Ambulatory Surgical Center Medicare Payment Modernization Act of 2007

H.R. 1823, S. 2550; Ambulatory Surgical Center Medicare Payment Modernization Act of 2007.

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

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

S. 1164/H.R. 1926: Colon Cancer Screen for Life Act of 2007 CY2009 Physician Fee Schedule and SGR issues CMS-1517-F: Revised Payment System Policies for Services Furnished in Ambulatory Surgery Centers (ASCs) Beginning CY 2008 (formula and adequacy for GI ASCs) CMS-1404-P: Medicare Program: Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates (Provisions affecting ASC payments) CMS-1392-FC: Final Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates (Provisions affecting ASC payments) CMS-1403-P: Proposed Revision to Payment Policies under the Physician Fee Schedule, and other Revisions to Part B for CY 2009; and Revisions to the Amendment of the E-Prescribing Exemption for Computer Generated Facsimile Transmissions (Proposed rule) (Provisions relating to anti-mark-up rule, independent diagnostic testing facilities, pay-for-performance/reporting, physician update and Welcome-to-Medicare physical) CMS0013P: HIPAA Administrative Simplification: Modification to Medical Data Code Set Standards to Adopt ICD10CM and ICD10PCS (Proposed rule) CMS0009P: Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards (Proposed rule; timeframe for adoption of 5010 standard) H.R. 1823/ S. 2250 The Ambulatory Surgical Center Medicare Payment Modernization Act H.R. 3060, The Colorectal Cancer Screening and Detection Coverage Act of 2007 H.R. 3162: Childrens Health and Medicare Protection (CHAMP) Act (Provisions on physician reimbursement and preventive services) S. 2785: "Save Medicare Act of 2008 Infection control in the ambulatory setting H.R. 4879, "Virtual Screening for Cancer Act of 2007." S. 2785/H.R. 6091, "Save Medicare Act, Physician reimbursement S. 3118, Preserving Access to Medicare Act S. 3101/H.R. 6331/P.L. 110-275, "Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Colorectal Cancer FDA labeling and approval of sedation agents used in endoscopy HR 6357: Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008' or the `PRO(TECH)T Act of 2008'. S. 3343/H.R. 6821 The Medicare Imaging Disclosure Sunshine Act of 2008 H. Res. 1381, Expressing the sense of the House that there should be an increased Federal commitment prioritizing prevention and public health for all people in the United States S. 3584, Obesity Prevention, Treatment, and Research Act of 2008 Revisions to the National Cancer Act, focus on lethal cancers

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

S. 1164/H.R. 1926: Colon Cancer Screen for Life Act of 2007 CY2009 Physician Fee Schedule and SGR issues CMS-1517-F: Revised Payment System Policies for Services Furnished in Ambulatory Surgery Centers (ASCs) Beginning CY 2008 (formula and adequacy for GI ASCs) CMS-1404-P: Medicare Program: Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates (Provisions affecting ASC payments) CMS-1392-FC: Final Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates (Provisions affecting ASC payments) CMS-1403-P: Proposed Revision to Payment Policies under the Physician Fee Schedule, and other Revisions to Part B for CY 2009; and Revisions to the Amendment of the E-Prescribing Exemption for Computer Generated Facsimile Transmissions (Proposed rule) (Provisions relating to anti-mark-up rule, independent diagnostic testing facilities, pay-for-performance/reporting, physician update and Welcome-to-Medicare physical) CMS0013P: HIPAA Administrative Simplification: Modification to Medical Data Code Set Standards to Adopt ICD10CM and ICD10PCS (Proposed rule) CMS0009P: Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards (Proposed rule; timeframe for adoption of 5010 standard) H.R. 1823/ S. 2250 The Ambulatory Surgical Center Medicare Payment Modernization Act H.R. 3060, The Colorectal Cancer Screening and Detection Coverage Act of 2007 H.R. 3162: Childrens Health and Medicare Protection (CHAMP) Act (Provisions on physician reimbursement and preventive services) S. 2785: "Save Medicare Act of 2008 Infection control in the ambulatory setting H.R. 4879, "Virtual Screening for Cancer Act of 2007." S. 2785/H.R. 6091, "Save Medicare Act, Physician reimbursement S. 3118, Preserving Access to Medicare Act S. 3101/H.R. 6331/P.L. 110-275, "Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Colorectal Cancer FDA labeling and approval of sedation agents used in endoscopy HR 6357: Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008' or the `PRO(TECH)T Act of 2008'. S. 3343/H.R. 6821 The Medicare Imaging Disclosure Sunshine Act of 2008 H. Res. 1381, Expressing the sense of the House that there should be an increased Federal commitment prioritizing prevention and public health for all people in the United States S. 3584, Obesity Prevention, Treatment, and Research Act of 2008 Revisions to the National Cancer Act, focus on lethal cancers

