Physician Workforce Enhancement Act of 2008

Medicare and Medicaid reimbursement issues; reversal of CMS regulations; specialty hospital moratorium; S. 558, H.R. 1424, H.R. 6983, Mental Health Parity/Addiction Equity; H.R. 6331, Medicare Improvement for Patients & Providers Act; H.R. 6357 & H.R. 6898, Health Information Technology; H.R. 2583, Physician Workforce Enhancement Act; H.R. 6394 Border Health Care Relief Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid reimbursement issues; reversal of CMS regulations; specialty hospital moratorium; S. 558, H.R. 1424 & H.R. 6983, Mental Health Parity Act; H.R. 6331, Medicare Improvement for Patients & Providers Act; H.R. 6357 & H.R. 6898, Health Information Technology; H.R. 2583, Physician Workforce Enhancement Act; H.R. 6394 Border Health Care Relief Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 110-24, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Increased funding for the Agency for Healthcare Research and Quality in Fiscal Year 2009, Adequate funding for NHSC to relieve student debt. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

Client expense: $755,699 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-204, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 7192, Preserving Patient Access to Primary Care Act, To provide support for medical training for primary care and for primary care physician practices. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Increased appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs.

Client expense: $755,699 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

Client expense: $755,699 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. No Bill, Title VII Health Professions Grants for Primary Care Medicine Training Reauthorization, Promote Title VII Health Professions Grants for Primary Care Training programs.

Client expense: $755,146 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, CMS Meetings regarding Medicare payment, PCMH Pilot, GME. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas.

Client expense: $755,146 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Agency for Healthcare Research and Quality (AHRQ) FY 2009 Appropriations, Adequate funding for Health Information Technology and Comparable Effectiveness Research. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Antitrust issues related to health care plan consolidation and physician collective bargaining, Oppose anticompetitive insurance consolidation. Allow physicians to bargain collectively; remove antitrust barriers on physicians; reform Federal Trade Commission regulation. No Bill, Collective Negotiation by Physicians with Health Plans, To allow physicians to bargain collectively with health plans. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Physician Quality Reporting Initiative; Value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Promoting the US health delivery system reform to a Patient Centered Medical Home model of care, Promoting health care reform based on the PCMH model of care. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas. No Bill, Title VII Health Professions Grants for Primary Care Medicine Training Reauthorization, Promote Title VII Health Professions Grants for Primary Care Training programs.

Client expense: $755,146 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act H.R. 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442, TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: Not reported · Firm income: Not reported

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

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act H.R. 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442, TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: $40,345 · Firm income: Not reported

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

S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

Client expense: $3,119,054 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-204, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 7192, Preserving Patient Access to Primary Care Act, To provide support for medical training for primary care and for primary care physician practices. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Increased appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs.

Client expense: $3,119,054 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-24, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Increased funding for the Agency for Healthcare Research and Quality in Fiscal Year 2009, Adequate funding for NHSC to relieve student debt. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

