Rural Health Services Preservation Act of 2007

S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007, provisions dealing with RHC reimbursement H.R. 2860 Health Care Access and Rural Equity Act of 2007, provisions dealing with RHC reimbursement S. 630 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health clinics H.R. 2159 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health cli H.R. 3162 Children's Health and Medicare Protection (CHAMP) Act of 2007, provisions relating to RHC reimbursement Medicare, Medicaid, SCHIP Extension Act of 2007, provisions related to RHC reimbursement S. 1693 Wired for Health Care Quality Act, provisions related to infrastructure development for rural providers H.R. 630 Rural Health Services Preservation Act, provisions related to RHC reimbursement H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, raising the rural health clinics per visit cap S. 901 Health Centers Renewal Act of 2007, provisions dealing with Rural Health Clinics H.R. 1343 Health Centers Renewal Act of 2007 provisions dealing with Rural Health Clinics S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, provisions dealing with delay of RHC rules S. 3367 Legislation to modify the RHC statute to make certification timetables consistent

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

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

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, 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. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program; H.R. 6912 and S. 3300 Rural Hospital Assistance Act of 2008, to amend title XVIII of the Social Security Act to provide for temporary improvements to the Medicare inpatient hospital payment adjustment for low-volume hospitals and to provide for the use of the non-wage adjusted PPS rate under the Medicare-dependent hospital (MDH) program, and for other purposes; S. 3327 Empowered at Home Act of 2008, to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; H.R. 6394 Border Health Care Relief Act of 2008, to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend Federal reimbursement of emergency health services furnished to undocumented aliens, and for other purposes; S. 3367, to amend title XVIII of the Social Security Act to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program; S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, a bill to preserve access to healthcare under the Medicare and Medicaid programs. The sections related to the Medicare indirect medical education adjustment factor and the delay in implementation of Medicaid outpatient hospital services regulation; S. 1595 Critical Access Hospital Flexibility Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; S. 2853, to amend title XVIII of the Social Security Act to remove the cap on disproportionate share adjustment percentages for certain rural hospitals; H. R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008, to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; H. R. 6966 and S. 3582 Safeguarding Our Hospitals' Futures Act of 2008, all provisions to require continued application of budget neutrality on a national basis in calculation of the Medicare urban hospital wage floor.

Client expense: $3,950,000 · Firm income: Not reported

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

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act-Oppose Card Check process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on medicaid regulations affecting intergovernmental transfers; S.2499 Medicare, medicaid, and SCHIP extension act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and establish moratorium on Medicaid rules; increase FMAP; S.3101 the Medicare improvements for patients and providers act; S.3656 Preserving access to healthcare (PATH) act of 2008; H.R.800 Employee free choice act (oppose card check process); H.R.866 Secret ballot protection act; H.R.976 Children's health insurance reauthoriation act of 2007; H.R.1105 Physician pathology services continuity act; H.R.1177 Sole commuunity hospital preservation act; H.R.1424 Paul Wellstone mental health and addiction equity act of 2007; H.R.1644 Oppose reversal of NLRB quidance on when charge nurses are classified as supervisors; H.R.1663 Medicare mental health modernization act of 2007; H.R.2159 Rural health services preservation act; H.R.2406 establishes NIST role in standard setting for health IT; H.R.2638 Consolidated security, disaster assistance, and continuing appropriations act, 2009; Continuing resolution 2009; H.R.2642 Supplemental appropriations act, 2008; H.R.3162 Children health and Medicare protection act of 2007; H.R.3326 Early treatment for HIV act; H.R.3533 Public and teaching hospital preservation Act; H.R.4105 One-year moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5480 Medicare funding warning response act of 2008; H.R.5613 Extend and establish moratorium on Medicaid rules; H.R.5924 Emergency nursing supply relief act; H.R.6331 Physician Medicare payment releif; H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology; H.R.6898 Health-E IT Act of 2008; H.R.7067 Quality FIRST Act of 2008; H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision; H.R.7219 the Protecting Hospital and outpatient and community clinic services act of 2008; H.R.7241 Preserving access to health care (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare prescription drug improvement and modernization act of 2003; FFY 2009 budget and budget resolutions/Medicare and Medicaid cuts; FFY 2009 Labor, health and human services, education and pension appropriations bill; FFY 2009 Medicare Inpatient hospital PPS rules; CY 2009 Medicare inpatient Psychiatric facility PPS rules; FFY 2009 Medicare inpatient rehabiltiation facility PPS and "75% rule," rules; CY 2009 Medicare otupatient PPS rules; FFY 2009 Medicare skilled nursing facility PPS rules; CY 2009 Medicare home health agency PPS rules; CY 2009 Medicare physician fee schedule update; CMS proposed rule to limit intergovernmental transfers and certified public expenditures; CMS proposed value-based purchasing program; CMS proposed rule on Medicad graduate medical education payments; State childrens health insurance program funding; IRS Form 990 revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; pay for performance/value based purchasing; health information technology; hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductibel health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; mental health parity; Limited service hospitals; Department of Housing and Urban Development's federal housing assistance mortage program for hospitals; Defiend benefit pension plans; National Institute of Health funding; Health care workforce recruting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340b drug pricing program; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; CMS directive to states establishing new requirements for increasing SCHIP coverage; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: $220,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Continuity Act, S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas H.R. 6357 Protecting Records, Optimizing Treatment and Easing Communications through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB)

