Community Choice Act of 2007

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Discussed with Senate staff possible introduction of a Direct Support Professional bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill To provide for a temporary increase in the Federal Medical Assistance Percentage, and for other purposes--supported FMAP increase (H.R. 5268) A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill Empowered at Home Act of 2008: aimed at removing existing barriers to the new Medicaid Section 1915(i) HCBS benefit, strengthening HCBS services in order to prevent or decrease the likelihood of institutionalization, provide state assistance to facilitate HCBS services, improve purchase of long term care, and improve CMS collection of state data regarding number of individuals, expenditures, types of services, and waiting lists. S. 3327 would increase income eligibility from current 150% of FPL to 300% of SSI; eliminate option to waive statewideness; expand scope of services to include "other services", and eliminate option to limit number of eligible individuals and extends time period for eligibility (S. 3327)--supported bill

Client expense: $44,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1809, Medicare Independent Living Ct of 2007, provisions that assist persons with disabilities. P.L. 109-171, Choice Act, Direct Support Profefssioinals Fairness andSecurity Act (H.R. 1279). S. 1799 and H.R. 1621, Community Choice Act, provisions providing independence for individuals with disabilities. H.R. 1279, Direct Support Professional Fairness and Security Act of 2007, provisions dealing with direct support workers for persons with disabilities. P.L. 109-171, implementation of the Deficit ReductionAct, provisions dealing with TANF and Medicaid. S. 2499, Medicare, Medicaid and SCHIP Extension Act of 2007. Legislation not yet introduced to amend the Deficit Reduction Act of 2005 to improve usefullness of the new section 1915(i) Home and Community-Based Services Option. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, sections pertaining to moratoria on Centers for Medicare and Medicaid Services rehabilitation option, case management and school based services/transportation regulations. S. 2819, Economic Recovery in Health Care Act of 2008, same as above as well as provision to impose a moratoria on SCHIP directive and provisions to provide state fiscal relief. S. 2578 and H.R. 5173, legisation to impose a one year moratorium on the CMS case management rule. H.R. 4355, moratorium on rehabilitation option and school-based transportation rule. S.Con.Res. 70 and H.Con.Res. 312, FY 2009 Budget Resolutions, provisions dealing with Medicaid reserve funds.

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

H 976/S 1893: State Children's Health Insurance Program; HR 3963: Children's Health Insurance Program Reauthorization Act of 2007; Medicare and Medicaid reform; Medicare competitive bidding; PL 108-173: Medicare Prescription Drug and Modernization Act of 2003; HR 1017/S 578 Protecting Children's Health in Schools Act; Federal Medical Assistance Percentage legislation; HR 1333/S 647: Medicare Patient Access to Physical Therapists Act of 2005 HR 748/S 450: Medicare Access to Rehabilitation Services Act; H. Con. Res. 99/S. Con. Res. 21 budget legislation; HR 1621/S 799: Community Choice Act of 2007; HR 5613: Protecting the Medicaid Safety Net Act of 2008; HR 6331/S 3101: Medicare Improvements for Patients and Providers Act of 2008; HR 2642: Military Construction and Veterans Affairs Appropriation Act of 2008; S 2819: Economic Recovery in Health Care Act.

Client expense: $78,906 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

S 898/HR 1560 - Alzheimer's Breakthrough Act of 2007 S 558/HR 1424 - Mental Health Parity Act of 2007 S 325/HR 506 - Health Partnership Act H.R.6282/S 2950 - Helping HANDS for Autism Act of 2008 H.R. 1669/S 982 - Positive Aging Act of 2007 H.R. 1424 - Emergency Economic Stabilization Act of 2008 H.R. 3 - Stem Cell Research Enhancement Act of 2007 H.R. 1621/ S 799- Community Choice Act of 2007 S. 2267- Americans Giving Care to Elders Act of 2007 S. 1758/HR 3001- Community Living Assistance Services and Supports Act H.R. 4897/S. 1854- Stop Senior Suicide Act H.R. 977 - The Genomic Research and Accessibility Act Long-Term Care Social Service Block Grant S 937/HR 1881 - Expanding the Promise for Individuals With Autism Act of 2007 HR 7202- Temporary Tax Relief Act of 2008 HR 6049- Renewable Energy and Job Creation Act of 2008