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

340B Program, S.1376 and H.R.2606; Hospital Outpatient Pharmacy Departments (HOPDs); Legislation increasing ASC Payments - H.R.1823 and S.225; S.1693 the Wired for Health Care Quality Act; S.334 the Healthy Americans Act; H.R. 2580 medical liability reform legislation; Mental Health Parity legislation - H.R.1424 (provision limiting physician self referral; and health related provisions in the Iraq War Supplemental - H.R.2206 - dealing with limiting physician self referral.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 7110: Job Creation & Unemployment Relief Act of 2008, Title III, Temporary increase in FMAP. HR 2583: Physician Workforce Enhancement Act of 2008, provisions relating to hospitals. HR 6912: Rural Hospital Assistance Act of 2008, entire bill. S 3300: Rural Hospital Assistance Act of 2008, entire bill. S 3582: Safeguarding our Hospitals' Futures Act of 2008, entire bill. HR 6966: Safeguarding our Hospitals' Futures Act of 2008, entire bill. HR 7067: Quality FIRST Act of 2008, provisions relating to hospitals and value-based purchasing. S 3656: Preserving Access to Healthcare (PATH) Act of 2008, sections relating to hospitals, rural health clinics, hospices. HR 6873: Medicare Hospice Protection Act of 2008, entire bill. S 3484: Hospice Protection Act of 2008, entire bill. HR 6652: Nurses Higher Education and Loan Repayment Act of 2008, entire bill. HR 1424: Emergency Economic Stabilization Act of 2008, section 512, mental health parity. HR 1343: Health Care Safety Net Act of 2008, section 3: National Health Service Corps., section 7: Revision of Timeframe for RHCs. S 3367: Rural Health Clinic bill to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program, entire bill. HR 6699: Health Security for All Americans Act of 2008, section 105 involving improvements to MDH program; section 106 involving payment adjustment for low-volume hospitals. S 1693: Wired for Health Care Quality Act, provisions related to hospitals. HR 6898: Health-e Information Technology Act, provisions related to hospitals. HR 6867: Unemployment Compensation Extension Act of 2008, provisions related to hospitals. S 3507: Unemployment Compensation Extension Act of 2008, provisions related to hospitals. HR 6357: PRO(TECH)T Act of 2008, provisions related to hospitals. HR 1823: Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, entire bill. S 2250: Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, entire bill. HR 800: Employee Free Choice Act of 2007, entire bill. S 1041: Employee Free Choice Act of 2007, entire bill. Other Issues: CAH conditions of participation, section 485.635 Healthcare reform Value-based purchasing, including Grassley/Baucus VBP discussion drafts Guidance for clinical integration Electronic health records and Health IT Payment updates for physicians and hospital inpatient/outpatient services CMS DME and oxygen payment rules Self-referral and physician-owned hospitals HHS provider conscience regulations Capital IME CMS guidelines related to use of providers contracted through a locum service CMS recovery audit contractor program Wage index reclassification ICD-10-CM and ICD-10-PCS medical data code sets

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1665/S 2352- Medicare Hearing Health Care Enhancement Act of 2007, all provisions. HR 1823/S 2250- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, all provisions. HR 1774/S 45- Establishes a separate definition of outpatient speech-language pathology services under Medicare, all provisions. S 2785- Save Medicare Act of 2008, all provisions. S. 3101 - Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3118 - Preserving Access to Medicare Act of 2008, all provisions HR 6331- Medicare Improvements for Patients and Providers Act of 2008, all provisions HR 2585/S 2729- Ensuring the Future Physician Workforce Act of 2008, all provisions. 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, all provisions. CMS Transmittals- 84, 1470, and 1550 - "Incident to" policy relating to audiology services.

Client expense: $98,648 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Personnel Management (OPM), SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424), War Supplemental Appropriations (HR 2642) and wherever proposed support HR 1823/S. 2250 on reimbursement for ambulatory surgical centers oppose IDTF regulations in PFS

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

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 (HR 2642) and wherever proposed support HR 1823/S. 2250 on reimbursement for ambulatory surgical centers oppose IDTF regulations in PFS

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

support revisions to 75% Inpatient Rehabilitation Rule (HR 110/S. 543) support legislation regarding Hospital in Hospital regulations (HR 552/S.338) oppose legislation mandating a moratorium on physician owned hospitals (CHAMP ACT HR 3162) (Mental Health Parity bill (HR 1424) and wherever attempted; support legislation reforming ASC reimbursement (HR 1823/S.2250)

Client expense: Not reported · Firm income: $33,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1164/HR 1926; HR 1823/S 2250; HE 3060 -- lobbying related to medicare reimbursement for GI procedures and services, as well as ambulatory surgery centers (ACSs) and infection control in the ambulatory setting.

