To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009.

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

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

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

HR 748 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps S 450 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps HR 1552 - Medicare Patient Access to Physical Therapists Act S 932 - Medicare Patient Access to Physical Therapists Act HR 1846 - Medicare Access to Physical Medicine and Rehabilitation Services Improvement 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 S 2785 - Save Medicare Act of 2008 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. S 787 - 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 HR 5590 - Medicare Oral Health Rehabilitative Enhancement Act of 2008 HR 5613 - Protecting Medicaid Safety Net Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H CON RES 312 - Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013 HR 1459 - 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 S 1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 HR 3057 - Medicare Long-Term Care Patient Safety and Improvement Act of 2007 CORF, ORF conditions of participation- social and vocational services requirements Medicaid regulations promulgated by CMS Stark provisions in Fee Schedule Rule Physician Quality Reporting Initiative Durable Medical Equipment, Prosthetic, Orthotic & Supplies (DMEPOS) Regulations Medicare Post Acute Care Demo Medicare Home Health Demo Medicare Electronic Health Record demo CMS Alternative Payment System Project Comments to American Health Information Community re: successor Payment updates for physicians, hospitals, skilled nursing facilities, and home health Medicare Manual revisions In office ancillary services exception Inpatient Rehabilitation Facilities under Medicare Improving Funding for the Medicaid Program Extending legislative moratoria on Medicaid Regulations in President's FY 2009 budget Working with plan to mandate implementation of the International Classification of Diseases, 10th edition Medicaid Federal Medical Assistance Percentage (FMAP) 2009 Medicare Physician Fee Schedule Proposed Rule HR 6331-the Medicare Improvements for Patients and Providers Act S 3101- the Medicare Improvements for Patients and Providers Act S 3118 - Preserving Access to Medicare Act of 2008 HR 6252 - Medicare DMEPOS Competive Acquisition Reform Act of 2008 S 3144- Medicare DMEPOS Competive Acquisition Reform Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program S 2812 - Medicare Telehealth Improvement Act of 2008 HR 5445 - Increase Medicare Payments for physician services S 2785 - Increase Medicare Payments for physician services HR 5704 - Home Health Flexibility Act of 2008 Outpatient Hospital Medicaid Regulations

Client expense: $378,766 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

H.R.685: To amend the Social Security Act to eliminate the 5-month waiting period for Social Security disability and the 24-month waiting period for Medicare benefits in the cases of individuals with disabling burn injuries. S.173: A bill to amend title XVIII of the Social Security Act to establish Medicare Health Savings Accounts. S. 2320: to amend title XVIII of the Social Security Act to provide continued entitlement to coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare program that have received a kidney transplant and whose entitlement to coverage would otherwise expire, and for other purposes. H.R.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: $515,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

E-Prescribing, S. 2408/HR 4296 Medicare Electronic Medication and Safety Protection Act, Physician Disclosure, HR 5605/ S 2029 - Physician Payments Sunshine Act, Physician Reimbursement/Medicare Physician Fee Schedule, HR 3162, Children's Health and Medicare Protection Act, S. 2785, Save Medicare Act, HR 5545/S.2729 Ensuring the Future Physician Workforce, HR 5445 - to increase Medicare payments for physicians' services, Imaging, HR 1293/S1338, Access to Medicare Imaging Act, Health Information Technology S 1042/HR 583 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act Appropriateness Criteria and Accreditation National Coverage Decision on CTA (CMS) National Coverage Decision on Percutaneous Transluminal Angioplasty concurrent w/Stenting (CMS) Quality Improvement (PQRI) Specialty Hospitals Comparative Effectiveness HR 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, the Medicare Improvements for Patients and Providers Act of 2008 S. 3118, Preserving Access to Medicare Act of 2008 Cardiac Magnetic Resonance Services Coverage for Carotid Stenting IDTF and Anti-markip rules in Physician Fee Schedule Value-based Purchasing