Client expense: $34,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

H.R. 1809, Medicare Independent Living Act of 2007, provisions that assist persons with disabilities. S. 1799 and H.R. 1621, Community Choice Act, provisions providing independence for individuals with disabilities. P.L. 109-171, implementation of the Deficit ReductionAct, provisions dealing with Medicaid. S. 2499, Medicare, Medicaid and SCHIP Extension Act of 2007. P.L. 110-252, Protecting the Medicaid Safety Net Act of 2008, sections pertaining to moratoria on Centers for Medicare and Medicaid Services rehabilitation option, case management and school based services/transportation regulations. H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008. S. 2819, Economic Recovery in Health Care Act of 2008, same as above as well as provision to impose a moratoria on SCHIP directive and provisions to provide state fiscal relief. S.Con.Res. 70 and H.Con.Res. 312, FY 2009 Budget Resolutions, provisions dealing with Medicaid reserve funds. Legislation dealing with direct support worker issues. Implementation of Medicaid Section 1917 (d) regarding trusts and transfer of asset rules. S.3327, the Empowered at Home Act of 2008 to amend the Medicaid Section 1915 (i) Home and Community Based Services Option. Efforts to elminate the 24-month waiting period for Medicare. Implementation of the Olmstead decision regarding community integration. Health Care Reform. Federal Medical Assistance Percentage (FMAP increase.

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

S.1242: To amend the Federal Crop Insurance Act and the Farm Security and Rural Investment Act of 2002 to establish a biofuel pilot program and a program to make loans and loan guarantees to producers of experimental biofuel crops. H.R.3160: To amen the Internal Revenue Code of 1986 to prevent corporations from exploiting tax treaties to evade taxation of U.S. income H.R.2419/S.2302: Farm, Nutrition, and Bioenergy Act: EQUIP, CSP, Nutrient Management and Biomass definition sections H.R.1621/S.2280: To amend the Internal Revenue Code of 1986 to treat certain farming business machinery and equipment as 5-yar property for purposes of depreciation H.R.872: New ERA Act of 2007 H.R.1023: To repeal the imposition of withholding on certain payments made to vendors by government entities S.1759: The Agricultural Competition Enhancement Act S. 1872: The Farm Safety Net Improvement Act S.2242: Heartland, Habitat, Harvest and Horticulture Act of 2007 H.R.2419: Farm, Nutrition & Bioenergy Act: PL 110-234 S.3268: Stop Excessive Energy Speculation Act of 2008 S. 3478, A bill to amend the Internal Revenue Code of 1986 to provide incentives for the production of energy, to provide transportation and domestic fuel security, and to provide incentives for energy conservation and energy efficiency, and for other purposes. S. 3538: A bill to amend the Food, Conservation, and Energy Act of 2008 to suspend a prohibition on payments to certain farms with limited base acres for the 2008 and 2009 crop years, to extend the signup for direct payments and counter-cyclical payments for the 2008 crop year, and for other purposes. USDA Climate Change scoping plan

Client expense: $280,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, 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

S. 450 and HR 748, The Medicare Access to Rehabilitation Services Act of 2007 - All provisions, passage. HR 1846, The Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 - Opposed based on quality, cost accountability, and scope of practice concerns. S. 1224 and HR 3269, Children's Health Insurance Program (CHIP) Reauthorization Act of 2007 - Advocated in support of the CHIP program and an expanded role for occuaptional therapy. H.R. 3162, Children's Health and Medicare Protections Act of 2007 (CHAMP) - Advocated for Medicare provision regarding therapy caps, 75% rule on inpatient rehabilitation facilities, SGR cuts and Medicaid provisions. S. 799 and H.R. 1621, The Community Choice Act - Supported all provisions. S. 578 and H.R. 1017, Protecting Children's Health in Schools Act - supported passage and maintaining Medicaid funding for school based administrative claiming and transportation services. H.R. 1809 and S. 2103, Medicare Independent Living Act - Supported the provision of improved access to mobility devices for people with disabilities. H.R. 4082 and S. 1980, Long-term Care Quality and Modernization Act of 2007 - Advocated for inclusion of occupational therapy in quality reporting. S. 932 and H.R. 1552, Medicare Patient Access to Physical Therapist Act of 2007 - Advocated regarding impact on occupational therapy. H.R. 1663, Medicare Mental Health Modernization Act of 2007 - Advocated for passage and improved role for occupational therapy. S. 1628, Nurse Faculty and Physical Therapist Education Act of 2007 - Advocated for inclusion of occupational therapy loan repayment. H.R. 4248, Ensuring Medicare Access to Recreational Thearpy Act - Opposed findings language referring to functional capacities and worked to amend that language. No bill number - Medicaid Rehabilitation Services Proposed Rule - Before Congress advocated for moratorium; opposed proposal to restrict the reimbursement of services under the rehabilitation option. HR 5704, The Medicare Home Health Flexibility Act: Advocated for the promotion of occupational therapy in home health under Medicare. No bill number: Advocated and educated about the role of occupational therapy in mental health practice. HR 5590, Medicare Oral Health Rehabilitative Enhancement Act - inclusion of occupational therapy coverage language. No bill number - Preserving Access to Medicare Act - advocated for passage and inclusion of Part B outpatient therapy cap exceptions process extension, physician fee schedule update, and physician quality review incentive (PQRI). HR 2231 and S 2931 - Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007 - advocated for exemption of complex rehab from competitive bidding for DMEPOS. H.R. 7130 and S. 3631 - Medically Fragile Childrens Act of 2008 - Advocated for provision of occupational therapy. H.R. 6878 - Medicare Orthotics and Prosthetics Improvement Act of 2008 - Opposed due to negative impact on occupational therapy scope of practice and reimbursement.