Client expense: $3,119,054 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.583 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2007 H.R.882 - Access to Emergency Medical Services Act of 2007 H.R.1108 - Family Smoking Prevention and Tobacco Control Act H.R.1233 - Mitigating the Impact of Uncompensated Service and Time Act of 2007 H.R.2050 - Medicaid Emergency Psychiatric Care Act of 2007 H.R. 2164 - Medicare Ambulance Payment Extension Act H.R.2464 - Wakefield Act H.R.2583 - Physician Workforce and Graduate Medical Education Enhancement Act of 2007 H.R.2584 - High-Need Physician Workforce Incentives Act of 2007 H.R.2749 - Voluntary Medicare Quality Reporting Act H.R.3163 - Healthy Americans Act H.R.3344 - Treat Physicians Fairly Act of 2007 H.R.3495 - Kids in Disasters Well-Being, Safety and Health Act of 2007 H.R.3800 - Promoting Health Information Technology Act H.R.4321 - Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2007 H.R.4736 - To Amend Part B of title XVIII of the Social Security Act to repeal limiting charges under the Medicare Program for non-participating physicians and to preempt State laws that prohibit balance billing H.R.5545 - Ensuring the Future Physician Workforce Act of 2008 H.R.5605 - Physician Payments Sunshine Act of 2008 H.R.5613 - Protecting the Medicaid Safety Net Act of 2008 H.R.5942 - National Trauma Center Stabilization Act of 2008 H.R.6091 - Save Medicare Act of 2008 H.R.6357 - Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 H.R.6898 - Health-e Information Technology Act of 2008 P.L.110-343 - Emergency Economic Stabilization Act of 2008 (Specifically - Subtitle B: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 P.L.110-355 - Health Care Safety Net Act of 2008 P.L.110-377 - Poison Center Support, Enhancement and Awareness Act of 2008 P.L. 110-379 - QI Program Supplemental Funding Act of 2008 P.L.110-381 - Michelle's Law S.60 Wakefield Act S.334 Healthy Americans Act S.625 - Family Smoking Prevention and Tobacco Control Act S.1003 - Access to Emergency Medical Services Act of 2007 S.1042 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2007 S.1310 - Medicare Ambulance Payment Extension Act S.1519 - Voluntary Medicare Quality Reporting Act S.1693 - Wired for Health Care Quality Act S.1970 Kids in Disasters Well-Being, Safety and Health Act of 2007 S.2029 - Physician Payments Sunshine Act of 2007 S. 2319 - National Trauma Center Stabilization Act of 2007 S.2406 - Medicaid Emergency Psychiatric Care Act of 2007 S.2729 - Ensuring the Future Physician Workforce Act of 2008 S.2785 - Save Medicare Act of 2008 S.2819 - Economic Recovery in Health Care Act of 2008

Client expense: $482,302 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment; Graduate Medical Education: H.R. 2583, Physician Workforce Enhancement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment; Patient access to care; Health Information Technology; Graduate Medical Education: S. 1693, Wired for Health Care Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 2583, Physician Workforce Enhancement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid reimbursement issues, reversal of CMS regulations; speciality hospital moratorium; S. 558 and H.R. 1421, H.R. 6983: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; H.R. 6331 Medicare Improvement for Patients and Providers Act of 2008; H.R. 6357 and H.R. 6898 Health Information Technology; H.R. 2583 - Physician Workforce Enhancement Act of 2008; H.R. 6394 Border Health Care Relief Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act HR 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442 TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: $61,364 · Firm income: Not reported

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

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act HR 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442 TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: Not reported · Firm income: Not reported

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

See attached Iroquois Healthcare Alliance Federal legislation for July 1 through September 30, 2008 Preserving Access to Healthcare (PATH) Act, S.3656/ H.R. 7241 blocks for six months implementation of both the Medicare capital IME cut and the Medicaid outpatient regulation Rural Hospital Assistance Act of 2008 S.3300 IS / H.R.6912.IH 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. Physician Availability Act of 2008 H.R.5739.IH Physician Workforce and Graduate Medical Education Enhancement Act of 2007 HR 2583 IH To amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs. Physician Workforce Enhancement Act of 2008 HR 2583 EH Nursing and Allied Health Education Preservation Act of 2008 S.3468 IS /H.R.5174.IH To amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs. 340B Program Improvement and Integrity Act of 2007 S.1376 Resident Physician Shortage Reduction Act of 2007 S.588.IS/ H.R.1093.IH Medicare Rural Health Access Improvement Act of 2008 S.2786.IS Physician Availability Act of 2008 HR 5739 IH To assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act HR 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442 TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: $97,022 · Firm income: Not reported

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

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Agency for Healthcare Research and Quality (AHRQ) FY 2009 Appropriations, Adequate funding for Health Information Technology and Comparable Effectiveness Research. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Antitrust issues related to health care plan consolidation and physician collective bargaining, Oppose anticompetitive insurance consolidation. Allow physicians to bargain collectively; remove antitrust barriers on physicians; reform Federal Trade Commission regulation. No Bill, Collective Negotiation by Physicians with Health Plans, To allow physicians to bargain collectively with health plans. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Physician Quality Reporting Initiative; Value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Promoting the US health delivery system reform to a Patient Centered Medical Home model of care, Promoting health care reform based on the PCMH model of care. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas. No Bill, Title VII Health Professions Grants for Primary Care Medicine Training Reauthorization, Promote Title VII Health Professions Grants for Primary Care Training programs.