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

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

HR 1665/S 2352- Medicare Hearing Health Care Enhancement Act of 2007, all provisions. HR 1823/S 2250- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, all provisions. HR 1774/S 45- Establishes a separate definition of outpatient speech-language pathology services under Medicare, all provisions. S 2785- Save Medicare Act of 2008, all provisions. S. 3101 - Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3118 - Preserving Access to Medicare Act of 2008, all provisions HR 6331- Medicare Improvements for Patients and Providers Act of 2008, all provisions HR 2585/S 2729- Ensuring the Future Physician Workforce Act of 2008, all provisions. HR 5445- To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009, all provisions. CMS Transmittals- 84, 1470, and 1550 - "Incident to" policy relating to audiology services.

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

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

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; Include expansion of the medical home as well as transformation grants for the medical home in SCHIP re-authorizing legislation Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Client expense: $269,132 · Firm income: Not reported

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

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; Include expansion of the medical home as well as transformation grants for the medical home in SCHIP re-authorizing legislation. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Client expense: $142,652 · Firm income: Not reported

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

CMS reimbursement policy for Medicare physician services. H.R. 2585 - Ensuring the Future Physician Workforce Act of 2007 S. 2729 - Ensuring the Future Physician Workforce Act of 2008 H.R. 5445 - To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S. 2785 - Save Medicare Act of 2008 - To amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program. H.R. 6331 - Medicare Improvements for Patients and Providers Act. S. 3101 - Medicare Improvements for Patients and Providers Act

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

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

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

HR 1665/S 2352- Medicare Hearing Health Care Enhancement Act of 2007, all provisions. HR 1823/S 2250- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, all provisions. HR 1774/S 45- Establishes a separate definition of outpatient speech-language pathology services under Medicare, all provisions. S 2785- Save Medicare Act of 2008, all provisions. S. 3101 - Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3118 - Preserving Access to Medicare Act of 2008, all provisions HR 6331- Medicare Improvements for Patients and Providers Act of 2008, all provisions HR 2585/S 2729- Ensuring the Future Physician Workforce Act of 2008, all provisions. HR 5445- To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009, all provisions. CMS Transmittals- 84, 1470, and 1550 - "Incident to" policy relating to audiology services.

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

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

S. 3101, the Medicare Improvements for Patients and Providers Act of 2008, Medicare reimbursement for physicians. H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008, Medicare reimbursement for physicians. S. 2785, Save Medicare Act of 2008, physician reimbursement issues. H.R. 5545 and S. 2729, Ensuring the Future Physician Workforce Act of 2008, physician reimbursement issues. H.R. 5445, to amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physician services through December 31, 2009, physician reimbursement issues. S. 2408 and H.R. 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007, issues related to electronic prescribing of medications. Private Fee for Service Plans in the Medicare Advantage Program, payment rates. Preservation of the whole-hospital exception to the Stark laws. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, concerning Medicaid regulations. Medicaid Tamper Resistant Pads. Medicare Program - Physician Quality Reporting Initiative Medicare Program - Medicare Electronic Health Record Demonstration project Medicare Program - Proposed Standards for E-prescribing under Medicare Part D. Medicare Program - Medicare Advantage Medicare Program - Physican Enrollment