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors;S.1041 Employee Free Choice Act-Oppose Card Check Process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R. 800 Employee Free Choice Act-Oppose Card Check Process; H.r. 866 Secret Ballot Protection Act; H.R. 976 Children's Health Insurance Reauthorization Act of 2007; H.R. 1105 Physician Pathology Services Continuity Act; H.R. 1177 Sole Community Hospital Preservation Act; H.R. 1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R. 1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R. 1663 Medicare Mental Health Modernization Act of 2007; H.R. 2159 Rural Health Services Preservation Act; H.R. 2406 Establishes NIST Role in Standard Setting for Health IT; H.R. 2642 Supplemental Appropriations Act, 2008; H.R. 3162 Children's Health and Medicare Protection Act of 2007; H.R. 3326 Early Treatment for HIV Act; H.R. 3533 Public and Teaching Hospital Preservation Act; H.R. 4105 One-Year Moratorium on the Recovery Audit Contractor (RAC) Program; H.R. 4854 False Claims Act Correction Act of 2007; H.R. 5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R. 5613 Extend and Establish Moratorium on Medicaid Rules; HR. 6331 Physician Medicare Payment Relief; H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations Bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule", Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance/Value Based Purchasing; Health Information Technology; Hospital Charity Care/Financial Aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration, Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Development's Federal Housing Assistance Mortgage program for Hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas; S.3101 The Medicare Improvements for Patients and Providers Act; S.3656 Preserving Access to Healthcare (PATH) Act of 2008; H.R. 2638 Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 (continuing resolution 2009); H.R. 5480 Medicare Funding Warning Response Act of 2008; H.R. 5924 Emergency Nursing Supply Relief Act; H.R. 6898 Health-e IT Act of 2008; HR. 7067 Quality FIRST Act of 2008; H.R. 7110 Job Creation and Unemployment Relief Act of 2008 (Title III includes FMAP provision); H.R. 7219 The Protecting Hospital Outpatient and Community Clinic Services Act of 2008; H.R. 7241 Preserving Access to Healthcare (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Client expense: Not reported · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007, provisions dealing with RHC reimbursement H.R. 2860 Health Care Access and Rural Equity Act of 2007, provisions dealing with RHC reimbursement S. 630 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health clinics H.R. 2159 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health cli H.R. 3162 Children's Health and Medicare Protection (CHAMP) Act of 2007, provisions relating to RHC reimbursement Medicare, Medicaid, SCHIP Extension Act of 2007, provisions related to RHC reimbursement S. 1693 Wired for Health Care Quality Act, provisions related to infrastructure development for rural providers H.R. 630 Rural Health Services Preservation Act, provisions related to RHC reimbursement H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, raising the rural health clinics per visit cap S. 901 Health Centers Renewal Act of 2007, provisions dealing with Rural Health Clinics H.R. 1343 Health Centers Renewal Act of 2007 provisions dealing with Rural Health Clinics S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, provisions dealing with delay of RHC rules S. 3367 Legislation to modify the RHC statute to make certification timetables consistent

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

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

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3162 Childrens Health and Medicare Protection Act of 2007, all provisions related to the Children's Health Insurance Program; S. 2499 Medicare, Medicaid, and SCHIP Extension Act of 2007, all provisions; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 3533 The Public and Teaching Hospital Preservation Act, all provisions to extend moratorium on implementation of a rule relating to the partnership under Medicaid SCHIP and finalization rule regarding GME; S. 2460 To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program and on finalization of a rule regarding graduate medical education under Medicaid and to include a moratorium on the finalization of the outpatient Medicaid rule making similar changes; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, 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. 976 and S. 1893 Childrens Health Insurance Program Reauthorization Act of 2007, all provisions related to this bill; H.R. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program

Client expense: $4,070,000 · Firm income: Not reported

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

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free choice Act-Opose Card Check Process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R.800 Employee Free Choice Act Oppose Card Check process; H.R.866 Secret Ballot Protection Act; H.R.976 Childrens Health Insurance Reauthorization Act of 2007; H.R.1105 Physician Pathology Services Continuity Act; H.R.1177 Sole Community Hospital Preservation Act; H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R.1663 Medicare Mental Health Modernization Act of 2007; H.R.2159 rural Health Services Preservation Act; H.R.2406 Establishes NIST Role in Standard Setting for Health IT; H.R.2642, Supplemental Appropriations Act, 2008; H.R.3162 Children Health and Medicare Protection Act of 2007; H.R.3326 Early Treatment for HIV Act; H.R.3533 Public and Teaching Hospital Preservation Act; H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5613 Extend and Establish Moratorium on Medicaid Rules; H.R.6331 Physician Medicare payment relief; H.R.6357 Protecting records, optimizing treatment, and easing communication thorugh healthcare technology; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program funding; IRS Form 990 Revision; Stark and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance / value based purchasing; Health information technology; Hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/trigger; Medicare GME residency slot distribution; National Health Service Corp funding; Public Health Service Act nursing and allied health professions program funding; HRSAs health professions shortage areas and medically underserved areas.

Client expense: $190,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007, provisions dealing with RHC reimbursement H.R. 2860 Health Care Access and Rural Equity Act of 2007, provisions dealing with RHC reimbursement S. 630 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health clinics H.R. 2159 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health clinics H.R. 3162 Children's Health and Medicare Protection (CHAMP) Act of 2007, provisions relating to RHC reimbursement Medicare, Medicaid, SCHIP Extension Act of 2007, provisions related to RHC reimbursement S. 1693 Wired for Health Care Quality Act, provisions related to infrastructure development for rural providers H.R. 630 Rural Health Services Preservation Act, provisions related to RHC reimbursement H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, raising the rural health clinics per visit cap

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

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

S.458 Physician Pathology Continuity Act, S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas H.R. 6357 Protecting Records, Optimizing Treatment and Easing Communications through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