Client expense: $2,363,355 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, CMS Meetings regarding Medicare payment, PCMH Pilot, GME. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas.

Client expense: $2,363,355 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. No Bill, Title VII Health Professions Grants for Primary Care Medicine Training Reauthorization, Promote Title VII Health Professions Grants for Primary Care Training programs.

Client expense: $2,363,355 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

Physician payment; Patient access to care; Health Information Technology; Graduate Medical Education: S. 1693, Wired for Health Care Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 3162, Children's Health and Medicare Protection Act of 2007; H.R. 2583, Physician Workforce Enhancement Act of 2008; S.3101, Medicare Improvements for Patients and Providers Act of 2008; H.R.6331, Medicare Improvements for Patients and Providers Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment; Graduate Medical Education: H.R. 3162, Children's Health and Medicare Protection Act of 2007; H.R. 2583, Physician Workforce Enhancement Act of 2008; S. 3101, Medicare Improvements for Patients and Providers Act of 2008; S. 3118, Preserving Access to Medicare Act of 2008; H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 3656: Preserving Access to Healthcare (PATH) Act of 2008, sections relating to rural health clinics, hospices, and hospitals. HR 6873: Medicare Hospice Protection Act of 2008, entire bill. S 3484: Hospice Protection Act of 2008, entire bill. HR 1424: Emergency Economic Stabilization Act of 2008, Title V, Subsection B, mental health parity. S 3367: Rural Health Clinic bill to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program, entire bill. HR 1343: Health Care Safety Net Act of 2008, section 7: Revision of Timeframe for RHCs; section 3: National Health Service Corps. HR 6966: Safeguarding our Hospitals' Futures Act of 2008, entire bill. S 3582: Safeguarding our Hospitals' Futures Act of 2008, entire bill. HR 6912: Rural Hospital Assistance Act of 2008, entire bill. S 3300: Rural Hospital Assistance Act of 2008, entire bill. HR 6652: Nurses' Higher Education and Loan Repayment Act of 2008, entire bill. HR 6331: Medicare Improvements for Patients and Providers Act of 2008, section 131 involving the physician-fix; section 122 involving rebasing for sole community hospitals, section 148, clarification of payment for clinical laboratory tests furnished by CAH. S 3101: Medicare Improvements for Patients and Providers Act of 2008, section 131 involving the physician-fix; section 122 involving rebasing for sole community hospitals, section 149, clarification of payment for clinical laboratory tests furnished by CAH. HR 6699: Health Security for All Americans Act of 2008, section 105 involving improvements to Medicare-dependent hospital program; section 106 involving payment adjustment for low-volume hospitals. HR 2583: Physician Workforce Enhancement Act of 2008, provisions relating to hospitals. HR 7067: Quality FIRST Act of 2008, provisions relating to hospitals and value-based purchasing. Other issues: Physician self-referral to physician-owned hospitals. Reject cuts in the indirect medical education adjustment for teaching hospitals' capital costs: Schumer,Specter,Clinton Senate letter and Marshall,King House letter. Critical Access Hospital contract/employment issue involving 485.635 CoP: Provision of services (CAH). Guidance for clinical integration