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

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

HR 748 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps S 450 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps HR 1552 - Medicare Patient Access to Physical Therapists Act S 932 - Medicare Patient Access to Physical Therapists Act HR 1846 - Medicare Access to Physical Medicine and Rehabilitation Services Improvement 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 S 2785 - Save Medicare Act of 2008 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. S 787 - 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 HR 5590 - Medicare Oral Health Rehabilitative Enhancement Act of 2008 HR 5613 - Protecting Medicaid Safety Net Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H CON RES 312 - Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013 HR 1459 - 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 S 1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 HR 3057 - Medicare Long-Term Care Patient Safety and Improvement Act of 2007 CORF, ORF conditions of participation- social and vocational services requirements Medicaid regulations promulgated by CMS Stark provisions in Fee Schedule Rule Physician Quality Reporting Initiative Durable Medical Equipment, Prosthetic, Orthotic & Supplies (DMEPOS) Regulations Medicare Post Acute Care Demo Medicare Home Health Demo Medicare Electronic Health Record demo CMS Alternative Payment System Project Comments to American Health Information Community re: successor Payment updates for physicians, hospitals, skilled nursing facilities, and home health Medicare Manual revisions In office ancillary services exception Inpatient Rehabilitation Facilities under Medicare Improving Funding for the Medicaid Program Extending legislative moratoria on Medicaid Regulations in President's FY 2009 budget Working with plan to mandate implementation of the International Classification of Diseases, 10th edition Medicaid Federal Medical Assistance Percentage (FMAP) 2009 Medicare Physician Fee Schedule Proposed Rule HR 6331-the Medicare Improvements for Patients and Providers Act S 3101- the Medicare Improvements for Patients and Providers Act S 3118 - Preserving Access to Medicare Act of 2008 HR 6252 - Medicare DMEPOS Competive Acquisition Reform Act of 2008 S 3144- Medicare DMEPOS Competive Acquisition Reform Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program S 2812 - Medicare Telehealth Improvement Act of 2008 HR 5445 - Increase Medicare Payments for physician services S 2785 - Increase Medicare Payments for physician services HR 5704 - Home Health Flexibility Act of 2008 Outpatient Hospital Medicaid Regulations

Client expense: $355,739 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

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

H.R.685: To amend the Social Security Act to eliminate the 5-month waiting period for Social Security disability and the 24-month waiting period for Medicare benefits in the cases of individuals with disabling burn injuries. S.173: A bill to amend title XVIII of the Social Security Act to establish Medicare Health Savings Accounts. S. 2320: to amend title XVIII of the Social Security Act to provide continued entitlement to coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare program that have received a kidney transplant and whose entitlement to coverage would otherwise expire, and for other purposes. H.R.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: $470,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

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

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Client expense: $276,799 · Firm income: Not reported

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

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Client expense: $167,205 · Firm income: Not reported

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

CMS reimbursement policy for Medicare physician services. H.R. 2585 - Ensuring the Future Physician Workforce Act of 2007 S. 2729 - Ensuring the Future Physician Workforce Act of 2008 H.R. 5445 - To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S. 2785 - Save Medicare Act of 2008 - To amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program. H.R. 6331 - Medicare Improvements for Patients and Providers Act. S. 3101 - Medicare Improvements for Patients and Providers Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

E-Prescribing, S. 2408/HR 4296 Medicare Electronic Medication and Safety Protection Act, Physician Disclosure, HR 5605/ S 2029 - Physician Payments Sunshine Act, Physician Reimbursement/Medicare Physician Fee Schedule, HR 3162, Children's Health and Medicare Protection Act, S. 2785, Save Medicare Act, HR 5545/S.2729 Ensuring the Future Physician Workforce, HR 5445 - to increase Medicare payments for physicians' services, Imaging, HR 1293/S1338, Access to Medicare Imaging Act, Health Information Technology S 1042/HR 583 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act Appropriateness Criteria and Accreditation National Coverage Decision on CTA (CMS) National Coverage Decision on Percutaneous Transluminal Angioplasty concurrent w/Stenting (CMS) Quality Improvement (PQRI) Specialty Hospitals Comparative Effectiveness HR 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, the Medicare Improvements for Patients and Providers Act of 2008 S. 3118, Preserving Access to Medicare Act of 2008