Client expense: $90,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 799/H.R. 1621, the "Community Choice Act" H.R. 2231/S. 2931, the "Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007"

Client expense: $42,254 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Improvements for Patients & Providers Act of 2008, HR 6331, and related bills, HR 6252, S. 3118, including provisions to fix the physician payment rate, delay Medicare competitive bidding for durable medical equipment and exempt complex rehabilitation from competitive bidding altogether (because of impacts on popel who need wheelchairs and other durable medical equipment), provider Medicare mental health parity, delay cuts to Medicare therapies, require Medicare Part D to cover cont. certain drugs, strengthen CMS authority to require Part D plans to ensure broad coverage on prescription durg plan formularies, improve access to the Medicare Savings Program, eliminate Medicare Part D enrollment penalties, limit out-of-pocket costs for people who are qualified Medicare beneficiaries and people who are eligible for both Medicare and Medicaid (dual eligibles), simplify and align Medicare low-income assistance programs, bring outdated asset limits in line with today's cost of living, improve outreach and participation for those people currently eligible. S 3327 -- to improve the state plan option under Medicaid providing for home and community-based services -- changes the home and community-based services option in the 2005 Deficit Reduction Act to allow more people to access these services. HR 1845 & S. 6252 - Medicare DMEPOS Competitive Acquisition Reform Act of 2007 regarding competitive bidding for durable medical equiptment. HR 1809/ S 2103 -- Medicare Independent Living Act -- to reverse Medicare regulations and policies that restrict payment for power mobility devices (wheelchairs) to those needed "in the home" rather than in the community -- such as for going to work, school, grocery shopping, medical appointments, places of worship and to accompany childred to school and activities. HR 1621/ S 799 - Community Choice Act of 2007 -- to support Medicaid coverage of community based services such as personal care, activities of daily living, etc. HR 1279 -- Direct Support Professional's Fairness & Security Act -- to support equalization of wages between privately and publicly employed direct support professionals. Discussions with senior CMS officials about what will be happening with competitive bidding following enactment of HR 6331 that delayed competitive bidding temporarily and exempted complex rehabilitation from competive bidding altogether. Discussions about possible future legislation to: -- make permanent some of the temporary delays/moratoria that were included in HR 6331 and related bills -- protect the Medicaid waiver application process and require transparency on behalf of states and CMS. -- delay the Medicare 24-month waiting period -- seek permanent repeal of Medicaid rules that were delayed by legislation (e.g. enactment of HR 5613)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

H.R. 1809, Medicare Independent Living Ct of 2007, provisions that assist persons with disabilities. S. 1799 and H.R. 1621, Community Choice Act, provisions providing independence for individuals with disabilities. P.L. 109-171, implementation of the Deficit ReductionAct, provisions dealing with Medicaid. S. 2499, Medicare, Medicaid and SCHIP Extension Act of 2007. Legislation not yet introduced to amend the Deficit Reduction Act of 2005 to improve usefullness of the new section 1915(i) Home and Community-Based Services Option. P.L. 110-252, Protecting the Medicaid Safety Net Act of 2008, sections pertaining to moratoria on Centers for Medicare and Medicaid Services rehabilitation option, case management and school based services/transportation regulations. H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008. H.R. 2642, FY 2008 Iraq/Afghanistan War Supplemental Appropriations bill, domestic provisions. S. 2819, Economic Recovery in Health Care Act of 2008, same as above as well as provision to impose a moratoria on SCHIP directive and provisions to provide state fiscal relief. S. 2578 and H.R. 5173, legisation to impose a one year moratorium on the CMS case management rule. H.R. 4355, moratorium on rehabilitation option and school-based transportation rule. S.Con.Res. 70 and H.Con.Res. 312, FY 2009 Budget Resolutions, provisions dealing with Medicaid reserve funds. Legislation dealing with direct support worker issues. Implementation of Medicaid Section 1917 (d) regarding trusts and transfer of asset rules. S.3327, the Empowered at Home Act of 2008 to amend the Medicaid Section 1915 (i) Home and Community Based Services Option. Efforts to elminate the 24-month waiting period for Medicare. Implementation of the Olmstead decision regarding community integration.

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 976/S 1893: State Children's Health Insurance Program; HR 3963: Children's Health Insurance Program Reauthorization Act of 2007; Medicare and Medicaid reform; Medicare competitive bidding; PL 108-173: Medicare Prescription Drug and Modernization Act of 2003; HR 1017/S 578 Protecting Children's Health in Schools Act; Federal Medical Assistance Percentage legislation; HR 1333/S 647: Medicare Patient Access to Physical Therapists Act of 2005 HR 748/S 450: Medicare Access to Rehabilitation Services Act; H. Con. Res. 99/S. Con. Res. 21 budget legislation; HR 1621/S 799: Community Choice Act of 2007; HR 5613: Protecting the Medicaid Safety Net Act of 2008; HR 6331/S 3101: Medicare Improvements for Patients and Providers Act of 2008; HR 2642: Military Construction and Veterans Affairs Appropriation Act of 2008; S 2819: Economic Recovery in Health Care Act.

Client expense: $115,423 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

S. 450 and HR 748, The Medicare Access to Rehabilitation Services Act of 2007 - All provisions, passage. HR 1846, The Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 - Opposed based on quality, cost accountability, and scope of practice concerns. S. 1224 and HR 3269, Children's Health Insurance Program (CHIP) Reauthorization Act of 2007 - Advocated in support of the CHIP program and an expanded role for occuaptional therapy. H.R. 3162, Children's Health and Medicare Protections Act of 2007 (CHAMP) - Advocated for Medicare provision regarding therapy caps, 75% rule on inpatient rehabilitation facilities, SGR cuts and Medicaid provisions. S. 799 and H.R. 1621, The Community Choice Act - Supported all provisions. S. 578 and H.R. 1017, Protecting Children's Health in Schools Act - supported passage and maintaining Medicaid funding for school based administrative claiming and transportation services. H.R. 1809 and S. 2103, Medicare Independent Living Act - Supported the provision of improved access to mobility devices for people with disabilities. H.R. 4082 and S. 1980, Long-term Care Quality and Modernization Act of 2007 - Advocated for inclusion of occupational therapy in quality reporting. S. 932 and H.R. 1552, Medicare Patient Access to Physical Therapist Act of 2007 - Advocated regarding impact on occupational therapy. H.R. 1663, Medicare Mental Health Modernization Act of 2007 - Advocated for passage and improved role for occupational therapy. S. 1628, Nurse Faculty and Physical Therapist Education Act of 2007 - Advocated for inclusion of occupational therapy loan repayment. H.R. 4248, Ensuring Medicare Access to Recreational Thearpy Act - Opposed findings language referring to functional capacities and worked to amend that language. HR 2642 (PL 110-252) Iraq War Supplemental Appropriations -Advocated for moratorium on Medicaid School-based Transportation and Administrative Claiming Costs and opposed elimination of reimbursement for rehab service option. No bill number - Medicaid Rehabilitation Services Proposed Rule - Before Congress advocated for moratorium; opposed proposal to restrict the reimbursement of services under the rehabilitation option. HR 5704, The Medicare Home Health Flexibility Act: Advocated for the promotion of occupational therapy in home health under Medicare. No bill number: Advocated and educated about the role of occupational therapy in mental health practice. HR 6331 and S 3101, Medicare Improvement for Patients and Providers act of 2008 - Advocated for passage and inclusion of following provisions: Part B Outpatient therapy cap exceptions process extension, physician fee schedule update; reduction in copay for Medicare mental health provisions, and delay competitive bidding for DMEPOS; and PQRI. HR 5590, Medicare Oral Health Rehabilitative Enhancement Act - inclusion of occupational therapy coverage language. No bill number - Preserving Access to Medicare Act - advocated for passage and inclusion of Part B outpatient therapy cap exceptions process extension, physician fee schedule update, and physician quality review incentive (PQRI). HR 2231 and S 2931 - Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007 - advocated for exemption of complex rehab from competitive bidding for DMEPOS. H.R. 7130 and S. 3631 - Medically Fragile Childrens Act of 2008 - Advocated for provision of occupational therapy. H.R. 6878 - Medicare Orthotics and Prosthetics Improvement Act of 2008 - Opposed due to negative impact on occupational therapy scope of practice and reimbursement.

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799 and H.R. 1621, and H.R. 6331), as well as initiatives aimed at expanding health coverage (including but not limited to S. 334).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799, H.R. 1621, and H.R. 6331), as well as initiatives aimed at expanding health coverage (including but not limited to S. 334).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799 and H.R. 1621, and H.R. 6331), as well as initiatives aimed at expanding health coverage (including but not limited to S. 334).