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

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

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

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors;S.1041 Employee Free Choice Act-Oppose Card Check Process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R. 800 Employee Free Choice Act-Oppose Card Check Process; H.r. 866 Secret Ballot Protection Act; H.R. 976 Children's Health Insurance Reauthorization Act of 2007; H.R. 1105 Physician Pathology Services Continuity Act; H.R. 1177 Sole Community Hospital Preservation Act; H.R. 1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R. 1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R. 1663 Medicare Mental Health Modernization Act of 2007; H.R. 2159 Rural Health Services Preservation Act; H.R. 2406 Establishes NIST Role in Standard Setting for Health IT; H.R. 2642 Supplemental Appropriations Act, 2008; H.R. 3162 Children's Health and Medicare Protection Act of 2007; H.R. 3326 Early Treatment for HIV Act; H.R. 3533 Public and Teaching Hospital Preservation Act; H.R. 4105 One-Year Moratorium on the Recovery Audit Contractor (RAC) Program; H.R. 4854 False Claims Act Correction Act of 2007; H.R. 5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R. 5613 Extend and Establish Moratorium on Medicaid Rules; HR. 6331 Physician Medicare Payment Relief; H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations Bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule", Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance/Value Based Purchasing; Health Information Technology; Hospital Charity Care/Financial Aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration, Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Development's Federal Housing Assistance Mortgage program for Hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: Not reported · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007;S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act Oppose Card Check process; S.1693 Health Information Exchange Act; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R.800 Employee Free Choice Act Oppose Card Check process; H.R.866 Secret Ballot Protection Act; H.R.976 Childrens Health Insurance Reauthorization Act of 2007; H.R.1105 Physician Pathology Services Continuity Act; H.R.1177 Sole Community Hospital Preservation Act; H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R.1663 Medicare Mental Health Modernization Act of 2007; H.R.2159 rural Health Services Preservation Act; H.R.2406 Establishes NIST Role in Standard Setting for Health IT; H.R.3162 Children Health and Medicare Protection Act of 2007; H.R.3326 Early Treatment for HIV Act; H.R.3533 Public and Teaching Hospital Preservation Act; H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5613 Extend and Establish Moratorium on Medicaid Rules; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program funding IRS Form 990 Revision; Stark and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance / value based purchasing; Health information technology; Hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/trigger; Medicare GME residency slot distribution; National Health Service Corp funding; Public Health Service Act nursing and allied health professions program funding; HRSAs health professions shortage areas and medically underserved areas.

Client expense: $220,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

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

Physician Pathology Services Continuity Act (S.458); Rural Health Services Preservation Act (S.630); Nursing Education and Quality of Health Care Act of 2007 (S.1604); Health Information Exchange (S.1693); Extend Moratorium on Medicaid Regulations Affecting Intergovernmental Transfers (S.2460); Medicare, Medicaid and SCHIP Extension Act of 2007 (S.2499); Temporary increase in Federal medical assistance percentages under Medicaid program (S.2620); Extend and Establish Moratorium on Medicaid Rules; increase FMAP (s.2819); Children's Health Insurance Reauthorization Act of 2007 (H.R.976); Medicare Mental Health Modernization Act of 2007 (H.R.1663); Rural Health Services Preservation Act (H.R.2159); One-Year Moratorium on the Recovery Audit Contractor (RAC) program (H.R.4105); Temporary increase in federal medical assistance percentages under Medicaid program (H.R.5268); Extend and Establish Moratorium on Medicaid Rules (H.R.5613); FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule"; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; Hospital pricing transparency; Not-for-Profit Hospital Tax-Exempt Status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance/value based purchasing; Health information technology; Hospital charity care/financial aid; Associated health plans; Coverage for the uninsured; Emergency Preparedness; Medicare wage index; Mental health parity; Limited service hospitals; Dept. of Housing and Urban Development's Federal Housing Assistance mortgage program for hospitals; Defined benefit pension plans; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False Claims Act expansion; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: Not reported · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 H.R. 1177/S.2381 - Sole Community Hospital Preservation Act of 2007 S. 2499 The Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS H.R. 3533/S. 2460 Extend the Moratorium on Medicaid Payment Restrictions H.R. 5613 Extend the Moratorium on Medicaid Payment Restrictions H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H.R. 1424 The Paul Wellstone Mental Health Equity Act S. 2786 The Medicare Rural Health Access Improvement Act of 2008 H.R. 3963 Childrens Health Insurance Program Reauthorization Act S. 2221 The Transparency in Medical Device Pricing Act of 2007 H.R. 5480/S. 2662 Medicare Trigger Legislation The Protecting the Medicaid Safety Net Act of 2008 S. 2819 Economic Recovery in Health Care Act of 2008 Opposition to the Administrations FY 2009 Proposed Budget