Client expense: Not reported · Firm income: $22,500

Government targets: Health & Human Services, Dept of (HHS)

HR 1665/S 2352- Medicare Hearing Health Care Enhancement Act of 2007, all provisions. HR 1823/S 2250- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, all provisions. HR 1774/S 45- Establishes a separate definition of outpatient speech-language pathology services under Medicare, all provisions. S 2785- Save Medicare Act of 2008, all provisions. S. 3101 - Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3118 - Preserving Access to Medicare Act of 2008, all provisions HR 6331- Medicare Improvements for Patients and Providers Act of 2008, all provisions HR 2585/S 2729- Ensuring the Future Physician Workforce Act of 2008, all provisions. 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, all provisions. CMS Transmittals- 84, 1470, and 1550 - "Incident to" policy relating to audiology services.

Client expense: $90,262 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Personnel Management (OPM), SENATE

HR. 1823/S. 2250-- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1164/H.R. 1926 Colon Cancer Screen for Life Act; S. 3101/H.R. 6331, Medicare Improvement for Patients and Providers Act of 2008; S. 3118, Preserving Access to Medicare Act of 2008; S. 2250/H.R. 1823, Ambulatory Surgical Center Medicare Payment Modernization Act of 2007; CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Cancer.

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), SENATE

Medicare reimbursement for ambulatory surgical centers HR 1823/S. 2250-- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007 Extension of the research and development tax credit

Client expense: Not reported · Firm income: Not reported

Medicare reimbursement for ambulatory surgical centers HR 1823/S. 2250-- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007 Extension of the research and development tax credit

Client expense: Not reported · Firm income: Not reported

Proposed Revisions Medicare payment policies for services furnished in ambulatory surgery centers (ASCs) (CMS-1404-P) Proposed Revisions to Medicare's definition of an ASC (CMS-3887-P) HR 1823/S 2250, "Ambulatory Surgical Center Medicare Payment Modernization Act of 2007" (entire bill) HR 6331, "Medicare Improvements for Patients and Providers Act of 2008"

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

Payment rates in ASC rule (CMS-1404-P). Proposed overnight stay regulations in ASC/HOPD rule (CMS-3887-P). H.R. 1823/S. 2250, "Ambulatory Surgical Center Medicare Payment Modernization Act of 2007." H.R. 6331, "Medicare Improvements for Patients and Providers Act of 2008."

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

340B Program - S.1376 and H.R.2606; Hospital Outpatient Pharmacy Departments (HOPDs); legislation increasing ASC Payments - H.R.1823 and S.225; S.1693 the WIred for Health Care Quality Act; S.334 the Healthy Americans Act; H.R.2580 medical liability reform legislation; Mental Health Parity legislation H.R.1424 (provision limiting physician Self Referral; and, health related provisions in the Iraq War Supplemental - H.R.2206 and H.R.2206 - specifically dealing with limiting physician self referral.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1164/H.R. 1926: Colon Cancer Screen for Life Act of 2007 CY2009 Physician Fee Schedule and SGR issues CMS-1517-F: Revised Payment System Policies for Services Furnished in Ambulatory Surgery Centers (ASCs) Beginning CY 2008 (formula and adequacy for GI ASCs) CMS-1404-P: Medicare Program: Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates (Provisions affecting ASC payments) CMS-1392-FC: Final Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates (Provisions affecting ASC payments) CMS-1403-P: Proposed Revision to Payment Policies under the Physician Fee Schedule, and other Revisions to Part B for CY 2009; and Revisions to the Amendment of the E-Prescribing; Exemption for Computer Generated Facsimile Transmissions (Proposed rule) (Provisions relating to anti-mark-up rule, independent diagnostic testing facilities, pay-for-performance/ reporting, physician update and Welcome-to-Medicare physical) CMS0013P: HIPAA Administrative Simplification: Modification to Medical Data Code Set Standards to Adopt ICD10CM and ICD10PCS (Proposed rule) CMS0009P: Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards (Proposed rule; timeframe for adoption of 5010 standard) H.R. 1823/ S. 2250 The Ambulatory Surgical Center Medicare Payment Modernization Act H.R. 3060, The Colorectal Cancer Screening and Detection Coverage Act of 2007 H.R. 3162: Childrens Health and Medicare Protection (CHAMP) Act (Provisions on physician reimbursement and preventive services) S. 2785: "Save Medicare Act of 2008 Infection control in the ambulatory setting H.R. 4879, "Virtual Screening for Cancer Act of 2007." S. 2785/H.R. 6091, "Save Medicare Act, Physician reimbursement S. 3118, Preserving Access to Medicare Act S. 3101/H.R. 6331/P.L. 110-275, "Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Colorectal Cancer FDA labeling and approval of sedation agents used in endoscopy HR 6357: Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008' or the `PRO(TECH)T Act of 2008'. S. 3343/H.R. 6821 The Medicare Imaging Disclosure Sunshine Act of 2008 H. Res. 1381, Expressing the sense of the House that there should be an increased Federal commitment prioritizing prevention and public health for all people in the United States S. 3584, Obesity Prevention, Treatment, and Research Act of 2008 Revisions to the National Cancer Act, focus on lethal cancers FDA communications to physicians on product issues