programs. Medicaid DSH letter: Rep. John Sullivan letter requesting funding increases and to update the definition to Medicaid's Low DSH states. Value-based purchasing. CMS proposed rule for the FY2009 inpatient PPS: proposals relating to hospitals. CMS Recovery Audit Contractors program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.583 - Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 H.R.882 - Access to Emergency Medical Services Act of 2007 H.R.1108 - Family Smoking Prevention and Tobacco Control Act H.R.1233 - Mitigating the Impact of Uncompensated Services & Time Act of 2007 H.R.1343 - Health Centers Renewal Act of 2008 H.R.1424 - Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1553 - Caroline Pryce Walker Conquer Childhood Cancer Act of 2008 H.R.2164 - Medicare Ambulance Payment Extension Act H.R.2464 - Wakefield Act H.R.2583 - Physician Workforce & Guidance Medical Education Enhancement Act of 2007 H.R.2584 - High-Need Physician Workforce Incentives Act of 2007 H.R.2638 - Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 H.R.2749 - Voluntary Medicare Quality Reporting Act H.R.2851 - Michelle's Law H.R.3163 - Healthy Americans Act H.R.3173 - Improving Emergency Medical Care & Response Act of 2007 H.R.3344 - Treat Physicians Fairly Act of 2007 H.R.3403 - 911 Modernization and Public Safety Act H.R.3495 - Kids in Disasters Well-Being, Safety & Health Act of 2007 H.R.3800 - Promoting Health Information Technology (PHIT) Act H.R.4321 - Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2007 H.R.4736 - To Amend Part B of Title XVIII of the Social Security Act to Repeal Limiting Charges Under the Medicare Program for Non-Participating Physicians and to Preempt State Laws that Prohibit Balance Billing H.R.5545 - Ensuring the Future Physician Workforce Act of 2008 H.R.5605 - Physician Payments Sunshine Act of 2008 H.R.5613 - Protecting the Medicaid Safety Net Act of 2008 H.R.5669 - Poison Center Support, Enhancement & Awareness Act of 2008 H.R.5942 - National Trauma Center Stabilization Act of 2008 H.R.6091 - Save Medicare Act of 2008 H.R.6331 - Medicare Improvements for Patients & Providers Act (MIPPA) of 2008 H.R.6357 - Protecting Records, Optimizing Treatment, and Easing Communication Through Healthcare Technology Act of 2008 H.R.6898 - Health-e Information Technology Act of 2008 P.L.110-252 - Supplemental Appropriations Act of 2008 S.60 - Wakefield Act S.334 - Healthy Americans Act S.558 - Mental Health Parity Act of 2007 S.625 - Family Smoking Prevention and Tobacco Control Act S.901 - Health Care Safety net Act of 2007 S.911 - Conquer Childhood Cancer Act of 2007 S.1003 - Access to Emergency Medical Services Act of 2007 S.1042 - Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 S.1310 - Medicare Ambulance Payment Extension Act S.1519 - Voluntary Medicare Quality Reporting Act S.1693 - Wired for Health Care Quality Act S.1873 - Improving Emergency Medical Care & Response Act of 2007 S.1970 - Kids in Disasters Well-Being, Safety & Health Act of 2007 S.2029 - Physician Payments Sunshine Act of 2007 S.2319 - National Trauma Center Stabilization Act of 2007 S.2406 - Medicaid Emergency Psychiatric Care Act of 2007 S.2729 - Ensuring the Future Physician Workforce Act of 2008 S.2785 - Save Medicare Act of 2008 S.2819 - Economic Recovery in Health Care Act of 2008 S.2932 - Poison Center Support, Enhancement & Awareness Act of 2008 S.3101 - Medicare Improvements for Patients & Providers Act (MIPPA) of 2008 S.3560 - QI Program Supplemental Funding Act of 2008