Client expense: $117,660 · Firm income: Not reported

S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007, provisions dealing with RHC reimbursement H.R. 2860 Health Care Access and Rural Equity Act of 2007, provisions dealing with RHC reimbursement S. 630 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health clinics H.R. 2159 Rural Health Services Preservation Act of 2007, provisions relating to payments for rural health clinics H.R. 3162 Children's Health and Medicare Protection (CHAMP) Act of 2007, provisions relating to RHC reimbursement Medicare, Medicaid, SCHIP Extension Act of 2007, provisions related to RHC reimbursement S. 1693 Wired for Health Care Quality Act, provisions related to infrastructure development for rural providers H.R. 630 Rural Health Services Preservation Act, provisions related to RHC reimbursement

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

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

S.458 Physician Pathology Services Continuity Act, S.558 The Mental Health Parity Act of 2007,S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act,S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

See attached list S. 250, Medicare Enhancements for Needed Drugs Act of 2007 S.581.IS, Medicare Prescription Drug Cost Containment Act S.273, Prescription Drug and Health Improvement Act of 2007 S.2665, Medicare Prescription Drug Simplification Act S.2563, Pharmacist Access and Recognition in Medicare (PhARM) S.2255-7, Medicare Drug Formulary Protection Act S.173, Medicare Health Savings Accounts Act of 2007 S.1544, Medicare Quality Enhancement Act of 2007 S.137, Preserving Medicare for All Act of 2007 S.1340, Geriatric Assessment and Chronic Care Coordination Act of 2007 S.130, Medicare Cost Contract Extension and Refinement Act of 2007 S.1218, Medicare for All Act S.1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007 S.1103, Helping Fill the Medicare Rx Gap Act of 2007 S.1102, Part D Equity for low Income Seniors Act of 2007 S.1052, Healthy Children and Families Act of 2007 S.028, Generics First Act of 2007 S.003, Medicare Prescription Drug Price Negotiation Act of 2007 S.885, Community Pharmacy Fairness Act of 2007 S.273, Prescription Drug Health Improvement Act of 2007 S.2601/H.R.4551, Health Care Choices for Seniors Act H.R.4, Medicare Prescription Drug Price Negotiation Act of 2007 H.R.971, Community Pharmacy Fairness Act of 2007 H.R.749, Health Care Choices for Senior Act H.R.3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R.2945, Medicare Advantage Truth in Advertising Act of 2007 H.R.2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R.2685.IH, Medicare Prescription Drug Price Negotiation Act H.R.2307, Preventing Medicare Seniors from being Confused due to Abusive Marketing (Prevent Medicare SCAMs) Act of 2007 H.R.2159/S.630, Rural Health Services Preservation Act of 2007 H.R.2149, Healthcare Eligibility for Late Participants (HELP) in Medicare Part D Act of 2007 H.R.2065, Medicare Drug Savings Through Choice Act of 2007 H.R.2058, Helping fill the Medicare Rx Gap Act of 2007 H.R.2056, Medicare Part D Improvement Act of 2007 H.R.2055, Improving Childrens Access to Health Care Act of 2007 H.R.205, Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.2034, Medicare for All Act H.R.1990, Medicare Cost Contract Extension and Refinement Act of 2007 H.R.195, Seniors Health Care Freedom Act of 2007 H.R.1536, Prescription Coverage Now Act of 2007 H.R.1521, Universal Health Act of 2007: Repeal of the Late Enrollment Penalty in Medicare Part D H.R.1310, Relief and Elimination of the Medicare Enrollment Deadline Penalty (REMEDY) Act or 2007 H.R.1277, Medicare Prescription Drug Benefit Gap Elimination Act of 2007 H.R.1218, Medicare Prescription Drug Improvement Act H.R.118, To amend part D of Title XVIII of the Social Security Act to authorize the secretary of HHS to negotiate prices for part D covered drugs for Medicare beneficiaries H.R.1046, Medicare Quality Improvement Organization Modernization Act of 2007 H.R.004, Medicare Prescription Drug Price Negotiation Act of 2007

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, Transportation, Dept of (DOT), UNDETERMINED, White House Office

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

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

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

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

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

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

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

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

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

S. 1595 - Critical Access Hospital Flexibility Act of 2007 S. 1277 - Critical Access to Clinical Lab Services Act of 2007 S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007 S. 458/H.R. 1105 Physician Pathology Services Continuity Act of 2007 H.R. 1899 Enhanced Options for Rural Health Care Act of 2007 S. 629 Loans and Grants for Construction and Rehabilitation of CAHs S. 1605 The Craig Thomas Rural Hospital and Provider Equity Act of 2007 (R-HoPE) S. 1376/H.R. 2606 340B Program Improvement and Integrity Act of 2007 H.R. 1177 Sole Community Hospital Preservation Act of 2007 H.R. 1730 MedPAC Rural Representation Act S. 1604 Nursing Education and Quality of Health Care Act of 2007 H.R. 1866 Medicare Access to Rural Anesthesiology Act of 2007 H.R. 3162/H.R. 976 State Childrens Health Insurance Program S. 1958/H.R. 3057 Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 H.R. 3043 2008 Appropriations for U.S. Departments of Labor, Health & Human Services and Education (Health Spending Bill) H.R. 3997 Renewal of Federal Mental Health Parity Law S. 558 Mental Health Parity Act of 2007 H.R. 2699 Medical Student Loan Repayment S. 1947/H.R. 1046 Medicare Quality Improvement Organization (QIO) System Medicaid Prescription Drug 340B Program Expansion Proposed Medicaid Regulations to Limit the Use of Local and State Funds Proposed Medicaid Regulations to Eliminate Federal Funding of Medical Graduate Medical Education Behavioral Offset Cuts Under Medicare Inpatient Prospective Payment System Medicare, Medicaid and SCHIP Extension Act of 2007 Repeal of the Whole Hospital Exception Under the Stark Anti-Fraud Law Renewal of the Missouri Medicaid Partnership Agreement Between the State of Missouri and CMS Medicare Inpatient PPS Behavioral Offset

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

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

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

Client expense: $9,080,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE

HR 3963/S 1893 - Children's Health Insurance Program Reauthorization Act of 2007 S 2460 - One Year Extension of Medicare/Medicaid HR 2159 - Rural Health Services Preservation Act of 2007 S 355 - Social Security and Medicare Solvency Commission Act

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Natl Aeronautics & Space Administration (NASA), Natl Institutes of Health (NIH), Natl Oceanic & Atmospheric Administration (NOAA), Natl Science Foundation (NSF), SENATE, Veterans Affairs, Dept of (VA), White House Office

S. 1595 - Critical Access Hospital Flexibility Act of 2007 S. 1277 - Critical Access to Clinical Lab Services Act of 2007 S. 543/H.R. 1459 - Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 630/H.R. 1563/H.R. 2159 - Rural Health Services Preservation Act of 2007

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

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

H.R. 1459 all provisions to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility; H.R. 1177 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 1741 all provisions to impose a 2-year moratorium on implementation of a proposed rule relating to the Federal-State financial partnerships under Medicaid and the State Children's Health Insurance Program; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007, all provisions to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals. Medicare inpatient and outpatient hospital payment rates; Issues pertaining to coverage of the uninsured; see next page