Client expense: $490,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), 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.685: To amend the Social Security Act to eliminate the 5-month waiting period for Social Security disability and the 24-month waiting period for Medicare benefits in the cases of individuals with disabling burn injuries. S.173: A bill to amend title XVIII of the Social Security Act to establish Medicare Health Savings Accounts. S. 2320: to amend title XVIII of the Social Security Act to provide continued entitlement to coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare program that have received a kidney transplant and whose entitlement to coverage would otherwise expire, and for other purposes. H.R.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: $540,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

S. 3101, the Medicare Improvements for Patients and Providers Act of 2008, Medicare reimbursement for physicians. H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008, Medicare reimbursement for physicians. S. 2785, Save Medicare Act of 2008, physician reimbursement issues. H.R. 5545 and S. 2729, Ensuring the Future Physician Workforce Act of 2008, physician reimbursement issues. H.R. 5445, to amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physician services through December 31, 2009, physician reimbursement issues. S. 2408 and H.R. 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007, issues related to electronic prescribing of medications. Private Fee for Service Plans in the Medicare Advantage Program, payment rates. Preservation of the whole-hospital exception to the Stark laws. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, concerning Medicaid regulations. Medicaid Tamper Resistant Pads. Medicare Program - Physician Quality Reporting Initiative Medicare Program - Medicare Electronic Health Record Demonstration project Medicare Program - Proposed Standards for E-prescribing under Medicare Part D. Medicare Program - Medicare Advantage Medicare Program - Physican Enrollment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), 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: $1,251,000 · 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

HR 748 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps S 450 - Medicare Access to Rehabilitation Services Act, Repeal of Therapy Caps HR 1552 - Medicare Patient Access to Physical Therapists Act S 932 - Medicare Patient Access to Physical Therapists Act HR 1846 - Medicare Access to Physical Medicine and Rehabilitation Services Improvement 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 S 2785 - Save Medicare Act of 2008 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. S 787 - 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 HR 5590 - Medicare Oral Health Rehabilitative Enhancement Act of 2008 HR 5613 - Protecting Medicaid Safety Net Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 H CON RES 312 - Revising the congressional budget for the United States Government for fiscal year 2008, establishing the congressional budget for the United States Government for fiscal year 2009, and setting forth appropriate budgetary levels for fiscal years 2010 through 2013 HR 1459 - 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 S 1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007 HR 3057 - Medicare Long-Term Care Patient Safety and Improvement Act of 2007 CORF, ORF conditions of participation- social and vocational services requirements Medicaid regulations promulgated by CMS Stark provisions in Fee Schedule Rule Physician Quality Reporting Initiative Durable Medical Equipment, Prosthetic, Orthotic & Supplies (DMEPOS) Regulations Medicare Post Acute Care Demo Medicare Home Health Demo Medicare Electronic Health Record demo CMS Alternative Payment System Project Comments to American Health Information Community re: successor Payment updates for physicians, hospitals, skilled nursing facilities, and home health Medicare Manual revisions In office ancillary services exception Inpatient Rehabilitation Facilities under Medicare Improving Funding for the Medicaid Program Extending legislative moratoria on Medicaid Regulations in President's FY 2009 budget Working with plan to mandate implementation of the International Classification of Diseases, 10th edition Medicaid Federal Medical Assistance Percentage (FMAP) 2009 Medicare Physician Fee Schedule Proposed Rule HR 6331-the Medicare Improvements for Patients and Providers Act S 3101- the Medicare Improvements for Patients and Providers Act S 3118 - Preserving Access to Medicare Act of 2008 HR 6252 - Medicare DMEPOS Competive Acquisition Reform Act of 2008 S 3144- Medicare DMEPOS Competive Acquisition Reform Act of 2008 HR 4105 - Medicare Recovery Audit Contractor Program S 2812 - Meciare Telehealth Improvement Act of 2008 HR 5445 - Increase Medicare Payments for physician services S 2785 - Increase Medicare Payments for physician services

Client expense: $566,146 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

E-Prescribing, S. 2408/HR 4296 Medicare Electronic Medication and Safety Protection Act, Physician Disclosure, HR 5605/ S 2029 - Physician Payments Sunshine Act, Physician Reimbursement/Medicare Physician Fee Schedule, HR 3162, Children's Health and Medicare Protection Act, S. 2785, Save Medicare Act, HR 5545/S.2729 Ensuring the Future Physician Workforce, HR 5445 - to increase Medicare payments for physicians' services, Imaging, HR 1293/S1338, Access to Medicare Imaging Act, Health Information Technology S 1042/HR 583 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act Appropriateness Criteria and Accreditation National Coverage Decision on CTA (CMS) National Coverage Decision on Percutaneous Transluminal Angioplasty concurrent w/Stenting (CMS) Quality Improvement (PQRI) Specialty Hospitals Comparative Effectiveness HR 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3101, the Medicare Improvements for Patients and Providers Act of 2008 S. 3118, Preserving Access to Medicare Act of 2008

Client expense: $490,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), 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. 6091 and S. 2785, Save Medicare Act of 2008, all provisions S. 3101, Medicare Improvements for Patients and Physicians Act of 2008, all provisions S. 3118, Preserving Access to Medicare Act of 2008, all provisions H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3164, Seniors & Taxpayers Obligation Protection Act of 2008, all provisions H.R. 4736, to amend part B of title XVIII of the Social Security Act to repeal limiting charges under the Medicare Program for non-participating physicians and to preempt State laws that prohibit balance billing, all provisions H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, provisions relating to the Physician Assistance and Quality Initiative (PAQI) Funds and moratorium on implementation of new Medicaid regulations, and physician-owned hospitals H.R. 4296 and S. 2408, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007, all provisions H.R. 5445, to amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009, all provisions H.R. 5545 and S. 2729, Ensuring the Future Physician Workforce Act of 2008, all provisions H.R. 6252, Medicare DMEPOS Competitive Acquisition Reform Act of 2008, all provisions H.R. 1665, Medicare Hearing Health Care Enhancement Act of 2007, provisions on scope of practice H.R. 2043, Medicaid Access Project Through Information Technology (MAPIT) Act, all provisions Section 511 of the Tax Prevention and Reconciliation Act of 2005, 3 percent withhold Medicare Program - Medically Underserved Populations and Health Professional Shortage Areas Medicare Program - Hospital Inpatient Prospective Payment Systems Medicare Program - Physician Self-Referral Rules Medicare Program - Medicare Advantage Medicare Program - E-Prescribing Medicare Program - Physician Compare Website Medicare & Medicaid Programs - National Provider Identifier, compliance date extension Medicare Program - Consultations Medicare Program - EMTALA Medicare Program - Recovery Audit Contractors Medicare Program - Physician Enrollment Medicare Program - Vaccine Access Medicare Program - Conditions of Participation Medicare Program - Administrative Contractors Medicare Program - Physician Quality Reporting Initiative Medicare Program - Value-based Purchasing Medicare Program - Hospital Acquired Conditions, Present on Admission Reporting Medicare Program - Imaging Medicare Program - Comparative Effectiveness Medicare Program - Physician Practice Expenses

Client expense: $6,360,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), SENATE

H.R.685: To amend the Social Security Act to eliminate the 5-month waiting period for Social Security disability and the 24-month waiting period for Medicare benefits in the cases of individuals with disabling burn injuries. S.173: A bill to amend title XVIII of the Social Security Act to establish Medicare Health Savings Accounts. S. 2320: to amend title XVIII of the Social Security Act to provide continued entitlement to coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare program that have received a kidney transplant and whose entitlement to coverage would otherwise expire, and for other purposes. H.R.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: $540,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 /S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Client expense: $334,690 · Firm income: Not reported

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

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; H.R. 2351, the Healthcare Act of 2007; S. 1169, the State-Based Health Care Reform Act. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R.. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Client expense: $334,690 · Firm income: Not reported

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

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; H.R. 2351, the Healthcare Act of 2007; S. 1169, the State-Based Health Care Reform Act. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Client expense: $173,509 · Firm income: Not reported

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

CMS reimbursement policy for Medicare physician services. H.R. 2585 - Ensuring the Future Physician Workforce Act of 2007 S. 2729 - Ensuring the Future Physician Workforce Act of 2008 H.R. 5445 - To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009 S. 2785 - Save Medicare Act of 2008 - To amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare program. H.R. 6331 - Medicare Improvements for Patients and Providers Act. S. 3101 - Medicare Improvements for Patients and Providers Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1665/S 2352- Medicare Hearing Health Care Enhancement Act of 2007, all provisions. HR 1823/S 2250- Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, all provisions. HR 1774/S 45- Establishes a separate definition of outpatient speech-language pathology services under Medicare, all provisions. S 2785- Save Medicare Act of 2008, all provisions. S. 3101 - Medicare Improvements for Patients and Providers Act of 2008, all provisions S. 3118 - Preserving Access to Medicare Act of 2008, all provisions HR 6331- Medicare Improvements for Patients and Providers Act of 2008, all provisions HR 2585/S 2729- Ensuring the Future Physician Workforce Act of 2008, all provisions. HR 5445- To amend part B of title XVIII of the Social Security Act to increase Medicare payments for physicians' services through December 31, 2009, all provisions.

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

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

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

S. 2785, Save Medicare Act of 2008, physician reimbursement issues. H.R. 5545 and S. 2729, Ensuring the Future Physician Workforce Act of 2008, physician reimbursement issues. H.R. 5445, to amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physician services through December 31, 2009, physician reimbursement issues. S. 2408 and H.R. 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007, issues related to electronic prescribing of medications. Private Fee for Service Plans in the Medicare Advantage Program, payment rates. Preservation of the whole-hospital exception to the Stark laws. H.R. 5613, Protecting the Medicaid Safety Net Act of 2008, concerning Medicaid regulations. Medicaid Tamper Resistant Pads. ICD-10 Coding Transition Medicare Program - National Provider Identifier Medicare Program - Medical Home Demonstration Project Medicare Program - Physician Quality Reporting Initiative Medicare Program - Medicare Electronic Health Record Demonstration project Medicare Program - Proposed Standards for E-prescribing under Medicare Part D. Medicare Program - Medicare Advantage Medicare Program - Physican Enrollment

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

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

H.R.685: To amend the Social Security Act to eliminate the 5-month waiting period for Social Security disability and the 24-month waiting period for Medicare benefits in the cases of individuals with disabling burn injuries. S.173: A bill to amend title XVIII of the Social Security Act to establish Medicare Health Savings Accounts. S. 2320: to amend title XVIII of the Social Security Act to provide continued entitlement to coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare program that have received a kidney transplant and whose entitlement to coverage would otherwise expire, and for other purposes. H.R.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: $870,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade & Development Agency (USTDA), U.S. Trade Representative (USTR)

E-Prescribing, S. 2408/HR 4296 Medicare Electronic Medication and Safety Protection Act, Physician Disclosure, HR 5605/ S 2029 - Physician Payments Sunshine Act, Physician Reimbursement/Medicare Physician Fee Schedule, HR 3162, Children's Health and Medicare Protection Act, S. 2785, Save Medicare Act, HR 5545/S.2729 Ensuring the Future Physician Workforce, HR 5445 - to increase Medicare payments for physicians' services, Imaging, HR 1293/S1338, Access to Medicare Imaging Act, Health Information Technology S 1042/HR 583 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act Appropriateness Criteria and Accreditation National Coverage Decision on CTA (CMS) National Coverage Decision on Percutaneous Transluminal Angioplasty concurrent w/Stenting (CMS) Quality Improvement (PQRI) Specialty Hospitals Comparative Effectiveness

Client expense: $440,000 · Firm income: Not reported

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