Client expense: $528,537 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2583 - Physician Workforce & Graduate Medical Education Enhancement Act of 2007 H.R.2584 - High-Need Physician Workforce Incentives Act of 2007 H.R.4321 - Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2007 H.R.5669 - Poison Center Support, Enhancement & Awareness Act of 2008 H.R.6898 - Health-e Information Technology Act of 2008 S.2932 - Poison Center Support, Enhancement & Awareness Act of 2008

Client expense: $528,537 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2464 - Wakefield Act H.R.2583 - Physician Workforce & Graduate Medical Education Enhancement Act of 2007 H.R.2638 - Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 H.R.3173 - Improving Emergency Medical Care & Response Act of 2007 H.R.3403 - 911 Modernization and Public Safety Act of 2007 H.R.3495 - Kids in Disasters Well-Being, Safety & Health Act of 2007 H.R.5942 - National Trauma Center Stabilization Act of 2008 S.60 - Wakefield Act S.1873 - Improving Emergency Medical Care & Response Act of 2007 S.1970 - Kids in Disasters Well-Being, Safety & Health Act of 2007 S.2319 - National Trauma Center Stabilization Act of 2007

Client expense: $528,537 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid reimbursement issues, reversal of CMS regulations; speciality hospital moratorium; S. 558 and H.R. 1421, H.R. 6983: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; H.R. 6331 Medicare Improvement for Patients and Providers Act of 2008; H.R. 6357 and H.R. 6898 Health Information Technology; H.R. 2583 - Physician Workforce Enhancement Act of 2008; H.R. 6394 Border Health Care Relief Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6210 Small Business Health Options Program (SHOP) Act S. 2795 Small Business Health Options Program (SHOP) Act H.R 6582 Cooperative for Health Care Options to Improve Coverage for Employers (Small Business CHOICE) Act of 2008 H.R. 6699 Health Security for All Americans Act of 2008 H.R. 2851, Michelles Law S. 334 Healthy Americans Act H.R. 6444 Healthy Americans Act H.R. 6280, Americas Affordable Health Care Act of 2008 S.3402, Consumer Health Education and Transparency Act of 2008 H.R. 2642, Supplemental Appropriations Act of 2008 H.R. 1424 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 S. 558, Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 S. 901Health Care Safety Net Act of 2008 H.R. 1343, Health Care Safety Net Act of 2008 S. 3321, Federal Obesity Prevention Act of 2008 S.1200, Indian Health Care Improvement Amendment Act H.R. 6652, Nurses Higher Education and Loan Repayment Act of 2008 H.R. 6337 Caring for an Aging America Act of 2008 S. 2708, Caring for an Aging America Act of 2008 S. 2672, Conrad 30 State Improvement Act, H.R. 6104 Enhancing Science, Technology, Engineering and Mathematics Education Act of 2008 S. 3047, Enhancing Science, Technology, Engineering and Mathematics Education Act of 2008 S. 3224, Science, Technology, Engineering, and Mathematics Education for the 21st Century Act of 2008 H.R. 6351, 21st Century Rural Health Care Act H.R. 5571, To extend for 5 years the program relating to waiver of the foreign country residence requirement with respect to international medical graduates H.R. 5924, Emergency Nursing Supply Relief Act H.R. 6792, Veterans Physical Therapy Services Improvement Act of 2008 S. 901 Health Care Safety Net Act of 2008 H.R. 1343, Health Care Safety Net Act of 2008 H.R. 2583, Physician Workforce Enhancement Act of 2008 H.R. 4137, College Opportunity and Affordability Act H.R. 2991 Independent Health Record Trust Act H.R. 3800 Promoting Health Information Technology Act H.R. 5442 Technologies for Restoring Users' Security and Trust in Health Information Act H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology (PROTECHT) Act H.R. 6898 Health-e Information Technology Act S. 1693Wired for Health Care Quality Act S. 1814 Health Information Privacy and Security Act S. 3408Comparative Effectiveness Research Act

