. 1944, S. 1113/H.R. 2098

Client expense: Not reported · Firm income: $20,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

H.R. 1809, Medicare Independent Living Act of 2007; H.R. 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007

Client expense: Not reported · Firm income: $40,000

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

HR 748 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps S 450 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps HR 1552 - Medicare Patient Access to Physical Therapists Act S 932 - Medicare Patient Access to Physical Therapists Act HR 1846 - Medicare Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 HR 5445 - To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S 2785 - Save Medicare Act of 2008 S 2460 - To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program. S 787 - To impose a 2-year moratorium on implementation of a proposed rule relating to the Federal-State financial partnerships under Medicaid and the State Children's Health Insurance Program HR 5590 - Medicare Oral Health Rehabilitative Enhancement Act of 2008 HR 5613 - Protecting Medicaid Safety Net Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H CON RES 312 - Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013 HR 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility S 1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 HR 3057 - Medicare Long-Term Care Patient Safety and Improvement Act of 2007 CORF, ORF conditions of participation- social and vocational services requirements Medicaid regulations promulgated by CMS Stark provisions in Fee Schedule Rule Physician Quality Reporting Initiative Durable Medical Equipment, Prosthetic, Orthotic & Supplies (DMEPOS) Regulations Medicare Post Acute Care Demo Medicare Home Health Demo Medicare Electronic Health Record demo CMS Alternative Payment System Project Comments to American Health Information Community re: successor Payment updates for physicians, hospitals, skilled nursing facilities, and home health Medicare Manual revisions In office ancillary services exception Inpatient Rehabilitation Facilities under Medicare Improving Funding for the Medicaid Program Extending legislative moratoria on Medicaid Regulations in President's FY 2009 budget Working with plan to mandate implementation of the International Classification of Diseases, 10th edition Medicaid Federal Medical Assistance Percentage (FMAP) 2009 Medicare Physician Fee Schedule Proposed Rule HR 6331-the Medicare Improvements for Patients and Providers Act S 3101- the Medicare Improvements for Patients and Providers Act S 3118 - Preserving Access to Medicare Act of 2008 HR 6252 - Medicare DMEPOS Competive Acquisition Reform Act of 2008 S 3144- Medicare DMEPOS Competive Acquisition Reform Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program S 2812 - Medicare Telehealth Improvement Act of 2008 HR 5445 - Increase Medicare Payments for physician services S 2785 - Increase Medicare Payments for physician services HR 5704 - Home Health Flexibility Act of 2008 Outpatient Hospital Medicaid Regulations

Client expense: $355,739 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R. 4105 - To impose a moratorium on the use of recovery audit contrators under the Medicare Integrity Program. H.R. 976 - An act to amend title XXI of the Social Sercurity Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R. 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold to determine whether a hospital or unit is an impatient rehabilitation facility. H.R. 562 - To amend title XVIII of teh Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. H.R. 3162 - To amend titles XVII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes. H.R. 1621 - To amnd title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. H.R. 1536 - To amend part D of title XVII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. H.R. 4541 - To amend title XVIII of the Social Security Act to provide for patient protections under the Medicare prescription drug program for residents of long term care facilities. H.R.3963 - To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.5604 - To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009, and for other purposes. H.R.6331 - To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. H.R.5480 - To respond to a Medicare funding warning. S.2662 - A bill to respond to a medicare funding warning. S.543 - A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S.1107 - A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S. 2819 - A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn, and for other purposes. S. 3101 - A bill to amend titles XVII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care sub rural areas, including pharmacy access, and for other purposes. S.1893 - An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. S.338 - A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program. S.2499 - A bill to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. S.2396 - A bill to amend title XI of the Social Security Act to modernize the quality improvement organization (QIO) program. S. 2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and firect care workers dedicated to providing quality care to the growing population of older Americans. S. 2705 - A bill to authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. S. 2786 - A bill to amend title XVIII of the Social Security Act to improve access to health care under teh Medicare program for beneficiaries residing in rural areas. H.R.5480 - To respond to a Medicare funding warning.

Client expense: $390,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medical necessity and therapy caps extension issues (H.R. 1459): Preserving Access to Inpatient Rehabilitation Act and S. 543: Tim Johnson Inpatient Rehabilitation Preservation Act); H.R. 4105: Medicare Recovery Audit Contractor Program Moratorium Act; Implementation of Medicare, Medicaid, and SCHIP Extension Act (PL 110-173);Therapy cap exceptions extension; Medical Necessity and RAC audit issues; HR 6331 Medicare Improvements for Patients and Providers Act of 2008 (PL 110-275) and S. 3101.

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 1459: Inpatient Rehabilitation Preservation Act of 2007; S. 543: "Tim Johnson Inpatient Rehabilitation Preservation Act of 2007" - medical necessity and therapy caps extension issues; H.R. 4105: "Medicare Recovery Audit Contractor Program Moratorium Act of 2007"; Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 (Pub. L. No.: 110-173).

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA), White House Office

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. Supplemental Appropriations Act, 2008 (HR 2642) Sec. 7001. (a) Moratoria on Certain Medicaid Regulations HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program HR 7110: Job Creation and Unemployment Relief Act: Title III, temporary increase in Medicaid matching rate S 3656: Preserving Access to Healthcare (PATH) Act -- which would delay cuts to Medicare capital indirect medical education (IME) payments for six months self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce, HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

Client expense: $100,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, White House Office

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 H.R.1459 To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. S. 1107 Home and Community Services Copayment Equity Act of 2007 S. 1102 Part D Equity for Low-Income Seniors Act of 2007 S.2641 Nursing Home Transparency and Improvement Act of 2008 H.R.5799 Nursing Home Transparency and Improvement Act of 2008 H.R.7128 Nursing Home Transparency and Quality of Care Improvement Act of 2008

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 3230, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2009, health care information technology funding and projects, HRSA critical and specialty care and continuing education and rural emergency services. CONTINUED ON NEXT PAGE Promote regional electronic health record demonstration and telehealth. HR 2043, to provide for a Medicaid demonstration project for chronic disease management. HR 1459, to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. S 1455, to provide for the establishment of a health information technology and privacy system. HR 6947 and S 3181, DHS Appropriations for FY-09, critical healthcare infrastructure and regional disease surveillance.

Client expense: Not reported · Firm income: $60,000

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), SENATE

Sec. 508 wage index reclassification; Nursing training and visa issues; Rehabilitation hospitals legislation (H.R. 1459, S. 543); Section 340B inpatient drug discount legislation; SCHIP legislation

Client expense: Not reported · Firm income: $50,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 6331/S. 3101/S. 3118 - Medicare Improvements for Patients and Providers Act of 2008 H.R. 2642 - Supplemental Appropriations Act, 2008 Repeal of the "Whole Hospital" Exception Under the Stark Anti-Fraud Law H.R. 1424 The Paul Wellstone Mental Health Equity Act H.R. 3162 Childrens Health and Medicare Protection (CHAMP) Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 2773/H.R. 6089 The National Pediatric Research Consortia Act of 2008 H.R. 5574 To amend the Public Health Service Act to reauthorize support for graduate medical education programs in childrens hospitals Support Continuing Budget Resolution Childrens Hospitals Graduate Medical Education Principals for Childrens Coverage in Health Care Reform

Client expense: $150,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424) and wherever proposed support HR 1459/S. 543 related to the 75% Rule

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424), War Supplemental Appropriations Act (HR 2642), and wherever proposed support HR 1459/S. 543 related to the 75% Rule

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Sec. 508 wage index reclassification; Nursing training and visa issues; Rehabilitation hospitals legislation (H.R. 1459, S. 543); Section 340B inpatient drug discount legislation; SCHIP legislation

Client expense: Not reported · Firm income: $50,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

P.L. 108-173, Medicare Prescription Drug Modernization act of 2003, implementation of provisions for dual eligibles. P.L. 108-171, Deficit Reduction Act of 2005, implementation of provisions dealing with Medicaid, TANF, other human services. Implemetation of the Health Insurance Flexibility and Accountability Waiver. Implementation of Family Caregivers Support Act. Family Support Act of 2007, provisions dealing with buying into Medicaid. Funding for Lifespan Respite Care Act, provisions that address respite care services for family caregivers of individuals with special needs. H.Con.Res 99 and S.Con.Res.21, FY 2008 Budget Resolution, provisions dealing with reserve funds for SCHIP and the reabilitation option. H.R. 1459 and S. 543, Preserving Access to In Patient Rehabilitation Hospital Act of 2007. S. 1050 and H.R. 3294, Promoting Wellness for Individuals with Disabilities Act of 2007. Legislative proposals to reauthorize the State Children's Health Insurance Program (SCHIP). S. 558. Mental Health Parity Act of 2007. P.L. 110-204, Newborn Screening Saves Lives Act. Moratorium for Medicaid's regulations on rehabilitation, school-based administration and transportation services, and case management.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Election Assistance Commission (EAC), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

H.R. 1809, Medicare Independent Living Act of 2007; H.R. 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007

Client expense: Not reported · Firm income: $40,000

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

HR 748 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps S 450 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps HR 1552 - Medicare Patient Access to Physical Therapists Act S 932 - Medicare Patient Access to Physical Therapists Act HR 1846 - Medicare Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 HR 5445 - To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S 2785 - Save Medicare Act of 2008 S 2460 - To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program. S 787 - To impose a 2-year moratorium on implementation of a proposed rule relating to the Federal-State financial partnerships under Medicaid and the State Children's Health Insurance Program HR 5590 - Medicare Oral Health Rehabilitative Enhancement Act of 2008 HR 5613 - Protecting Medicaid Safety Net Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H CON RES 312 - Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013 HR 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility S 1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 HR 3057 - Medicare Long-Term Care Patient Safety and Improvement Act of 2007 CORF, ORF conditions of participation- social and vocational services requirements Medicaid regulations promulgated by CMS Stark provisions in Fee Schedule Rule Physician Quality Reporting Initiative Durable Medical Equipment, Prosthetic, Orthotic & Supplies (DMEPOS) Regulations Medicare Post Acute Care Demo Medicare Home Health Demo Medicare Electronic Health Record demo CMS Alternative Payment System Project Comments to American Health Information Community re: successor Payment updates for physicians, hospitals, skilled nursing facilities, and home health Medicare Manual revisions In office ancillary services exception Inpatient Rehabilitation Facilities under Medicare Improving Funding for the Medicaid Program Extending legislative moratoria on Medicaid Regulations in President's FY 2009 budget Working with plan to mandate implementation of the International Classification of Diseases, 10th edition Medicaid Federal Medical Assistance Percentage (FMAP) 2009 Medicare Physician Fee Schedule Proposed Rule HR 6331-the Medicare Improvements for Patients and Providers Act S 3101- the Medicare Improvements for Patients and Providers Act S 3118 - Preserving Access to Medicare Act of 2008 HR 6252 - Medicare DMEPOS Competive Acquisition Reform Act of 2008 S 3144- Medicare DMEPOS Competive Acquisition Reform Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program S 2812 - Meciare Telehealth Improvement Act of 2008 HR 5445 - Increase Medicare Payments for physician services S 2785 - Increase Medicare Payments for physician services

Client expense: $566,146 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce, HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

Client expense: $120,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Medical necessity and therapy caps extension issues (H.R. 1459: Preserving Access to Inpatient Rehabilitation Act and S. 543: Tim Johnson Inpatient Rehabilitation Preservation Act); H.R. 4105: Medicare Recovery Audit Contractor Program Moratorium Act; Implementation of Medicare, Medicaid, and SCHIP Extension Act (PL 110-173);Therapy cap exceptions extension; Medical Necessity and RAC audit issues; HR 6331 (PL 110-275)and S. 3101

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 1459: Inpatient Rehabilitation Preservation Act of 2007; S. 543: "Tim Johnson Inpatient Rehabilitation Preservation Act of 2007" - medical necessity and therapy caps extension issues; H.R. 4105: "Medicare Recovery Audit Contractor Program Moratorium Act of 2007"; Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 (Pub. L. No.: 110-173).

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 1459/S. 543, H.R. 477/S. 999, H.R. 2384, H.R. 2621, H.R. 2201, S. 1349, H.R. 2199, S. 1233, S.793/H.R. 1418, H.R. 2179, H.R. 1944, S. 1113/H.R. 2098

Client expense: Not reported · Firm income: $20,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

HR 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. HR 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold d to determie whether a hospital or unit is an impatient rehabilitation facility. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.562 - To amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. H.R.4105 - To impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program. H.R.3162 - To amend titles XVIII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes. H.R.1621 - To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. H.R.1536 - To amend part D of title XVIII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. H.R.4541 - To amend title XVIII of the Social Security Act to provide for patient protections under the Medicare prescription drug program for residents of long term care facilities. H.R.3963 - To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.5604 - To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S.543 - A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S.1107 - A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S.1893 - An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. S.338 - A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program. S.2499 - A bill to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. S.2396 - A bill to amend title XI of the Social Security Act to modernize the quality improvement organization (QIO) program. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. S.2705 - A bill to authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. S.2786 - A bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009. S.2819 - A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn, and for other purposes. H.R.6331- To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. S.3101 - A bill to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes.

Client expense: $380,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 H.R.1459 To improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. S. 1107 Home and Community Services Copayment Equity Act of 2007 S 1102 Part D Equity for Low-Income Seniors Act of 2007 S. 2641 Nursing Home Transparency and Improvement Act of 2008

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 3230, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2009, health care information technology funding and projects, HRSA critical and specialty care and continuing education and rural emergency services. CONTINUED ON NEXT PAGE Promote regional electronic health record demonstration and telehealth. HR 2043, to provide for a Medicaid demonstration project for chronic disease management. HR 1459, to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility. S 1455, to provide for the establishment of a health information technology and privacy system. Unnumbered bill, DHS Appropriations for FY-09, critical healthcare infrastructure and regional disease surveillance.

Client expense: Not reported · Firm income: $60,000

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), SENATE

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 - The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation S. 2819 Economic Recovery in Health Care Act of 2008 H.R. 5613 Protecting the Medicaid Safety Net Act of 2008 S. 3101 Medicare Improvements for Patients and Providers Act of 2008 S. 3118 Preserving Access to Medicare Act H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008

Client expense: $180,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424) and wherever proposed support HR 1459/S. 543 related to the 75% Rule

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424), War Supplemental Appropriations Act (HR 2642), and wherever proposed support HR 1459/S. 543 related to the 75% Rule

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce, HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338 Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

Client expense: $120,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Sec. 508 wage index reclassification; Nursing training and visa issues; Rehabilitation hospitals legislation (H.R. 1459, S. 543); Section 340B inpatient drug discount legislation; SCHIP legislation

Client expense: Not reported · Firm income: $50,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

H.R.1459 and S.543, "To improve Medicare beneficiary to inpatient rehabilitation facilities," specifically to establish the criteria in HCFA Ruling 85-2, of July 31, 1985 (50 Fed. Reg. 31040), as the sole standard for determining the medical necessity of services for inpatient rehabilitation. H.R.4105, "To impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program," while supporting initiatives to ensure accountability in the Medicare program, the processes used by CMS and its contractors need to be reviewed to be sure that those processes are accurately identifying inappropriate claims No bill number at this time, support legislation that would enhance the Ethics in Patient Referrals Act of 1989 (the "Stark" law) to include physician ownership in a "whole" hospital S.458 and H.R. 1105, "physician pathology services under the Medicare program," specifically to extend the authority, currently expiring on June 30, 2008, to make direct payments to independent labs for the technical component of pathology services. H.R. 1177, "to extend and improve protections for sole community hospitals under the Medicare Program," specifically to extend the outpatient prospective payment system hold harmless provision and to permit the use of a more current cost reporting year to allow redetermination of hospital target amounts. S.630 and H.R. 2159, "to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare program," specifically to allow critical access hospitals to receive at least 101 percent of their costs for inpatient, swing-bed and outpatient hospital services S.2786, "Medicare Rural Health Access Improvement," specifically to extend th 5 percent bonus payment to physicians practicing in provider scarcity areas (critical access, sole community provider, and Medicare dependent or low-volume areas). H.R. 1845 and S.1428, "to assure access to durable medical equipment under the Medicare Program," specifically to adopt language that would allow hospital owned durable medical equipment companies that are willing to accept the competitive bid rate to provide durable medical equipment to patients upon discharge. S.1595, "flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program" specifically in favor of such increased flexibility.

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1459 all provisions to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 1741 all provisions to impose a 2-year moratorium on implementation of a proposed rule relating to the Federal-State financial partnerships under Medicaid and the State Children's Health Insurance Program; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007, all provisions to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3162 Childrens Health and Medicare Protection Act of 2007, all provisions related to the Children's Health Insurance Program; S. 2499 Medicare, Medicaid, and SCHIP Extension Act of 2007, all provisions; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 3533 The Public and Teaching Hospital Preservation Act, all provisions to extend moratorium on implementation of a rule relating to the partnership under Medicaid SCHIP and finalization rule regarding GME; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; H.R. 2860 and S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes.

Client expense: $3,800,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE

HR 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. HR 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold d to determie whether a hospital or unit is an impatient rehabilitation facility. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.562 - To amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. H.R.4105 - To impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program. H.R.3162 - To amend titles XVIII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes. H.R.1621 - To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. H.R.1536 - To amend part D of title XVIII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. H.R.4541 - To amend title XVIII of the Social Security Act to provide for patient protections under the Medicare prescription drug program for residents of long term care facilities. H.R.3963 - To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.5604 - To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S.543 - A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S.1107 - A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S.1893 - An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. S.338 - A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program. S.2499 - A bill to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. S.2396 - A bill to amend title XI of the Social Security Act to modernize the quality improvement organization (QIO) program. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. S.2705 - A bill to authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. S.2786 - A bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009.

Client expense: $420,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Funding for Lifespan Respite Care Act, provisions that address respite care services for family caregivers of individuals with special needs. H.Con.Res 99 and S.Con.Res.21, FY 2008 Budget Resolution, provisions dealing with reserve funds for SCHIP and the rehabilitation option. H.R. 1459 and S. 543, Preserving Access to In Patient Rehabilitation Hospital Act of 2007. S. 1050 and H.R. 3294, Promoting Wellness for Individuals with Disabilities Act of 2007. Legislative proposals to reauthorize the State Children's Health Insurance Program (SCHIP). S. 558. Mental Health Parity Act of 2007. S. 634 and H.R. 1634, Newborn Screening Saves Lives Act. Moratorium for Medicaid's regulations on rehabilitation, school-based administration and transportation services, and case management.

Client expense: $30,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Education, Dept of, Election Assistance Commission (EAC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office