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

Government targets: HOUSE OF REPRESENTATIVES, 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: $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

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Regulation on State Rehabilitation Option--opposed regulation To provide for a temporary increase in the Federal Medical Assistance Percentage, and for other purposes--supported FMAP increase (H.R. 5268) A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill Resolution Designating the week beginning September 8, 2008, as National Direct Support Professionals Recognition Week(S.Res. 613)--supported resolution Empowered at Home Act of 2008: aimed at removing existing barriers to the new Medicaid Section 1915(i) HCBS benefit, strengthening HCBS services in order to prevent or decrease the likelihood of institutionalization, provide state assistance to facilitate HCBS sevices, improve purchase of long term care, and improve CMS collection of state data regarding number of individuals, expenditures, types of services, and waiting lists. S. 3327 would increase income eligibility from current 150% of FPL to 300% of SSI; eliminate option to waive statewideness; expand scope of services to include "other services", and eliminate option to limit number of eligible individuals and extends time period for eligibility (S. 3327)--supported bill

Client expense: $56,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6331, Medicare Improvements for Patients and Providers Act - for provisions to renew therapy caps exceptions process HR 5268/S 2620 - temporary increase in federal Medicaid matching funds - for HR 3784, requiring separate reporting of staffing expenditures on nursing homes' Medicare cost reports - for S 799/HR 1621, Community Choice Act, allowing Medicaid coverage of community-based attendant services - for S 3327, Empowered at Home Act, to improve Medicaid coverage of adult day services - for

Client expense: $100,140 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), SENATE

S 898/HR 1560 - Alzheimer's Breakthrough Act of 2007 S 558 - Mental Health Parity Act of 2007 S 325/HR 506 - Health Partnership Act H.R.6282/S 2950 - Helping HANDS for Autism Act of 2008 H.R. 1669/S 982 - Positive Aging Act of 2007 H.R. 1424 - Emergency Economic Stabilization Act of 2008 H.R. 3 - Stem Cell Research Enhancement Act of 2007 H.R. 1621/ S 799- Community Choice Act of 2007 S. 2267- Americans Giving Care to Elders Act of 2007 S. 1758/HR 3001- Community Living Assistance Services and Supports Act H.R. 4897- Stop Senior Suicide Act H.R. 977 - The Genomic Research and Accessibility Act Long-Term Care Social Service Block Grant S 1758/HR 30001 - CLASS Act S 937/HR 1881 - Expanding the Promise for Individuals With Autism Act of 2007 HR 6983 - To amend section 712 of the Employee Retirement Income Security Act of 1974, section 2705 of the Public Health Service Act, and section 9812 of the Internal Revenue Code of 1986 to require equity in the provision of mental health and substance-related disorder benefits under group health plans, and for other purposes. HR 7202- Temporary Tax Relief Act of 2008 HR 6049- Renewable Energy and Job Creation Act of 2008

Client expense: $51,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

S.1242: To amend the Federal Crop Insurance Act and the Farm Security and Rural Investment Act of 2002 to establish a biofuel pilot program and a program to make loans and loan guarantees to producers of experimental biofuel crops. H.R.3160: To amen the Internal Revenue Code of 1986 to prevent corporations from exploiting tax treaties to evade taxation of U.S. income H.R.2419/S.2302: Farm, Nutrition, and Bioenergy Act: EQUIP, CSP, Nutrient Management and Biomass definition sections H.R.1621/S.2280: To amend the Internal Revenue Code of 1986 to treat certain farming business machinery and equipment as 5-yar property for purposes of depreciation H.R.872: New ERA Act of 2007 H.R.1023: To repeal the imposition of withholding on certain payments made to vendors by government entities S.1759: The Agricultural Competition Enhancement Act S. 1872: The Farm Safety Net Improvement Act S.2242: Heartland, Habitat, Harvest and Horticulture Act of 2007 H.R.2419: Farm, Nutrition & Bioenergy Act: PL 110-234 S.3268: Stop Excessive Energy Speculation Act of 2008 S. 3478, A bill to amend the Internal Revenue Code of 1986 to provide incentives for the production of energy, to provide transportation and domestic fuel security, and to provide incentives for energy conservation and energy efficiency, and for other purposes. S. 3538: A bill to amend the Food, Conservation, and Energy Act of 2008 to suspend a prohibition on payments to certain farms with limited base acres for the 2008 and 2009 crop years, to extend the signup for direct payments and counter-cyclical payments for the 2008 crop year, and for other purposes. USDA Climate Change scoping plan

Client expense: $1,040,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

S.799/H.R. 1621, the "Community Choice Act" H.R. 2231/S. 2931, the "Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007"

Client expense: $77,119 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

Client expense: Not reported · Firm income: Not reported

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

Client expense: Not reported · Firm income: Not reported

S.1242: To amend the Federal Crop Insurance Act and the Farm Security and Rural Investment Act of 2002 to establish a biofuel pilot program and a program to make loans and loan guarantees to producers of experimental biofuel crops. H.R.3160: To amen the Internal Revenue Code of 1986 to prevent corporations from exploiting tax treaties to evade taxation of U.S. income H.R.2419/S.2302: Farm, Nutrition, and Bioenergy Act: EQUIP, CSP, Nutrient Management and Biomass definition sections H.R.1621/S.2280: To amend the Internal Revenue Code of 1986 to treat certain farming business machinery and equipment as 5-yar property for purposes of depreciation H.R.872: New ERA Act of 2007 H.R.1023: To repeal the imposition of withholding on certain payments made to vendors by government entities S.1759: The Agricultural Competition Enhancement Act S. 1872: The Farm Safety Net Improvement Act S.2242: Heartland, Habitat, Harvest and Horticulture Act of 2007 H.R.2419: Farm, Nutrition & Bioenergy Act: PL 110-234 S.3268: Stop Excessive Energy Speculation Act of 2008

Client expense: $400,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE

H.R. 1809, Medicare Independent Living Ct of 2007, provisions that assist persons with disabilities. S. 1799 and H.R. 1621, Community Choice Act, provisions providing independence for individuals with disabilities. P.L. 109-171, implementation of the Deficit ReductionAct, provisions dealing with Medicaid. S. 2499, Medicare, Medicaid and SCHIP Extension Act of 2007. Legislation not yet introduced to amend the Deficit Reduction Act of 2005 to improve usefullness of the new section 1915(i) Home and Community-Based Services Option. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, sections pertaining to moratoria on Centers for Medicare and Medicaid Services rehabilitation option, case management and school based services/transportation regulations. H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008. H.R. 2642, FY 2008 Iraq/Afghanistan War Supplemental Appropriations bill, domestic provisions. S. 2819, Economic Recovery in Health Care Act of 2008, same as above as well as provision to impose a moratoria on SCHIP directive and provisions to provide state fiscal relief. S. 2578 and H.R. 5173, legisation to impose a one year moratorium on the CMS case management rule. H.R. 4355, moratorium on rehabilitation option and school-based transportation rule. S.Con.Res. 70 and H.Con.Res. 312, FY 2009 Budget Resolutions, provisions dealing with Medicaid reserve funds.

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

Medicare Improvements for Patients and Providers Act of 2008, HR. 6331, and related bills, HR 6252, S 3118, including provisions to fix the physician payment rate, delay Medicare competitive bidding, exempt complex rehab from competitive bidding (because of the impact of competitive bidding on people who need wheelchairs and other durable medical equipment) provide Medicare mental health parity, delay cuts to Medicare therapies, require Medicare Part D to cover certain drugs, strengthen CMS authority to require Part D plans to ensure broad coverage on prescription drug plan formularies, improve access to the Medicare Savings Program, eliminate Medicare Part D late enrollment penalties, limit out-of-poicket costs for dual eligibles and qualified Medicare beneficiaries, revise the definition of medically accepted indication for drugs, simplify and align Medicare low-income assistance programs, bring outdated asset limits in line with today's cost of living, improve outreach and participation for those currently eligible. HR 1845 and S. 1428 - Medicare Durable Medical Equipment Act of 2007 regarding competitive bidding for durable medical equipment (DME). S. 3144 and HR 6252 -- Medicare DMEPOS Competitive Acquisition Reform Act of 2007, to delay implementation of Medicare competitive bidding program. HR 2642 - Iraq War supplemental appropriation -- support provision to put a moratorium on certain Medicaid regulations. HR 5613 - Protecting Medicaid Safety Net -- support provision for moratoria on existing reguslations including those that would severely restrict rehabilitation and targeted case management. Medicare Independent Living Act (HR 1809/S 2103) to reverse Medicare regulations that restrict payment for power mobility devices (wheelchairs) to those needed "in the home" rather than in the community -- such as for going to work, school, grocery store, medical appointments, places of worship, and to accompany children to school and activities. Community Choice Act of 2007 (HR 1621/S 799) -- support Medicaid coverage of community based services such as personal care, activities of daily living, etc. Direct Support Professional's Fairness & Security Act (HR 1279) -- support equalization of wages between privately and publicly employed direct support professionals. Promoting Wellness for People with Disabilities Act of 2007 (S. 1050) -- support accessibility of medical examination and diagnostic equipment for people with disabilities. Letter to President Bush and Health & Human Services Secretary Leavitt urging CMS to change the policy in its directives of August 17, 2007 and May 7, 2008 in order to eliminate the hurdles for states to provide SCHIP (State Childrens Health Insurance Plan) coverage to uninsured children. HR 2642 -- supplemental appropriations for military consturction, Dept. of Veterans Affairs and related agencies for FY 08, including: Title III - GI bill -- Veterans Educational Assistance of 2008; Title V -- Medicaid provisions including amending the Medicare, Medicaid and SCHIP Extension Act of 2007 to extend moratorium on restrictions relating to Medicaid coverage or payment for rehabilitation services or school-based administration and school-based transportation, moratoria on specific Medicaird reguslations,

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Guidance on SCHIP income eligibility for program--opposed guidance CMS Regulation on State Rehabilitation Option--opposed regulation A bill to provide a temporary increase in Federal Medical Assistance Percentage (S. 2620 and H.R. 5268)--supported FMAP increase A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill Resolution Designating the week beginning September 8, 2008, as National Direct Support Professionals Recognition Week(S.Res. 613)--supported resolution

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including -- but not limited to -- S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, 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

S799 and HR 1621, the Community Choice Act, to promote the use of community-based attendant services and supports, and to establish a medicaid plan benefit for certain long-term care services

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 450 and HR 748, The Medicare Access to Rehabilitation Services Act of 2007 - All provisions, passage. HR 1846, The Access to Physical Medicine and Rehabilitation Services Improvement Act of 2007 - Opposed based on quality, cost accountability, and scope of practice concerns. S. 1224 and HR 3269, Children's Health Insurance Program (CHIP) Reauthorization Act of 2007 - Advocated in support of the CHIP program and an expanded role for occuaptional therapy. H.R. 3162, Children's Health and Medicare Protections Act of 2007 (CHAMP) - Advocated for Medicare provision regarding therapy caps, 75% rule on inpatient rehabilitation facilities, SGR cuts and Medicaid provisions. S. 799 and H.R. 1621, The Community Choice Act - Supported all provisions. S. 578 and H.R. 1017, Protecting Children's Health in Schools Act - supported passage and maintaining Medicaid funding for school based administrative claiming and transportation services. H.R. 1809 and S. 2103, Medicare Independent Living Act - Supported the provision of improved access to mobility devices for people with disabilities. H.R. 4082 and S. 1980, Long-term Care Quality and Modernization Act of 2007 - Advocated for inclusion of occupational therapy in quality reporting. S. 932 and H.R. 1552, Medicare Patient Access to Physical Therapist Act of 2007 - Advocated regarding impact on occupational therapy. H.R. 1663, Medicare Mental Health Modernization Act of 2007 - Advocated for passage and improved role for occupational therapy. S. 1628, Nurse Faculty and Physical Therapist Education Act of 2007 - Advocated for inclusion of occupational therapy loan repayment. H.R. 4248, Ensuring Medicare Access to Recreational Thearpy Act - Opposed findings language referring to functional capacities and worked to amend that language. HR 2642 (PL 110-252) Iraq War Supplemental Appropriations -Advocated for moratorium on Medicaid School-based Transportation and Administrative Claiming Costs and opposed elimination of reimbursement for rehab service option. No bill number - Medicaid Rehabilitation Services Proposed Rule - Before Congress advocated for moratorium; opposed proposal to restrict the reimbursement of services under the rehabilitation option. HR 5704, The Medicare Home Health Flexibility Act: Advocated for the promotion of occupational therapy in home health under Medicare. No bill number: Advocated and educated about the role of occupational therapy in mental health practice. HR 6331 and S 3101, Medicare Improvement for Patients and Providers act of 2008 - Advocated for passage and inclusion of following provisions: Part B Outpatient therapy cap exceptions process extension, physician fee schedule update; reduction in copay for Medicare mental health provisions, and delay competitive bidding for DMEPOS; and PQRI. HR 5590, Medicare Oral Health Rehabilitative Enhancement Act - inclusion of occupational therapy coverage language. No bill number - Preserving Access to Medicare Act - advocated for passage and inclusion of Part B outpatient therapy cap exceptions process extension, physician fee schedule update, and physician quality review incentive (PQRI). HR 2231 and S 2931 - Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007 - advocated for exemption of complex rehab from competitive bidding for DMEPOS.

Client expense: $140,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

H 976/S 1893: State Children's Health Insurance Program; HR 3963: Children's Health Insurance Program Reauthorization Act of 2007; Medicare and Medicaid reform; Medicare competitive bidding; PL 108-173: Medicare Prescription Drug and Modernization Act of 2003; HR 1017/S 578 Protecting Children's Health in Schools Act; Federal Medical Assistance Percentage legislation; HR 1333/S 647: Medicare Patient Access to Physical Therapists Act of 2005 HR 748/S 450: Medicare Access to Rehabilitation Services Act; H. Con. Res. 99/S. Con. Res. 21 budget legislation; HR 1621/S 799: Community Choice Act of 2007; HR 3162: Children's Health & Medicare Protection (CHAMP) Act; HR 5613: Protecting the Medicaid Safety Net Act of 2008; HR 6331/S 3101: Medicare Improvements for Patients and Providers Act of 2008; HR 5748: Ryan Dant Health Care Opportunity Act of 2008; HR 2642: Military Construction and Veterans Affairs Appropriation Act of 2008.

Client expense: $121,956 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

S 898/HR 1560 - Alzheimer's Breakthrough Act of 2007 S 558 - Mental Health Parity Act of 2007 S 325/HR 506 - Health Partnership Act H.R.6282/S 2950 - Helping HANDS for Autism Act of 2008 H.R. 1669/S 982 - Positive Aging Act of 2007 H.R. 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007 H.R. 3 - Stem Cell Research Enhancement Act of 2007 H.R. 1621/ S 799- Community Choice Act of 2007 S. 2267- Americans Giving Care to Elders Act of 2007 S. 1758/HR 3001- Community Living Assistance Services and Supports Act H.R. 4897- Stop Senior Suicide Act S. 358/HR 493 - Genetic Information Nondiscrimination Act of 2007 H.R. 977 - The Genomic Research and Accessibility Act Long-Term Care Social Service Block Grant S 1758/HR 30001 - CLASS Act S 937/HR 1881 - Expanding the Promise for Individuals With Autism Act of 2007

Client expense: $68,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

Protecting Medicaid Safety Net Act (HR 5613) - moratoria on existing regulations including those that would severely restrict rehabilitation and targeted case management. Medicare Independent Living Act (HR 1809/S2103) to reverse the Medicare regulation that restricts payment for power mobility devices (wheel chairs) to those needed "in the home" rather than in the community (such as for going to work, school, (continued) grocery store, pharmacy, medical appointments, places of worship, to vote, to accompany children to school). Community Choice Act of 2007 (HR 1621/S 799) -- to provide for Medicaid coverage of community based services such as personal care, activities of daily living, etc. Direct Support Professional's Fairness & Security Act (HR 1279) -- to equalize wages between privately and publicly employed direct support personnel. Promoting Wellness for People with Disabilities Act of 2007 (S. 1050) --- to promote accessibility of medical examination and diagnostic equipment for people with disabilities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Social Security Administration (SSA), State, Dept of (DOS)

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for policies designed to improve the long-term care delivery structure by addressing health care workforce shortages and ensuring quality in care delivery (including S. 799 and H.R. 1621).

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

Government targets: HOUSE OF REPRESENTATIVES, 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

The Direct Support Professional Fairness and Security Act of 2007 (H.R. 1279)--supported bill Community Living Assistance Services and Supports Act of 2007 (S 1758 and H.R. 3001)--supported bill CMS Guidance on SCHIP income eligibility for program--opposed guidance CMS Regulation on State Rehabilitation Option--opposed regulation CMS Regulation on (Targeted) Case Management--opposed regulation CMS Regulation on Public Provider taxes--opposed regulation A bill to provide a temporary increase in Federal Medical Assistance Percentage (S. 2620 and H.R. 5268)--supported FMAP increase A bill to provide a temporary increase in Federal Medical Assistance Percentage and fiscal relief to states--supported FMAP increase and state fiscal relief (S. 2586) To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services.(S. 2578 and H.R. 5173)--supported delaying implementation of CMS rule that would change payment rules for case management and targeted case management To impose a moratorium on Medicaid payment restrictions for rehabilitation services, or school-based administration, transportation, or medical services. (H.R. 4355)--supported bill Protecting the Medicaid Safety Net Act of 2008: To extend certain moratoria and impose additional moratoria on seven Medicaid regulations through April 1, 2009. (H.R. 5613)--supported moratoria on seven CMS regulations addressed: 1) health care provider taxes 2) case management/targeted case management 3) rehabilitation/habilitation payment restrictions 4) public provider taxes 5) transportation costs for school based services 6) graduate medical education Medicaid funding restrictions 7) Department of Appeal Board procedures Economic Recovery in Health Care Act of 2008 (H.R. 2819)--supported moratoria on seven CMS regulations cited above and supported the temporary FMAP increase and assistance to states Community Choice Act of 2007: Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals. (S. 799 and H.R. 1621)--supported bill

Client expense: $70,000 · Firm income: Not reported

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

H.R. 1809, Medicare Independent Living Ct of 2007, provisions that assist persons with disabilities. S. 1799 and H.R. 1621, Community Choice Act, provisions providing independence for individuals with disabilities. H.R. 1279, Direct Support Professional Fairness and Security Act of 2007, provisions dealing with direct support workers for persons with disabilities. S. 2499, Medicare, Medicaid and SCHIP Extension Act of 2007. Legislation not yet introduced to amend the Deficit Reduction Act of 2005 to improve usefullness of the new section 1915(i) Home and Community-Based Services Option. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, sections pertaining to moratoria on Centers for Medicare and Medicaid Services rehabilitation option, case management and school based services/transportation regulations. S. 2819, Economic Recovery in Health Care Act of 2008, same as above as well as provision to impose a moratoria on SCHIP directive and provisions to provide state fiscal relief. S. 2578 and H.R. 5173, legisation to impose a one year moratorium on the CMS case management rule. H.R. 4355, moratorium on rehabilitation option and school-based transportation rule. S.Con.Res. 70 and H.Con.Res. 312, FY 2009 Budget Resolutions, provisions dealing with Medicaid reserve funds.

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