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.583 - Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 H.R.882 - Access to Emergency Medical Services Act of 2007 H.R.1233 - Mitigating the Impact of Uncompensated Services & Time Act of 2007 H.R.1343 - Health Centers Renewal Act of 2008 H.R.1424 - Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1553 - Caroline Pryce Walker Conquer Childhood Cancer Act of 2008 H.R.2164 - Medicare Ambulance Payment Extension Act H.R.2464 - Wakefield Act H.R.2583 - Physician Workforce & Guidance Medical Education Enhancement Act of 2007 H.R.2584 - High-Need Physician Workforce Incentives Act of 2007 H.R.2749 - Voluntary Medicare Quality Reporting Act H.R.3163 - Healthy Americans Act H.R.3173 - Improving Emergency Medical Care & Response Act of 2007 H.R.3344 - Treat Physicians Fairly Act of 2007 H.R.3403 - 911 Modernization and Public Safety Act H.R.3495 - Kids in Disasters Well-Being, Safety & Health Act of 2007 H.R.3800 - Promoting Health Information Technology (PHIT) Act H.R.4321 - Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2007 H.R.4736 - To Amend Part B of Title XVIII of the Social Security Act to Repeal Limiting Charges Under the Medicare Program for Non-Participating Physicians and to Preempt State Laws that Prohibit Balance Billing H.R.5545 - Ensuring the Future Physician Workforce Act of 2008 H.R.5605 - Physician Payments Sunshine Act of 2008 H.R.5613 - Protecting the Medicaid Safety Net Act of 2008 H.R.5669 - Poison Center Support, Enhancement & Awareness Act of 2008 H.R.5942 - National Trauma Center Stabilization Act of 2008 H.R.6091 - Save Medicare Act of 2008 H.R.6331 - Medicare Improvements for Patients & Providers Act (MIPPA) of 2008 H.R.6357 - Protecting Records, Optimizing Treatment, and Easing Communication Through Healthcare Technology Act of 2008 P.L.110-252 - Supplemental Appropriations Act of 2008 S.60 - Wakefield Act S.334 - Healthy Americans Act S.558 - Mental Health Parity Act of 2007 S.901 - Health Care Safety net Act of 2007 S.911 - Conquer Childhood Cancer Act of 2007 S.1003 - Access to Emergency Medical Services Act of 2007 S.1042 - Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 S.1310 - Medicare Ambulance Payment Extension Act S.1519 - Voluntary Medicare Quality Reporting Act S.1693 - Wired for Health Care Quality Act S.1873 - Improving Emergency Medical Care & Response Act of 2007 S.1970 - Kids in Disasters Well-Being, Safety & Health Act of 2007 S.2029 - Physician Payments Sunshine Act of 2007 S.2319 - National Trauma Center Stabilization Act of 2007 S.2406 - Medicaid Emergency Psychiatric Care Act of 2007 S.2729 - Ensuring the Future Physician Workforce Act of 2008 S.2785 - Save Medicare Act of 2008 S.2819 - Economic Recovery in Health Care Act of 2008 S.2932 - Poison Center Support, Enhancement & Awareness Act of 2008 S.3101 - Medicare Improvements for Patients & Providers Act (MIPPA) of 2008

Client expense: $562,449 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2464 - Wakefield Act H.R.2583 - Physician Workforce & Graduate Medical Education Enhancement Act of 2007 H.R.3173 - Improving Emergency Medical Care & Response Act of 2007 H.R.3403 - 911 Modernization and Public Safety Act of 2007 H.R.3495 - Kids in Disasters Well-Being, Safety & Health Act of 2007 H.R.5942 - National Trauma Center Stabilization Act of 2008 S.60 - Wakefield Act S.1873 - Improving Emergency Medical Care & Response Act of 2007 S.1970 - Kids in Disasters Well-Being, Safety & Health Act of 2007 S.2319 - National Trauma Center Stabilization Act of 2007

Client expense: $562,449 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2583 - Physician Workforce & Graduate Medical Education Enhancement Act of 2007 H.R.2584 - High-Need Physician Workforce Incentives Act of 2007 H.R.4321 - Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2007 H.R.5669 - Poison Center Support, Enhancement & Awareness Act of 2008 S.2932 - Poison Center Support, Enhancement & Awareness Act of 2008

Client expense: $562,449 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment Graduate Medical Education H.R. 3162; H.R. 2583, S. 3101, S. 3118, H.R. 6331

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment; Patient access to care; Health Information Technology; Graduate Medical Education S. 1693; H.R. 3800; H.R. 3162; H.R. 2583

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment; Patient access to care; Health Information Technology; Graduate Medical Education S. 1693; H.R. 3800; H.R. 3162; H.R. 2583

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment Patient access to care Graduate Medical Education H.R. 3162; H.R. 2583

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1, HR477, HR882, HR976,HR1093,HR1655,HR2050,HR2164,HR2580,HR2583,HR2584,HR2626,HR2669,HR2749,HR2764,HR2900 HR3043,HR3074,HR3162,HR3173,HR3344,HR3495,HR3533,HR3963,PL 110-53,PL110-84 & PL110-161, S4, S60,S243,S244,S588,S999,S1003,S1082,S1310,S1408,S1519,S1588,S1642,S1644,S1710,S1789,S1873,S1893,S1970,S2319 S2499

Client expense: $1,129,163 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2583, & HR 2669 PL 110-84 S 1642

Client expense: $1,129,163 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment; Patient access to care; Health Information Technology; Graduate Medical Education S. 1693; H.R. 3800; H.R. 3162; H.R. 2583

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment Patient access to care Graduate Medical Education H.R. 3162; H.R. 2583

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE