Health Care Access and Rural Equity (H-CARE) Act of 2007

S.3: Medicare Prescription Drug Price Negotiation Act of 2007 S.158: Access to Affordable Health Care Act S. 273: Prescription Drug and Health Improvement Act of 2007 S. 290: Rural Physicians Relief Act of 2007 S. 334: Healthy Americans Act S. 397: Tax Equity and Affordability Act of 2007 S. 498: Rural Medicare Equity Act of 2007 S. 1342: HeLP America Act S. 1605: Craig Thomas Rural Hospital and Provider Equity Act of 2007 S. 1710: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 S. 2785: Save Medicare Act of 2008 S. 2603: Medicare Fraud Prevention Act of 2008 S. 2687: Medicare Beneficiary Protection Act of 2008 S. 2786: Medicare Rural Health Access Improvement Act of 2008 H.R.4: Medicare Prescription Drug Price Negotiation Act of 2007 H.R.15: National Health Insurance Act H.R.118: To amend part D of title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to negotiate prices for part D covered drugs for Medicare beneficiaries. H.R.205: Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.298: Flexible Spending Accounts Growth and Opportunities Act of 2007 HR 914: Tax Equity and Affordability Act of 2007 H.R. 1651: Rural Health Quality Advisory Commission Act of 2007 HR 2056: Medicare Part D Improvement Act of 2007 HR 2633: HeLP America Act (Introduced in House) HR 2860: Health Care Access and Rural Equity (H-CARE) Act of 2007 HR 3014: Health Equity and Accountability Act of 2007 H.R. 3043: Department of Health and Human Services Appropriations Act, 2008 HR 3163: Healthy Americans HR 4848: To extend for one year parity in the application of certain limits to mental health benefits, and for other purposes HR 1424: Paul Wellstone Mental Health and Addiction Equity Act of 2007 HR 5445: To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009. H.R. 6143: Pension Protection Act ERISA Amendments of 2008 H.R. 6382: Pension Protection Technical Corrections Act of 2008 H.R. 7242: Pension Protection Act IRC Amendments of 2008

Client expense: $2,095,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1571, Seniors Access to Mental Health Act of 2007 (Medicare parity) H.R. 1663, Medicare Mental Health Modernization Act of 2007 H.R. 2626, Comprehensive HealthCARE Act of 2007 (Price Healthcare Bill) H.R. 3162, Children's Health and Medicare Protection Act of 2007 H.R. 2585, Ensuring the Future Physician Workforce Act of 2007 (Burgess SGR Bill) H.R. 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R. 3061, Medicare Part D Drug Class Protection Act of 2007 (Six Classes Bill) H.R. 820, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 1588, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R. 2050, Medicaid Emergency Psychiatric Care Act of 2007 (IMD-EMTALA) H.R. 882, Access to Emergency Medical Services Act of 2007 (EMTALA) S. 1887, Medicare Access to Critical Medications Act (Six Classes Bill) H.R. 470, to provide Medicare coverage of benzodiazepines and off-label uses of certain prescription drugs, optional Medicaid coverage of Medicare prescription drug cost-sharing, and authorization for the Secretary of Health and Human Services to waive certain determinations denying Medicare prescription drug coverage S. 137, Preserving Medicare for All Act of 2007 (Cardin Healthcare Bill, Includes Benzos) S. 588, Physician Shortage Act S. 1715, Medicare Mental Health Copayment Equity Act of 2007 S. 2499, Medicare, Medicaid, and SCHIP Extension Act S. 2785, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program H.R. 5445, Ensuring the Future Physician Workforce Act of 2007 (physician payment under Medicare) H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, Medicare Improvements for Patients and Providers Act of 2008 Conditions selected for coverage under the chronic conditions special needs plans (SNPs) HIPAA Administrative Simplification: Modification to Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS; Proposed Rule RIN 0958-AN25 [CMS-0013-P] 73 Federal Register 49796

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Justice, Dept of (DOJ), Natl Institute of Mental Health (NIMH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA), White House Office

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. Supplemental Appropriations Act, 2008 (HR 2642) Sec. 7001. (a) Moratoria on Certain Medicaid Regulations HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program HR 7110: Job Creation and Unemployment Relief Act: Title III, temporary increase in Medicaid matching rate S 3656: Preserving Access to Healthcare (PATH) Act -- which would delay cuts to Medicare capital indirect medical education (IME) payments for six months provisions in the developing economic stimulus package to temporarily increase FMAP self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce: HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend 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. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program the Fiscal Year (FY) 2009 inpatient prospective payment system (IPPS) final rule eliminated indirect medical education (IME) adjustments to teaching hospitals' capital payments proposed rule to implement National Defense Authorization Act for Fiscal Year 2002" requirement that TRICARE payment methods for outpatient hospital care be determined outpatient reimbursement rules used by Medicare S 3656: to delay cuts to Medicare capital indirect medical education (IME) payments for six months quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend 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 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

Client expense: $100,000 · 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), SENATE, White House Office

Monitor S. 1695, Biologics Price Competition and Innovation Act of 2007, to ensure that it does not apply to plasma proteins. S. 1376 and H.R. 2606, 340B Program Improvement and Integrity Act of 2007; H.R. 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007: Ensure bills do not expand this program at the expense of patient access to plasma protein therapies. Monitor H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008. Maintain status quo for the Medicaid rebate as applied to plasma protein therapies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to home and hospice care, rural health, telehealth, medicare and state's health insurance program legislation (H.R. 6331); The Health Care Access and Rural Equity Act of 2007 (H.R. 2860); Craig Thomas Rural Hospital and Provider Equity Act of 2007 (S. 1605); Home Health Care Planning Improvement Act of 2007 (S. 1678); The Fair Home Health Care Act (S. 2181/H.R. 3865) Medicare Improvements for Patients and Providers Act of 2008 (S. 3101); Preserving Access to Medicare Act of 2008 (S. 3118); The Medicare Hospice Protection Act (S. 3484/H.R. 6873); The Home Health Care Planning Improvement Act (S. 1628/H.R. 6826)

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

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

Inclusion of Marriage and Family Therapists in the Veterans Affairs healthcare system HR 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007, Title 2, Section 201 which calls for coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 3162 - Children's Health and Medicare Protection Act of 2007, Subtitle A, Section 607 which relates to coverage for marriage and family therapist services and mental health counselor services. S. 498 - Rural Medicare Equity Act of 2007 - legislation calls for improvement of the Medicare program for beneficiaries residing in rural areas S. 1605 - Craig Thomas Rural Hospital and Provider Equity Act of 2007, Section 16 which would provide coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2860, The Health Care Access and Rural Equity Act of 2007 -- sections 305 and 309 S. 321, Fostering Independence Through Technology Act of 2007 -- All sections S. 1605, Craig Thomas Rural Hospital and Provider Equity Act of 2007 -- sections 14 and 18 S. 1678, Home Health Care Planning Improvement Act of 2007 -- All sections S. 2181/H.R. 3865, The Fair Home Health Care Act -- All sections H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 -- effort to include home health rural add-on as amendment S. 3101, Medicare Improvements for Patients and Providers Act of 2008 --effort to include home health rural add-on as amendment S. 3118, Preserving Access to Medicare Act of 2008 -- section 112 H.R. 5613/S. 2819, Protecting the Medicaid Safety Net Act of 2008 -- All sections H.R. 2642, Supplemental Appropriations Act, 2008 -- Title VII Medicaid H.R. 6163, Medicare Telehealth Enhancement Act of 2008 -- sections 104, 105, and 106 S. 3613/H.R. 7114, The Independence at Home Act -- All sections S. 1340, The Geriatric Assessment and Chronic Care Coordination Act of 2007 -- All sections S. 3484/H.R. 6873 -- The Medicare Hospice Protection Act -- All sections S. 1628/H.R. 6826 -- The Home Health Care Planning Improvement Act -- All sections S. 1577/H.R. 3078 -- The Patient Safety and Abuse Prevention Act -- All sections

Client expense: $170,000 · Firm income: Not reported

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

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions. Advocated for HR 2642 - Supplemental Appropration Act of 2008: Provisions relating to Medicaid payments to hospitals. Advocated for HR 6331 - Medicare Improvements for Patients and Providers Act of 2008: Provisions relating to Medicare Payments to Physicians and relating to rural hospitals.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions. Advocated for HR 2642 - Supplemental Appropration Act of 2008: Provisions relating to Medicaid payments to hospitals. Advocated for HR 6331 - Medicare Improvements for Patients and Providers Act of 2008: Provisions relating to Medicare Payments to Physicians and relating to rural hospitals. Advocated for HR 5924 - Emergency Nursing Supply Relief Act; all provisions.

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

Government targets: HOUSE OF REPRESENTATIVES, 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)

Home and Hospice Care (S. 1678 and H.R. 3865), Rural health (S. 1605 and H.R. 2860); telehealth; medicare and state's health insurance program legislation (H.R. 6331 and S. 3101) (H.R. 5704); Medicare Hospice Protection Act (H.R. 6873 and S. 3484); Health IT legislation; Preserving Access to Health Care Act (S. 3656 and H.R. 7241)

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

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

Home and Hospice Care (S. 1678 and H.R. 3865), Rural health (S. 1605 and H.R. 2860); telehealth; medicare and state's health insurance program legislation (H.R. 6331 and S. 3101) (H.R. 5704); Medicare Hospice Protection Act (H.R. 6873 and S. 3484); Health IT legislation; Preserving Access to Health Care Act (S. 3656 and H.R. 7241)

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

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

H.R. 1571, Seniors Access to Mental Health Act of 2007 (Medicare parity) H.R. 1663, Medicare Mental Health Modernization Act of 2007 H.R. 2626, Comprehensive HealthCARE Act of 2007 (Price Healthcare Bill) H.R. 3162, Children's Health and Medicare Protection Act of 2007 H.R. 2585, Ensuring the Future Physician Workforce Act of 2007 (Burgess SGR Bill) H.R. 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R. 3061, Medicare Part D Drug Class Protection Act of 2007 (Six Classes Bill) H.R. 820, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 1588, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R. 2050, Medicaid Emergency Psychiatric Care Act of 2007 (IMD-EMTALA) H.R. 882, Access to Emergency Medical Services Act of 2007 (EMTALA) S. 1887, Medicare Access to Critical Medications Act (Six Classes Bill) H.R. 470, to provide Medicare coverage of benzodiazepines and off-label uses of certain prescription drugs, optional Medicaid coverage of Medicare prescription drug cost-sharing, and authorization for the Secretary of Health and Human Services to waive certain determinations denying Medicare prescription drug coverage S. 137, Preserving Medicare for All Act of 2007 (Cardin Healthcare Bill, Includes Benzos) S. 588, Physician Shortage Act S. 1715, Medicare Mental Health Copayment Equity Act of 2007 S. 2499, Medicare, Medicaid, and SCHIP Extension Act S. 2785, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program H.R. 5445, Ensuring the Future Physician Workforce Act of 2007 (physician payment under Medicare) H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, Medicare Improvements for Patients and Providers Act of 2008 Notice of Proposed Rulemaking: Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2009; and Revisions to the Amendment of the E-Prescribing Exemption for Computer Generated Facsimile Transmissions Notice of Proposed Rulemaking: Proposed Changes to the Hospital Outpatient Prospective, Ambulatory Surgical Center Payment Systems and CY 2009 Payment Rates

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

Government targets: Bureau of Prisons (BOP), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Aviation Administration (FAA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Justice, Dept of (DOJ), Natl Institute of Mental Health (NIMH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. Supplemental Appropriations Act, 2008 (HR 2642) Sec. 7001. (a) Moratoria on Certain Medicaid Regulations HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program HR 7110: Job Creation and Unemployment Relief Act: Title III, temporary increase in Medicaid matching rate S 3656: Preserving Access to Healthcare (PATH) Act -- which would delay cuts to Medicare capital indirect medical education (IME) payments for six months self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce, HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend 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. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend 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 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

Client expense: $100,000 · 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), SENATE, White House Office

S.3: Medicare Prescription Drug Price Negotiation Act of 2007 S.158: Access to Affordable Health Care Act S. 273: Prescription Drug and Health Improvement Act of 2007 S. 290: Rural Physicians Relief Act of 2007 S. 334: Healthy Americans Act S. 397: Tax Equity and Affordability Act of 2007 S. 498: Rural Medicare Equity Act of 2007 S. 1342: HeLP America Act S. 1605: Craig Thomas Rural Hospital and Provider Equity Act of 2007 S. 1710: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 S. 2785: Save Medicare Act of 2008 S. 2603: Medicare Fraud Prevention Act of 2008 S. 2687: Medicare Beneficiary Protection Act of 2008 S. 2786: Medicare Rural Health Access Improvement Act of 2008 H.R.4: Medicare Prescription Drug Price Negotiation Act of 2007 H.R.15: National Health Insurance Act H.R.118: To amend part D of title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to negotiate prices for part D covered drugs for Medicare beneficiaries. H.R.205: Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.298: Flexible Spending Accounts Growth and Opportunities Act of 2007 HR 914: Tax Equity and Affordability Act of 2007 H.R. 1651: Rural Health Quality Advisory Commission Act of 2007 HR 2056: Medicare Part D Improvement Act of 2007 HR 2633: HeLP America Act (Introduced in House) HR 2860: Health Care Access and Rural Equity (H-CARE) Act of 2007 HR 3014: Health Equity and Accountability Act of 2007 H.R. 3043: Department of Health and Human Services Appropriations Act, 2008 HR 3163: Healthy Americans HR 4848: To extend for one year parity in the application of certain limits to mental health benefits, and for other purposes HR 1424: Paul Wellstone Mental Health and Addiction Equity Act of 2007 HR 5445: To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009. H.R. 6143: Pension Protection Act ERISA Amendments of 2008 H.R. 6382: Pension Protection Technical Corrections Act of 2008 H.R. 7242: Pension Protection Act IRC Amendments of 2008

Client expense: $1,113,000 · Firm income: Not reported

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 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

HR 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007, Title 2, Section 201 which calls for coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 3162 - Children's Health and Medicare Protection Act of 2007, Subtitle A, Section 607 which relates to coverage for marriage and family therapist services and mental health counselor services. S. 498 - Rural Medicare Equity Act of 2007 - legislation calls for improvement of the Medicare program for beneficiaries residing in rural areas S. 1605 - Craig Thomas Rural Hospital and Provider Equity Act of 2007, Section 16 which would provide coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 820 - To amend title XVIII of the Social Security Act to provide for the coverage of marriage and family therapist services under Part B of the Medicare Program, and for other purposes. HR 1663 - Title 3, Sec. 302. Coverage of marriage and family therapist services. To amend title XVIII of the Social Security Act to expand and improve coverage of mental health services under the Medicare Program. S. 2708 - Caring for An Aging America Act of 2008, Section 771 - Geriatric and Gerontology Loan Repayment Program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor S. 1695, Biologics Price Competition and Innovation Act of 2007, to ensure that it does not apply to plasma proteins. S. 1376 and H.R. 2606, 340B Program Improvement and Integrity Act of 2007; H.R. 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007: Ensure bills do not expand this program at the expense of patient access to plasma protein therapies. Monitor H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008. Maintain status quo for the Medicaid rebate as applied to plasma protein therapies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2860, The Health Care Access and Rural Equity Act of 2007 -- sections 305 and 309 S. 321, Fostering Independence Through Technology Act of 2007 -- All sections S. 1605, Craig Thomas Rural Hospital and Provider Equity Act of 2007 -- sections 14 and 18 S. 1678, Home Health Care Planning Improvement Act of 2007 -- All sections S. 2181/H.R. 3865, The Fair Home Health Care Act -- All sections H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 -- effort to include home health rural add-on as amendment S. 3101, Medicare Improvements for Patients and Providers Act of 2008 --effort to include home health rural add-on as amendment S. 3118, Preserving Access to Medicare Act of 2008 -- section 112 H.R. 5613/S. 2819, Protecting the Medicaid Safety Net Act of 2008 -- All sections H.R. 2642, Supplemental Appropriations Act, 2008 -- Title VII Medicaid H.R. 6163, Medicare Telehealth Enhancement Act of 2008 -- sections 104, 105, and 106 S. 3613/H.R. 7114, The Independence at Home Act -- All sections S. 1340, The Geriatric Assessment and Chronic Care Coordination Act of 2007 -- All sections S. 3484/H.R. 6873 -- The Medicare Hospice Protection Act -- All sections S. 1628/H.R. 6826 -- The Home Health Care Planning Improvement Act -- All sections S. 1577/H.R. 3078 -- The Patient Safety and Abuse Prevention Act -- All sections

Client expense: $92,550 · Firm income: Not reported

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

H.R. 2860, The Health Care Access and Rural Equity Act of 2007 -- sections 305 and 309 S. 321, Fostering Independence Through Technology Act of 2007 -- All sections S. 1605, Craig Thomas Rural Hospital and Provider Equity Act of 2007 -- sections 14 and 18 S. 1678, Home Health Care Planning Improvement Act of 2007 -- All sections S. 2181/H.R. 3865, The Fair Home Health Care Act -- All sections H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 -- effort to include home health rural add-on as amendment S. 3101, Medicare Improvements for Patients and Providers Act of 2008 --effort to include home health rural add-on as amendment S. 3118, Preserving Access to Medicare Act of 2008 -- section 112 H.R. 5613/S. 2819, Protecting the Medicaid Safety Net Act of 2008 -- All sections H.R. 2642, Supplemental Appropriations Act, 2008 -- Title VII Medicaid H.R. 6163, Medicare Telehealth Enhancement Act of 2008 -- sections 104, 105, and 106

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

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

H.R. 1571, Seniors Access to Mental Health Act of 2007 (Medicare parity) H.R. 1663, Medicare Mental Health Modernization Act of 2007 H.R. 2626, Comprehensive HealthCARE Act of 2007 (Price Healthcare Bill) H.R. 3162, Children's Health and Medicare Protection Act of 2007 H.R. 2585, Ensuring the Future Physician Workforce Act of 2007 (Burgess SGR Bill) H.R. 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R. 3061, Medicare Part D Drug Class Protection Act of 2007 (Six Classes Bill) H.R. 820, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 1588, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R. 2050, Medicaid Emergency Psychiatric Care Act of 2007 (IMD-EMTALA) H.R. 882, Access to Emergency Medical Services Act of 2007 (EMTALA) S. 1887, Medicare Access to Critical Medications Act (Six Classes Bill) H.R. 470, to provide Medicare coverage of benzodiazepines and off-label uses of certain prescription drugs, optional Medicaid coverage of Medicare prescription drug cost-sharing, and authorization for the Secretary of Health and Human Services to waive certain determinations denying Medicare prescription drug coverage S. 137, Preserving Medicare for All Act of 2007 (Cardin Healthcare Bill, Includes Benzos) S. 588, Physician Shortage Act S. 1715, Medicare Mental Health Copayment Equity Act of 2007 S. 2499, Medicare, Medicaid, and SCHIP Extension Act S. 2785, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program H.R. 5445, Ensuring the Future Physician Workforce Act of 2007 (physician payment under Medicare) H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, Medicare Improvements for Patients and Providers Act of 2008 Notice of Proposed Rulemaking for Medicare Program: Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Proposed Changes to Disclosure of Physician Ownership in Hospitals and Physician Self-Referral Rules; Proposed Collection of Information Regarding Financial Relationships Between Hospitals and Physicians

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Aviation Administration (FAA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Justice, Dept of (DOJ), Natl Institute of Mental Health (NIMH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

H.R. 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 A bill to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program. S. 2819 Economic Recovery in Health Care Act Legislation to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief. HR 5613 - Protecting the Medicaid Safety Net Act of 2008 To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009. HR 2642 - Supplemental Appropriations Act, 2008 Making appropriations for military construction, the Department of Veterans Affairs, and related agencies for the fiscal year ending September 30, 2008, and for other purposes. This bill included provisions related to a moratorium on Medicaid funding cuts. HR 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. HR 3533 - Public and Teaching Hospital Preservation Act 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 Medicaid rule regarding graduate medical education. S. 1605 - Craig Thomas Rural Hospital and Provider Equity Act of 2007 A bill 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. HR 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007 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. S. 2786 - Medicare Rural Health Access Improvement Act of 2008 A bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas.

Client expense: $435,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 2860, sections 305 and 309; S. 321, All sections; S. 1605, sections 14 and 18; S. 1678, All sections; H.R. 2642, Title VII Medicaid; H.R. 6163, sections 104, 105, and 106; S. 3118, section 112; H.R. 5613/S. 2819, All sections; S. 3101 and H.R. 6331, rural add-on amendment effort; S. 2181/H.R. 3865, All sections

Client expense: Not reported · Firm income: Not reported

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.3: Medicare Prescription Drug Price Negotiation Act of 2007 S.158: Access to Affordable Health Care Act S. 273: Prescription Drug and Health Improvement Act of 2007 S. 290: Rural Physicians Relief Act of 2007 S. 334: Healthy Americans Act S. 397: Tax Equity and Affordability Act of 2007 S. 498: Rural Medicare Equity Act of 2007 S. 1342: HeLP America Act S. 1605: Craig Thomas Rural Hospital and Provider Equity Act of 2007 S. 1710: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 S. 2785: Save Medicare Act of 2008 S. 2603: Medicare Fraud Prevention Act of 2008 S. 2687: Medicare Beneficiary Protection Act of 2008 S. 2786: Medicare Rural Health Access Improvement Act of 2008 H.R.4: Medicare Prescription Drug Price Negotiation Act of 2007 H.R.15: National Health Insurance Act H.R.118: To amend part D of title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to negotiate prices for part D covered drugs for Medicare beneficiaries. H.R.205: Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.298: Flexible Spending Accounts Growth and Opportunities Act of 2007 HR 914: Tax Equity and Affordability Act of 2007 H.R. 1651: Rural Health Quality Advisory Commission Act of 2007 HR 2056: Medicare Part D Improvement Act of 2007 HR 2633: HeLP America Act (Introduced in House) HR 2860: Health Care Access and Rural Equity (H-CARE) Act of 2007 HR 3014: Health Equity and Accountability Act of 2007 H.R. 3043: Department of Health and Human Services Appropriations Act, 2008 HR 3163: Healthy Americans HR 4848: To extend for one year parity in the application of certain limits to mental health benefits, and for other purposes HR 1424: Paul Wellstone Mental Health and Addiction Equity Act of 2007 HR 5445: To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009.

Client expense: $1,251,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions. Advocated for HR 2642 - Supplemental Appropration Act of 2008: Provisions relating to Medicaid payments to hospitals. Advocated for HR 6331 - Medicare Improvements for Patients and Providers Act of 2008: Provisions relating to Medicare Payments to Physicians and relating to rural hospitals.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions. Advocated for HR 2642 - Supplemental Appropration Act of 2008: Provisions relating to Medicaid payments to hospitals. Advocated for HR 6331 - Medicare Improvements for Patients and Providers Act of 2008: Provisions relating to Medicare Payments to Physicians and relating to rural hospitals.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1571, Seniors Access to Mental Health Act of 2007 (Medicare parity) H.R. 1663, Medicare Mental Health Modernization Act of 2007 H.R. 2626, Comprehensive HealthCARE Act of 2007 (Price Healthcare Bill) H.R. 3162, Children's Health and Medicare Protection Act of 2007 H.R. 2585, Ensuring the Future Physician Workforce Act of 2007 (Burgess SGR Bill) H.R. 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R. 3061, Medicare Part D Drug Class Protection Act of 2007 (Six Classes Bill) H.R. 820, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 1588, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R. 2050, Medicaid Emergency Psychiatric Care Act of 2007 (IMD-EMTALA) H.R. 882, Access to Emergency Medical Services Act of 2007 (EMTALA) S. 1887, Medicare Access to Critical Medications Act (Six Classes Bill) H.R. 470, to provide Medicare coverage of benzodiazepines and off-label uses of certain prescription drugs, optional Medicaid coverage of Medicare prescription drug cost-sharing, and authorization for the Secretary of Health and Human Services to waive certain determinations denying Medicare prescription drug coverage S. 137, Preserving Medicare for All Act of 2007 (Cardin Healthcare Bill, Includes Benzos) S. 588, Physician Shortage Act S. 1715, Medicare Mental Health Copayment Equity Act of 2007 S. 2499, Medicare, Medicaid, and SCHIP Extension Act S. 2785, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program H.R. 5445, Ensuring the Future Physician Workforce Act of 2007 (physician payment under Medicare) H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, Medicare Improvements for Patients and Providers Act of 2008 Notice of Proposed Rulemaking for Medicare Program: Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Proposed Changes to Disclosure of Physician Ownership in Hospitals and Physician Self-Referral Rules; Proposed Collection of Information Regarding Financial Relationships Between Hospitals and Physicians

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Aviation Administration (FAA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Justice, Dept of (DOJ), Natl Institute of Mental Health (NIMH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce, HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend 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. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend 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 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

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

H.R. 2860, The Health Care Access and Rural Equity Act of 2007 -- sections 305 and 309 S. 321, Fostering Independence Through Technology Act of 2007 -- All sections S. 1605, Craig Thomas Rural Hospital and Provider Equity Act of 2007 -- sections 14 and 18 S. 1678, Home Health Care Planning Improvement Act of 2007 -- All sections S. 2181/H.R. 3865, The Fair Home Health Care Act -- All sections H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 -- effort to include home health rural add-on as amendment S. 3101, Medicare Improvements for Patients and Providers Act of 2008 --effort to include home health rural add-on as amendment S. 3118, Preserving Access to Medicare Act of 2008 -- section 112 H.R. 5613/S. 2819, Protecting the Medicaid Safety Net Act of 2008 -- All sections H.R. 2642, Supplemental Appropriations Act, 2008 -- Title VII Medicaid H.R. 6163, Medicare Telehealth Enhancement Act of 2008 -- sections 104, 105, and 106

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

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

Monitor S. 1695, Biologics Price Competition and Innovation Act of 2007, to ensure that it does not apply to plasma proteins. S. 1376 and H.R. 2606, 340B Program Improvement and Integrity Act of 2007; H.R. 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007: Ensure bills do not expand this program at the expense of patient access to plasma protein therapies. Monitor H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008. Maintain status quo for the Medicaid rebate as applied to plasma protein therapies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007, Title 2, Section 201 which calls for coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 3162 - Children's Health and Medicare Protection Act of 2007, Subtitle A, Section 607 which relates to coverage for marriage and family therapist services and mental health counselor services. S. 498 - Rural Medicare Equity Act of 2007 - legislation calls for improvement of the Medicare program for beneficiaries residing in rural areas S. 1605 - Craig Thomas Rural Hospital and Provider Equity Act of 2007, Section 16 which would provide coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 820 - To amend title XVIII of the Social Security Act to provide for the coverage of marriage and family therapist services under Part B of the Medicare Program, and for other purposes. HR 1663 - Title 3, Sec. 302. Coverage of marriage and family therapist services. To amend title XVIII of the Social Security Act to expand and improve coverage of mental health services under the Medicare Program. S. 2708 - Caring for An Aging America Act of 2008, Section 771 - Geriatric and Gerontology Loan Repayment Program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce, HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend 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. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend 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 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338 Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions.

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

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions.

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

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.3: Medicare Prescription Drug Price Negotiation Act of 2007 S.158: Access to Affordable Health Care Act S. 273: Prescription Drug and Health Improvement Act of 2007 S. 290: Rural Physicians Relief Act of 2007 S. 334: Healthy Americans Act S. 397: Tax Equity and Affordability Act of 2007 S. 498: Rural Medicare Equity Act of 2007 S. 1342: HeLP America Act S. 1605: Craig Thomas Rural Hospital and Provider Equity Act of 2007 S. 1710: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 S. 2785: Save Medicare Act of 2008 S. 2603: Medicare Fraud Prevention Act of 2008 S. 2687: Medicare Beneficiary Protection Act of 2008 S. 2786: Medicare Rural Health Access Improvement Act of 2008 H.R.4: Medicare Prescription Drug Price Negotiation Act of 2007 H.R.15: National Health Insurance Act H.R.118: To amend part D of title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to negotiate prices for part D covered drugs for Medicare beneficiaries. H.R.205: Medicare Prescription Drug Enrollment Extension Act of 2007 H.R.298: Flexible Spending Accounts Growth and Opportunities Act of 2007 HR 914: Tax Equity and Affordability Act of 2007 H.R. 1651: Rural Health Quality Advisory Commission Act of 2007 HR 2056: Medicare Part D Improvement Act of 2007 HR 2633: HeLP America Act (Introduced in House) HR 2860: Health Care Access and Rural Equity (H-CARE) Act of 2007 HR 3014: Health Equity and Accountability Act of 2007 H.R. 3043: Department of Health and Human Services Appropriations Act, 2008 HR 3163: Healthy Americans HR 4848: To extend for one year parity in the application of certain limits to mental health benefits, and for other purposes HR 1424: Paul Wellstone Mental Health and Addiction Equity Act of 2007 HR 5445: To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009.

Client expense: $1,006,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1571, Seniors Access to Mental Health Act of 2007 (Medicare parity) H.R. 1663, Medicare Mental Health Modernization Act of 2007 H.R. 2626, Comprehensive HealthCARE Act of 2007 (Price Healthcare Bill) H.R. 3162, Children's Health and Medicare Protection Act of 2007 H.R. 2585, Ensuring the Future Physician Workforce Act of 2007 (Burgess SGR Bill) H.R. 3025, Medicare Prescription Drug Savings for Our Seniors (Medicare Prescription Drug SOS) Act of 2007 H.R. 3061, Medicare Part D Drug Class Protection Act of 2007 (Six Classes Bill) H.R. 820, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 1588, Seniors Mental Health Access Improvement Act of 2007 (MFTs/MHCs) H.R. 2860, Health Care Access and Rural Equity (H-CARE) Act of 2007 H.R. 2050, Medicaid Emergency Psychiatric Care Act of 2007 (IMD-EMTALA) H.R. 882, Access to Emergency Medical Services Act of 2007 (EMTALA) S. 1887, Medicare Access to Critical Medications Act (Six Classes Bill) H.R. 470, to provide Medicare coverage of benzodiazepines and off-label uses of certain prescription drugs, optional Medicaid coverage of Medicare prescription drug cost-sharing, and authorization for the Secretary of Health and Human Services to waive certain determinations denying Medicare prescription drug coverage S. 137, Preserving Medicare for All Act of 2007 (Cardin Healthcare Bill, Includes Benzos) S. 588, Physician Shortage Act S. 1715, Medicare Mental Health Copayment Equity Act of 2007 S. 2499, Medicare, Medicaid, and SCHIP Extension Act S. 2785, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program H.R. 5445, Ensuring the Future Physician Workforce Act of 2007 (physician payment under Medicare)

Client expense: $127,101 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Justice, Dept of (DOJ), Natl Institute of Mental Health (NIMH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Monitor S. 1695, Biologics Price Competition and Innovation Act of 2007, to ensure that it does not apply to plasma proteins. S. 1376 and H.R. 2606, 340B Program Improvement and Integrity Act of 2007; H.R. 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007: Ensure bills do not expand this program at the expense of patient access to plasma protein therapies. Maintain status quo for the Medicaid rebate as applied to plasma protein therapies.

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

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

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

H.R. 2860 -- The Health Care Access and Rural Equity Act of 2007: Sections 305 and 309 H.R. 3162 -- The Children's Health and Medicare Act of 2007: Sections 412, 701, 702, 706, and 707 S. 321 -- Fostering Independence Through Technoogy Act of 2007: All sections S. 1605 -- Craig Thomas Rural Hospital and Provider Equity Act of 2007: Sections 14 and 18 S. 1678 -- Home Health Care Planning Improvement Act of 2007: All sections S. 2181/H.R. 3865 -- The Home Health Care Access Protection Act: All sections H.R. 3582 -- The Fair Home Health Care Act: All sections

Client expense: $170,000 · Firm income: Not reported

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

HR 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007, Title 2, Section 201 which calls for coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 3162 - Children's Health and Medicare Protection Act of 2007, Subtitle A, Section 607 which relates to coverage for marriage and family therapist services and mental health counselor services. S. 498 - Rural Medicare Equity Act of 2007 - legislation calls for improvement of the Medicare program for beneficiaries residing in rural areas S. 1605 - Craig Thomas Rural Hospital and Provider Equity Act of 2007, Section 16 which would provide coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 820 - To amend title XVIII of the Social Security Act to provide for the coverage of marriage and family therapist services under Part B of the Medicare Program, and for other purposes. HR 1663 - Title 3, Sec. 302. Coverage of marriage and family therapist services. To amend title XVIII of the Social Security Act to expand and improve coverage of mental health services under the Medicare Program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE