Rural Health Services Preservation Act of 2007

FFY 2008 Administration Budget Proposal and Its Effect on Hospitals S. 1595 - Critical Access Hospital Flexibility Act of 2007 S. 1277 - Critical Access to Clinical Lab Services Act of 2007 S. 630 / H.R. 1563 / H.R. 2159 - Rural Health Services Preservation Act of 2007 S. 458 / H.R. 1105 - Physician Pathology Services Continuity Act of 2007 H.R. 1899 - Enhanced Options for Rural Health Care Act of 2007 S. 629 - Loans and Grants for Construction and Rehabilitation of CAHs S. 1605 - Craig Thomas Rural Hospital Provider Equity Act of 2007 S. 1376 / H.R. 2606 - 340B Program Improvement and Integrity Act of 2007 H.R. 1177 - Sole Community Hospital Preservation Act of 2007 H.R. 1730 - MedPAC Rural Representation Act S. 1604 - Nursing Education and Quality of Health Care Act of 2007 H.R. 1866 - Medicare Access to Rural Anestheisiology Act of 2007 S. 543 / H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act Reauthorization and Funding of State Children's Health Insurance Program Medicare and Medicaid Spending Reductions for Hospitals Medicaid State Plan Amendments and Waivers Renewal of the Missouri Medicaid Partnership Agreement with CMS

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

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

S. 498, "Rural Medicare Equity Act of 2007," provisions related to MedPAC representation and payment issues for rural providers H.R. 1730, "MedPAC Rural Representation Act," bill relates to MedPAC representation S. 2499, "SCHIP, Medicaid, and SCHIP Extension Act of 2007" S.1605, "Craig Thomas Rural Hospital and Provider Equity Act of 2007," all provisions relating to provider payments in rural areas H.R. 2860, "Health Care Access and Rural Equity (H-CARE) Act of 2007," all provisions relating to provider payments in rural areas H.R. 3162, "Children's Health and Medicare Protection (CHAMP) Act of 2007," provisions relating to provider payments in rural areas, SCHIP, hospital payments and a physician payment fix S. 1893/H.R. 976, "Children's Health Insurance Program Reauthorization Act of 2007," provisions relating to SCHIP reauthorization and to expanded outreach for rural children S. 1310, "Medicare Ambulance Payment Extension Act," provisions relating to rural amublance providers H.R. 2164, "Medicare Ambulance Payment Extension Act," provisions relating to rural ambulance providers S. 630, "Rural Health Services Preservation Act of 2007," provisions requiring MA organizations to pay a fair rate to RHC and CAHs H.R. 1563, "Rural Health Services Preservation Act of 2007," provisions requiring MA organizations to pay a fair rate to RHC and CAHs H.R. 2159, "Rural Health Services Preservation Act of 2007," provisions requiring MA organizations to pay a fair rate to RHC and CAHs

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

FFY 2008 Administration Budget Proposal and Its Effect on Hospitals S. 1595 - Critical Access Hospital Flexibility Act of 2007 S. 1277 - Critical Access to Clinical Lab Services Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 S. 458/H.R. 1105 Physician Pathology Services Continuity Act of 2007 H.R. 1899 Enhanced Options for Rural Health Care Act of 2007 S. 629 Loans and Grants for Construction and Rehabilitation of CAHs S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 S. 1376/H.R. 2606 340B Program Improvement and Integrity Act of 2007 H.R. 1177 Sole Community Hospital Preservation Act of 2007 H.R. 1730 MedPAC Rural Representation Act S. 1604 Nursing Education and Quality of Health Care Act of 2007 H.R. 1866 Medicare Access to Rural Anesthesiology Act of 2007 S. 543/H.R. 1459 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act Reauthorization and Funding of the State Childrens Health Insurance Program Medicare and Medicaid Spending Reductions for Hospitals Medicaid State Plan Amendments and Waivers Renewal of the Missouri Medicaid Partnership Agreement with CMS

Client expense: $228,009 · Firm income: Not reported

S. 1595 - Critical Access Hospital Flexibility Act of 2007 S. 1277 - Critical Access to Clinical Lab Services Act of 2007 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 S. 458/H.R. 1105 Physician Pathology Services Continuity Act of 2007 H.R. 1899 Enhanced Options for Rural Health Care Act of 2007 S. 629 Loans and Grants for Construction and Rehabilitation of CAHs S. 1605 The Craig Thomas Rural Hospital and Provider Equity Act of 2007 (R-HoPE) S. 1376/H.R. 2606 340B Program Improvement and Integrity Act of 2007 H.R. 1177 Sole Community Hospital Preservation Act of 2007 H.R. 1730 MedPAC Rural Representation Act S. 1604 Nursing Education and Quality of Health Care Act of 2007 H.R. 1866 Medicare Access to Rural Anesthesiology Act of 2007 H.R. 3162/H.R. 976 State Childrens Health Insurance Program S. 1958/H.R. 3057 Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 H.R. 3043 2008 Appropriations for U.S. Departments of Labor, Health & Human Services and Education (Health Spending Bill) H.R. 3997 Renewal of Federal Mental Health Parity Law S. 558 Mental Health Parity Act of 2007 H.R. 2699 Medical Student Loan Repayment S. 1947/H.R. 1046 Medicare Quality Improvement Organization (QIO) System Medicaid Prescription Drug 340B Program Expansion Proposed Medicaid Regulations to Limit the Use of Local and State Funds Proposed Medicaid Regulations to Eliminate Federal Funding of Medical Graduate Medical Education Behavioral Offset Cuts Under Medicare Inpatient Prospective Payment System 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 Medicare Inpatient PPS Behavioral Offset

S. 1595 - Critical Access Hospital Flexibility Act of 2007 S. 1277 - Critical Access to Clinical Lab Services Act of 2007 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

Client expense: $370,323 · Firm income: Not reported

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

S 329 / HR 552 - Provide coverage for cardiac and pulmonary rehabilitation services. HR 2244 - Provide Medicare beneficiaries with access to geriatric assessments and chronic care coordination services. HR 1809 - Eliminate the in home restriction for Medicare coverage of mobility services. S 749 - Permit Medicare - eligible seniors to elect to receive a voucher for HSAs or high deductible health insurance HR 1774 Establish separate definition of outpatient speech-language pathology services. S 173 - Establish Medicare health savings accounts. S 321- Pilot projects for home health agencies to utilize home monitoring and communications technologies. S 338 / HR 562 - Establish facility and patient criteria for long-term care hospitals. S 543 / HR 1459 - Extend the 60% compliance threshold used to determine IRF status. S 630 / HR 1563 - Provide for a minimum payment rate by Medicare Advantage organizations for services at critical access hospitals and rural health clinics. HR 1013- Prohibit approval or continuation of Title XXI section 1115 waivers that provide coverage to non-pregnant adults under SCHIP. HR 1017- Improve requirements under Medicaid for items and services furnished in or through an educational setting. HR 1111- Provide health coverage for every uninsured child through Medicaid and SCHIP. HR 1535- Children's Health First Act - expansion of SCHIP. HR 1329 - Guaranteed Access for SCHIP's Target Population Act. S 95 - Provide health coverage for every uninsured child through Medicaid and SCHIP. S 1281 / HR 2034 - Medicare for All Act S450 / HR 748 - Medicare Access to Rehabilitation Services Act. S 932/HR 1552 -Medicare Direct Access to Physical Therapy. HR 1846- Medicare Access to Physical Medicine and Rehabilitation Act. S 578 /HR 1017 - Improve requirements under Medicaid for items and services furnished in through an educational setting

Iroquois Healthcare Alliance Federal legislation for January 1 – June 30, 2007: Physician Shortage Elimination Act of 2007 [S.896.IS] United States Physician Shortage Elimination Act of 2007 [H.R.410. IH] 340B Program Improvement and Integrity Act of 2007 [H.R. 2606] [S1376.IS] Nurse Faculty Higher Education Act [H.R.2384] Health Care Access and Rural Equity (H-CARE) Act of 2007[H.R.2860.IH] Allied Health Reinvestment Act [S.605.IS] Wired for Health Care Quality Act [S.1693 IS] Allied Health Professions Reinvestment Act of 2005 [H.R.215.IH][S.473.IS] Healthy Communities Act of 2007 [S.1068.IS] Healthy Hospitals Act of 2007 [H.R.1174] Ensuring the Future Physician Workforce Act of 2007 [H.R. 2585 IH] Rural Physicians Relief Act of 2007 [S.290.IS] National Health Information Incentive Act of 2007 [H.R.1952 IH] National Health Information Technology & Privacy Advancement Act of 2007 [S. 1455] Rural Preventive Health Care Training Act of 2007 [S.53.IS] Critical Access to Health Information Technology Act of 2007 [S.628.IS] Rural Health Services Preservation Act of 2007 [S.630.IS] [H.R.2159 .IH] [H.R.1563] SCHIP Reauthorization and Reform Act of 2007 [H.R. 3176] Revised Continuing Appropriations Resolution, 2007 [H.J.RES.20.RDS], [H.J.RES.20.EH], [H.J.RES.20.IH], [H.J.RES.20.ENR], [H.J.RES.20.PCS] FFY 2008 Budget and Budget Resolutions FFY 2008 Labor, Health and Human Services, Education and Pension Appropriations Bill See attached

Client expense: $160,000 · Firm income: Not reported

H.R. 2159 - Rural Health Services Preservation Act of 2007 S. 1693 - Wired for Health Care Quality Act S. 1605 - Craig Thomas Rural Hospital and Provider Equity Act of 2007 H.R. 2860 - Health Care Access and Rural Equity Act of 2007 S. 630 - Rural Health Services Preservation Act of 2007 H.R. 1563 - Rural Health Services Preservation Act of 2007

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

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

S. 458/H.R. 1105 — Physician Pathology Services Continuity Act of 2007 H.R. 1899 — Enhanced Options for Rural Health Care Act of 2007 S. 629 — Loans and Grants for Construction and Rehabilitation of CAHs S. 1605 — Craig Thomas Rural Hospital and Provider Equity Act of 2007 S. 1376/H.R. 2606 — 340B Program Improvement and Integrity Act of 2007 H.R. 1177 — Sole Community Hospital Preservation Act of 2007 H.R. 1730 — MedPAC Rural Representation Act S. 1604 — Nursing Education and Quality of Health Care Act of 2007 H.R. 1866 — Medicare Access to Rural Anesthesiology Act of 2007 S. 543/H.R. 1459 — Preserving Patient Access to Inpatient Rehabilitation Hospitals Act Reauthorization and Funding of the State Children’s Health Insurance Program Medicare and Medicaid Spending Reductions for Hospitals Medicaid State Plan Amendments and Waivers Renewal of the Missouri Medicaid Partnership Agreement with CMS FFY 2008 Administration Budget Proposal and Its Effect on Hospitals S. 1595 - Critical Access Hospital Flexibility Act of 2007 S. 1277 - Critical Access to Clinical Lab Services Act of 2007 S. 630/H.R. 1563/H.R. 2159 — Rural Health Services Preservation Act of 2007

Client expense: $228,009 · Firm income: Not reported