Client expense: $200,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 1164/H.R. 1926: Colon Cancer Screen for Life Act of 2007 CY2009 Physician Fee Schedule and SGR issues CMS-1517-F: Revised Payment System Policies for Services Furnished in Ambulatory Surgery Centers (ASCs) Beginning CY 2008 (formula and adequacy for GI ASCs) CMS-1404-P: Medicare Program: Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates (Provisions affecting ASC payments) CMS-1392-FC: Final Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates (Provisions affecting ASC payments) CMS-1403-P: Proposed Revision to Payment Policies under the Physician Fee Schedule, and other Revisions to Part B for CY 2009; and Revisions to the Amendment of the E-Prescribing, Exemption for Computer Generated Facsimile Transmissions (Proposed rule) (Provisions relating to anti-mark-up rule, independent diagnostic testing facilities, pay-for- performance/ reporting, physician update and Welcome-to-Medicare physical) CMS0013P: HIPAA Administrative Simplification: Modification to Medical Data Code Set Standards to Adopt ICD10CM and ICD10PCS (Proposed rule) CMS0009P: Health Insurance Reform; Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards (Proposed rule; timeframe for adoption of 5010 standard) H.R. 1823/ S. 2250 The Ambulatory Surgical Center Medicare Payment Modernization Act H.R. 3060, The Colorectal Cancer Screening and Detection Coverage Act of 2007 H.R. 3162: Childrens Health and Medicare Protection (CHAMP) Act (Provisions on physician reimbursement and preventive services) S. 2785: "Save Medicare Act of 2008 Infection control in the ambulatory setting H.R. 4879, "Virtual Screening for Cancer Act of 2007." S. 2785/H.R. 6091, "Save Medicare Act, Physician reimbursement S. 3118, Preserving Access to Medicare Act S. 3101/H.R. 6331/P.L. 110-275, "Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Colorectal Cancer FDA labeling and approval of sedation agents used in endoscopy HR 6357: Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008' or the `PRO(TECH)T Act of 2008'. S. 3343/H.R. 6821 The Medicare Imaging Disclosure Sunshine Act of 2008 H. Res. 1381, Expressing the sense of the House that there should be an increased Federal commitment prioritizing prevention and public health for all people in the United States S. 3584, Obesity Prevention, Treatment, and Research Act of 2008 Revisions to the National Cancer Act, focus on lethal cancers FDA communications to physicians on product issues

Client expense: $200,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 1823 S.2250; Conditions for Coverage for Ambulatory Surgical Centers.

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

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

H.R. 1823, S. 2550; Ambulatory Surgical Center Medicare Payment Modernization Act of 2007.

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

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

support revisions to 75% Inpatient Rehabilitation Rule (HR 110/S. 543) support legislation regarding Hospital in Hospital regulations (HR 552/S.338) oppose legislation mandating a moratorium on physician owned hospitals (CHAMP ACT HR 3162) (Mental Health Parity bill (HR 1424) and wherever attempted; support legislation reforming ASC reimbursement (HR 1823/S.2250)

Client expense: Not reported · Firm income: $33,000

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424), War Supplemental Appropriations (HR 2642) and wherever proposed support HR 1823/S. 2250 on reimbursement for ambulatory surgical centers

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

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424), War Supplemental Appropriations (HR 2642) and wherever proposed support HR 1823/S. 2250 on reimbursement for ambulatory surgical centers

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

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

S. 1164/HR 1926, Colon Cancer Screen for Life Act; S. 3101/HR 6331, Medicare Improvement for Patients and Providers Act of 2008; S. 3118, Preserving Access to Medicare Act of 2008. S. 2250/HR 1823, Ambulatory Surgical Center Medicare Payment Modernization Act of 2007.

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), SENATE

Revised Medicare payment policies for services furnished in ambulatory surgery centers. H.R. 1823/S. 2250, "Ambulatory Surgical Center Medicare Payment Modernization Act of 2007." Revisions to Medicare's "overnight stay" criteria for services furnished in ambulatory surgery centers.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

H.R. 1823, S. 2550; Ambulatory Surgical Center Medicare Payment Modernization Act of 2007.

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

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

H.R. 1823 S.2250; Conditions for Coverage for Ambulatory Surgical Centers.