Client expense: $7,340,000 · Firm income: Not reported

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

H.R.4, Medicare Prescription Drug Price Negotiation Act of 2007 H.R.971, Community Pharmacy Fairness Act of 2007 H.R.749, Health Care Choices for Senior Act H.R.3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R.2945, Medicare Advantage Truth in Advertising Act of 2007 H.R.2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R.2685.IH, Medicare Prescription Drug Price Negotiation Act H.R.2307, Preventing Medicare Seniors from being Confused due to Abusive Marketing (Prevent Medicare SCAMs) Act of 2007 H.R.2159/S.630, Rural Health Services Preservation Act of 2007 H.R.2149, Healthcare Eligibility for Late Participants (HELP) in Medicare Part D Act of 2007 H.R.2065, Medicare Drug Savings Through Choice Act of 2007 H.R.2058, Helping fill the Medicare Rx Gap Act of 2007 H.R.2056, Medicare Part D Improvement Act of 2007 H.R.2055, Improving Children’s Access to Health Care Act of 2007 H.R.205, Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.2034, Medicare for All Act H.R.1990, Medicare Cost Contract Extension and Refinement Act of 2007 H.R.195, Seniors’ Health Care Freedom Act of 2007 H.R.1536, Prescription Coverage Now Act of 2007 H.R.1521, Universal Health Act of 2007: Repeal of the Late Enrollment Penalty in Medicare Part D H.R.1310, Relief and Elimination of the Medicare Enrollment Deadline Penalty (REMEDY) Act or 2007 H.R.1277, Medicare Prescription Drug Benefit Gap Elimination Act of 2007 H.R.1218, Medicare Prescription Drug Improvement Act H.R.118, To amend part D of Title XVIII of the Social Security Act to authorize the secretary of HHS to negotiate prices for part D covered drugs for Medicare beneficiaries H.R.1046, Medicare Quality Improvement Organization Modernization Act of 2007 H.R.004, Medicare Prescription Drug Price Negotiation Act of 2007 S. 250, Medicare Enhancements for Needed Drugs Act of 2007 S.581.IS, Medicare Prescription Drug Cost Containment Act S.273, Prescription Drug and Health Improvement Act of 2007 S.2665, Medicare Prescription Drug Simplification Act S.2563, Pharmacist Access and Recognition in Medicare (PhARM) S.2255-7, Medicare Drug Formulary Protection Act S.173, Medicare Health Savings Accounts Act of 2007 S.1544, Medicare Quality Enhancement Act of 2007 S.137, Preserving Medicare for All Act of 2007 S.1340, Geriatric Assessment and Chronic Care Coordination Act of 2007 S.130, Medicare Cost Contract Extension and Refinement Act of 2007 S.1218, Medicare for All Act S.1108, Medicare Part D Outreach and Enrollment Enhancement Act of 2007 S.1103, Helping Fill the Medicare Rx Gap Act of 2007 S.1102, Part D Equity for low Income Seniors Act of 2007 S.1052, Healthy Children and Families Act of 2007 S.028, Generics First Act of 2007 S.003, Medicare Prescription Drug Price Negotiation Act of 2007 S.885, Community Pharmacy Fairness Act of 2007 S.273, Prescription Drug Health Improvement Act of 2007 S.2601/H.R.4551, Health Care Choices for Seniors Act See attached list.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Economic Council (NEC), SENATE, Transportation, Dept of (DOT), White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

* Senate - Children's Health Insurance Program Reauthorization Act of 2007 H.R. 3162: Children's Health and Medicare Protection Act (CHAMP) S. 543 / H.R. 1459: Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 S. 1277: Critical Access to Clinical Lab Services Act of 2007 H.R. 2159: Rural Health Services Preservation Act of 2007 President's Proposed Budget for Fiscal Year 2008 S. 1605 / H.R. 2860: R-HoPE and H-CARE S. 329 / H.R. 552: Pulminary and Cardiac Rehabilitation Act of 2007

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

HR2159 - Rural Health Services Preservation Act of 2007 S355 - The Social Security and Medicare Solvency Commission Act HR1093/S588 - Resident Physician Shortage Reduction Act of 2007

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

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Aeronautics & Space Administration (NASA), Natl Institutes of Health (NIH), Natl Oceanic & Atmospheric Administration (NOAA), Natl Science Foundation (NSF), SENATE, Veterans Affairs, Dept of (VA)