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

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

S. 1164/H.R. 1926: Colon Cancer Screen for Life Act of 2007 CY2009 Physician Fee Schedule and SGR issues CMS-1517-F: Revised Payment System Policies for Services Furnished in Ambulatory Surgery Centers (ASCs) Beginning CY 2008 (formula and adequacy for GI ASCs) CMS-1392-P: Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2008 Rates; Medicare and Medicaid Programs; Proposed Changes to Hospital Conditions of Participation (formula and payment adequacy for GI ASCs) CMS-1392-FC Final Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates (Provisions affecting ASC payments) H.R. 1823/ S. 2250 The Ambulatory Surgical Center Medicare Payment Modernization Act H.R. 3060, The Colorectal Cancer Screening and Detection Coverage Act of 2007 H.R. 3162: Childrens Health and Medicare Protection (CHAMP) Act (Provisions on physician reimbursement and preventive services) S. 2785: "Save Medicare Act of 2008 Infection control in the ambulatory setting H. CON. RES.302: Supporting the observance of Colorectal Cancer Awareness Month, and for other purposes. H.R. 4879, "Virtual Screening for Cancer Act of 2007." S. 2785/H.R. 6091, "Save Medicare Act, Physician reimbursement S. 3118, Preserving Access to Medicare Act S. 3101: Medicare Improvements for Patients and Providers Act of 2008 H.R. 6331, "Medicare Improvements for Patients and Providers Act of 2008 CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Colorectal Cancer FDA labeling and approval of sedation agents used in endoscopy

Client expense: $210,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

S. 1164/H.R. 1926: Colon Cancer Screen for Life Act of 2007 CY2009 Physician Fee Schedule and SGR issues CMS-1517-F: Revised Payment System Policies for Services Furnished in Ambulatory Surgery Centers (ASCs) Beginning CY 2008 (formula and adequacy for GI ASCs) CMS-1392-P: Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2008 Rates; Medicare and Medicaid Programs; Proposed Changes to Hospital Conditions of Participation (formula and payment adequacy for GI ASCs) CMS-1392-FC Final Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates (Provisions affecting ASC payments) H.R. 1823/ S. 2250 The Ambulatory Surgical Center Medicare Payment Modernization Act H.R. 3060, The Colorectal Cancer Screening and Detection Coverage Act of 2007 H.R. 3162: Childrens Health and Medicare Protection (CHAMP) Act (Provisions on physician reimbursement and preventive services) S. 2785: "Save Medicare Act of 2008 Infection control in the ambulatory setting H. CON. RES.302: Supporting the observance of Colorectal Cancer Awareness Month, and for other purposes. H.R. 4879, "Virtual Screening for Cancer Act of 2007." S. 2785/H.R. 6091, "Save Medicare Act, Physician reimbursement S. 3118, Preserving Access to Medicare Act S. 3101: Medicare Improvements for Patients and Providers Act of 2008 H.R. 6331, "Medicare Improvements for Patients and Providers Act of 2008 CMS National Coverage Analysis on Screening Computed Tomography Colonography (CTC) for Colorectal Cancer FDA labeling and approval of sedation agents used in endoscopy

Client expense: $210,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

Provisions of the Presidents FY2008 Budget and related appropriations legislation (S Con Res 70) related to implementation of the Medicare Advantage and Prescription Drug Programs, the provision of Medicare and Medicaid services and benefits to patients, incentives to promote electronic health records for all Americans, and prescription drug benefits. S 3101, and HR 6331, the Medicare Improvements for Patients and Providers Act of 2008. Supported provisions that prevent the 10.6% cut in Medicare physician payment that was called for in the November 27, 2007 CMS final rule implementing the Medicare physician fee schedule. The bill replaces the 10.6% cut with an increase through 2008, and extended the 1.0 floor on the geographic adjustor for physician work initially included in the Medicare Modernization Act of 2003 through 2008. S.2812, the Medicare Improvement Act of 2008 introduced by senator Kent Conrad. This legislation will expand the number of originating sites, the list of eligible practitioners, and provide an advisory committee to CMS and Congress on payment issues related to services provided via TeleHealth. The Physician Payment Sunshine Act, S. 2029, introduced by Senator Kohl with Senator Grassley to create accountability among physicians and the manufacturers of drugs and devices that physicians utilize and prescribe for their patients. This legislation would require manufacturers of pharmaceutical drugs, medical devices, and biologics to disclose the amount of money they give to doctors through payments, gifts, honoraria, travel and other means. The Medicare Rural Health Access Improvement Act, S 2786, introduced by Senator Grassley to mitigate current inequities in Medicare reimbursement, improve access to health services in rural and underserved areas, and will begin to close the gap between Medicare reimbursement and the cost of providing services in predominantly rural areas. The legislation establishes a 1.0 floor for physician work and practice expense adjustments. It also revises the work and practice expense formulas to reduce payment differences and more accurately compensate physicians in rural areas for their true practice costs. The bill also extends the five percent incentive payments for primary care and specialty physicians in scarcity areas. Marshfield Clinic nominated Dr. Douglas Reding for an open position on the Medicare Payment Advisory Commission, and sought the endorsement of the Wisconsin delegation, and other Senators and Representatives that serve on the Committees with jurisdiction over the Medicare program. Sustainable Growth Rate Medicares SGR mechanism unfairly links physician payment updates to factors unrelated to patients needs and the cost of providing patient care. Reform proposals include reimbursement updated on a market basket basis, removal of prescription drugs from the calculation of Medicare Part B costs, and rebasing Part B to reflect current rather than cumulative costs. Support for S.2785, the Save Medicare Access Act of 2008, introduced by Sen. Debbie Stabenow. It would avert the 10.6% cut to physician payments scheduled to take effect in July and the additional cut of 5% or more scheduled in January 09. Payments would continue at their current rate through the remainder of 2008 and then would rise by 1.8% in 2009. The current work GPCI floor and physician scarcity bonus would also be continued through the end of 2009. Pay-for Reporting and Performance Currently the prevailing methods of paying for health care in the US neither incent nor reward providing high quality care. The rising costs of care coupled with the increasing awareness of poor quality care have made clear the need for a transformation in the way health care is financed. In the fee-for-service system Medicare currently reimburses for units of service, in a manner that promotes service utilization without regard to quality. This has had the unanticipated, but now recognized effect of economically stimulating growth in the numbers of services provided by physicians. Medicare must implement quality based payments for physician services, and capture the data on performance measures utilizing available claims-based data recoverable through enhanced IT functions. In 2005, the Centers for Medicare and Medicaid Services (CMS) proposed the Physicians Voluntary Reporting Program (PVRP). In late 2006 CMS renamed PVRP the Physicians Quality Reporting Initiative. (PQRI) In the PQRI program CMS calls on physicians to report on evidence-based performance measures selected with input from the National Quality Forum, the Ambulatory Care Quality Alliance, and the National Committee for Quality Assurance, (NCQA). For reporting purposes physicians will utilize provisional G- Codes developed by CMS to indicate whether a patient received a service, did not receive the service, was not a eligible candidate to receive the service, or would not be considered a patient under the care of the physician at the time of the service. Marshfield Clinic has recommended that CMS allow medical groups to electronically report quality measures in an aggregated, periodic, statistically valid basis to PQRI; and re-focus the PQRI on high cost/high volume disease states. Marshfield Clinic supports a request for CMS authorization and funding for a multi-center demonstration project with access to vast data resources across multiple states. This proposed project will connect treatments with outcomes and develop quality metrics that reflect the realities of the care setting and the severity of the patients illness. Information Technology Under current law the capital and operating expenses of installing and maintaining an electronic medical record are assumed to be part of the overhead expense of a medical practice. Since no more than 5 10% of the physician population has installed EMRs, CMS measurement of current physician practice expenses reflect minimal expense associated with IT. Congress should provide incentives for EMR adoption, and should establish standards to facilitate the sharing and exchange of data. S. 1693, the Wired for Health Care Quality Act introduced by Senator Ted Kennedy (D-MA) and Michael Enzi (R-WY) - Amends the Public Health Service Act to establish the Office of the National Coordinator of Health Information Technology to coordinate and oversee programs and activities to develop a nationwide interoperable health information technology infrastructure. HR 6357, the Protecting Records, Optimizing Treatment and Easing Communications through Health Care Technology Act of 2008 is important legislation that promotes Health Information Technology and the protection of patients personal health information. HR 6357 codifies ONCHIT, provides grants and loans for HIT, but most importantly the bill creates new privacy and security provisions which require notification of breaches of PHI by covered entities and business associates. The bill also includes restrictions on certain disclosures of PHI allowing patients to request that their information not be released to health plans in certain circumstances. It also includes an impractical consent provision that requires additional patient consent if the PHI is utilized in operations, such as peer review, quality review, standard of care review, malpractice review, or best practices analysis. Payment Fairness for Practice Costs The formulas by which Medicares payments are calculated are widely variable throughout Medicare localities, and are based upon outdated data assumptions regarding the cost and organization of medical practice. Alternatives: CMS should administratively revise its measurements of the costs of practice to assure the validity and fairness of payments; a payment floor could be established for practice expense; or the present variation (.705 1.501) in practice expense could be channeled into a narrower corridor of adjustment. Payment Equity Before MMA 03, Medicares payments were geographically adjusted based upon erroneous assumptions about the cost of hiring and retaining physicians. Congress established a floor payment mechanism for the physician work component of Medicare payment for 04 07 to assure that physicians in low payment localities were compensated for their work at least at the national average payment amount. This payment floor should be extended indefinitely or geographic adjustment of work should be eliminated entirely. The Rural Medicare Equity Act of 2007 (S 498), introduced by Senator Russ Feingold, Amends title XVIII (Medicare) of the Social Security Act (SSA) to eliminate the geographic physician work adjustment factor from the geographic indices used to adjust payments under the physician fee schedule. Rep. Braley introduced HR 2827, the Medicare Equity and Accessibility Act, along with Rep. Adrian Smith (R-Nebraska). This bill will increase the Medicare Part B reimbursement rates in Iowa and other rural states, by making permanent the 1.0 floor on the Geographic Practice Indexes for Work and Practice Expense. Support for Medicare Rural Health Access Improvement Act, S 2786, introduced by Senator Chuck Grassley especially provisions that would extend the 1.0 work floor through December 31,2009, and would recognize the equality of physician work in all geographic areas and eliminate differing work index values by establishing a national value of 1.0, effective 2010. Also support provisions for physician practice expense that would establish a practice expense floor of 1.0 for 2009 by requiring the Secretary to increase the value of any practice expense geographic index that was below 1.0 to 1.0 for services furnished on or after January 1, 2009 and before January 1, 2010. Subsection (b) would reduce the geographic adjustment for practice expense to 50 percent of the current adjustment for employee wages and rent, effective 2010. Support for Rep. Ron Kinds concept of a not yet introduced MEDICARE EFFICIENCY BILL that would amend the CHAMP Act (H.R. 3162) 304 in whole, by establishing that the 5% bonus payment would be expanded to the top 10% of efficient counties; and a corresponding 5% efficiency penalty for physicians in the bottom 10% of efficient counties. Medicare Prescription Drug, Improvement, and Modernization Act of 2003 - Public Law No: 108-173: Title II: Medicare Advantage -- (Sec. 211) Revises the payment system, requiring all plans to be paid at a rate at least as high as the rate for traditional Medicare fee-for-service plans. Makes change in budget neutrality for blended payments. Increases minimum percentage increase to national growth rate. Marshfield Clinic opposes reductions to Medicare Advantage payments in low payment states. Subtitle D: Additional Reforms - (Sec. 237) Provides that Federally Qualified Health Centers (FQHCs) will receive a wrap-around payment for the reasonable costs of care provided to Medicare managed care patients served at such centers. Raises reimbursements to FQHCs in order that when they are combined with MA payments and cost-sharing payments from beneficiaries they equal 100 percent of the reasonable costs of providing such services. Extends the safe harbor to include any remuneration between a FQHC (or entity controlled by an FQHC) and an MA organization. Title IV: Rural Provisions - Subtitle B: Provisions Relating to Part B Only - (Sec. 412) Directs the Secretary to increase the work geographic index to 1.00 for any locality for which such work geographic index is less than 1.00 for services furnished on or after January 1, 2004, and before January 1, 2007. Since this provision expires at the end of 2006 it must be extended or revised. See Tax Relief and Health Care Act provisions below (Sec. 413) Establishes a new five percent incentive payment program designed to reward both primary care and specialist care physicians for furnishing physicians' services on or after January 1, 2005, and before January 1, 2008 in physician scarcity areas. Directs the Secretary to pay the current law ten percent Health Professional Shortage Area (HPSA) incentive payment for services furnished in full county primary care geographic area HPSAs automatically rather than having the physician identify the health professional shortage area involved. Subtitle C: Other Provisions - (Sec. 626) Provides that in FY 2004, starting April 1, 2004, the ambulatory surgery center (ASC) update will be the Consumer Price Index for all urban consumers (U.S. city average) as estimated as of March 31, 2003, minus 3.0 percentage points. Provides that in FY 2005, the last quarter of calendar year 2005, and each of calendar years 2006 through 2009, the ASC update will be zero percent. Provides that subject to recommendations by the General Accounting Office, the Secretary will implement a revised payment system for payment of surgical services furnished in ASCs. Requires the new system to be implemented so that it is first effective on or after January 1, 2006, and not later than January 1, 2008. (Sec. 628) Provides that there will be no updates to the clinical diagnostic laboratory test fee schedule for 2004 through 2008. Subtitle D: Additional Demonstrations, Studies, and Other Provisions - (Sec. 649) Directs the Secretary to establish a pay-for-performance demonstration program with physicians to meet the needs of eligible beneficiaries through the adoption and use of health information technology and evidence-based outcomes measures Deficit Reduction Act (Section 5102) reduced reimbursements for multiple images on contiguous body parts in 2006; the DRA provision created in statute a basis for payment reductions on the imaging of contiguous body parts that CMS implemented through the rulemaking process in 2005; the DRA also requires that payment rates for imaging services delivered in physician offices do not exceed payment rates for identical imaging services delivered in hospital outpatient departments beginning in 2007. Clinic recommends that Congress repeal Section 5102, and direct MedPAC and CMS to conduct a comprehensive study of imaging and the geographic variation in services to determine where growth in the volume of imaging services is appropriate and develop workable solutions to control inappropriate imaging utilization. CMS Physician Group Practice Demonstration On September 27, 2002 the Centers for Medicare and Medicaid Services published a notice in the Federal Register informing interested parties of an opportunity to submit proposals for participation in the Medicare Physician Group Practice Demonstration (PGP) project to test a hybrid payment methodology that combines Medicare fee-for-service payments with a bonus pool derived from savings achieved by improvements in patient care management. Marshfield Clinic submitted a proposal for this demonstration and was selected by CMS to participate in the demonstration program, effective April 1, 2005. Marshfield Clinic supported CMS determination to extend this program, beyond its initial 3-year term. Also supports efforts to eliminate the 2% threshold for payments and the 5% limitation on payments. Ambulatory Surgical Center Medicare Payment Modernization Act of 2007 H.R.1823 Ambulatory Surgical Center Medicare Payment Modernization Act of 2007 introduced by Rep. Wally Herger and Kendrick Meek - Amends title XVIII (Medicare) of the Social Security Act to revise the requirements and the formula for payments for services, including an implantable medical device, furnished to individuals in ambulatory surgical centers. Regulatory clarification of Medicare anti-markup issues, and postponement of the effective date of CMS final rule regarding the applicability of the anti markup provisions with respect to: (1) the technical component of a purchased diagnostic test and (2) any anatomic pathology diagnostic testing services furnished in space that is utilized by a physician group practice as a "centralized building" for purposes of complying with the physician self-referral rules and does not qualify as a "same building".

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

S. 2785, the Save Medicare Act. Medicare Physician Payment Reform. Physician Performance Measures S. 2250 and H.R. 1823, the Ambulatory Surgical Center Medicare Payment Modernization Act -- reform of payments and access to ambulatory surgery centers.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Revised Medicare payment policies for services furnished in ambulatory surgery centers. H.R. 1823/S.2250, "Ambulatory Surgical Center Medicare Payment Modernization Act of 2007", entire bill. Proposed revisions to Medicare's definition of an ASC

Client expense: $110,000 · Firm income: Not reported

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

Revised Medicare payment policies for services furnished in ambulatory surgery centers. H.R. 1823/S.2250, "Ambulatory Surgical Center Medicare Payment Modernization Act of 2007." Revisions to Medicare's definition of an ambulatory surgery center.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

340B Program - S.1376 and H.R.2606; Hospital Outpatient Pharmacy Departments (HOPDs); legislation increasing ASC payments - H.R. 1823 and S.225; S. 1693, the Wired for Health Care Quality Act; S.334, The Healthy Americans Act; and, H.R. 2580 a medical liability reform bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1665/S 2352- Medicare Hearing Health Care Enhancement Act of 2007, all provisions. HR 1823/S 2250- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, all provisions. HR 1774/S 45- Establishes a separate definition of outpatient speech-language pathology services under Medicare, all provisions. S 2785- Save Medicare Act of 2008, all provisions. S. 3101 - Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3118 - Preserving Access to Medicare Act of 2008, all provisions HR 6331- Medicare Improvements for Patients and Providers Act of 2008, all provisions HR 2585/S 2729- Ensuring the Future Physician Workforce Act of 2008, all provisions. 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, all provisions.

Client expense: $78,500 · Firm income: Not reported

Government targets: Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Personnel Management (OPM), SENATE

oppose legislation to extend moratorium on physician owned hospitals in CHAMP ACT (HR 3162), Mental Health Parity Bill (HR 1424), War Supplemental Appropriations (HR 2642) and wherever proposed support HR 1823/S. 2250 on reimbursement for ambulatory surgical centers

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

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 (HR 2642) and wherever proposed support HR 1823/S. 2250 on reimbursement for ambulatory surgical centers

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

support revisions to 75% Inpatient Rehabilitation Rule (HR 110/S. 543);support legislation regarding Hospital in Hospital regulations (HR 552/S.338);oppose legislation mandating a moratorium on physician owned hospitals (CHAMP ACT HR 3162) (Mental Health Parity bill (HR 1424), War Supplemental Appropriations Act (HR2642), and wherever attempted; support legislation reforming ASC reimbursement (HR 1823/S.2250)

Client expense: Not reported · Firm income: $33,000

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

H.R. 1823, S. 2550; Ambulatory Surgical Center Medicare Payment Modernization Act of 2007.

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

Revised Medicare payment policies for services furnished in ambulatory surgery centers. H.R. 1823/S. 2250, "Ambulatory Surgical Center Medicare Payment Modernization Act of 2007." Revisions to Medicare's "overnight stay" criteria for services furnished in ambulatory surgery centers.

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

Revised Medicare payment policies for services furnished in ambulatory surgery centers. H.R. 1823/S.2250, "Ambulatory Surgical Center Medicare Payment Modernization Act of 2007", entire bill. Proposed revisions to Medicare's definition of an ASC

Client expense: $110,000 · Firm income: Not reported

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

H.R. 1823 S.2250; Conditions for Coverage for Ambulatory Surgical Centers.

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