To amend title 5, United States Code, to increase the maximum age to qualify for coverage as a "child" under the health benefits program for Federal employees.

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007" Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007"; HR1424 as passed: sections pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" Comparative Effectiveness Research: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Account/Medical Savings Accounts HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP" S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR758 "Breast Cancer Patient Protection Act of 2007"

Client expense: Not reported · Firm income: Not reported

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

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards: HIT Privacy; Electionic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007", S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007" Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007"; HR1424 as passed: secions pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" Comparative Effectiveness Research: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Account/Medical Savings Accounts HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP" S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR758 "Breast Cancer Patient Protection Act of 2007"

Client expense: Not reported · Firm income: Not reported

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards: HIT Privacy; Electionic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007", S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Enterprise Integration Act" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act" Genetic Non-discrimination: S358 "Genetic Information Nondiscrimination Act of 2007" Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007"; HR1424 as passed: sections pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" Comparative Effectiveness Research: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Account/Medical Savings Accounts HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP" S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR758 "Breast Cancer Patient Protection Act of 2007"

Client expense: Not reported · Firm income: Not reported

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007 Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007"; HR1424 as passed: sections pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" TAA; HR3801 and S1848 "TAA Health Coverage Improvement Act of 2007" Comparative Effectiveness Reseaarch: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Accounts/Medical Savings Accounts HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP" S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR758 "Breast Cancer Patient Protection Act of 2007"

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007 Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007" TAA; HR3801 and S1848 "TAA Health Coverage Improvement Act of 2007" Comparative Effectiveness Reseaarch: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Accounts/Medical Savings Accounts; SCHIP S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP"

Client expense: $1,940,000 · Firm income: Not reported

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007," S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD 10 Implementation: HR1368 "Personalized Health Information Act of 2007;" S1783 and S1693 "Wired for Health Care Quality Act;" HR3800 "Promoting Health Information Technology Act;" HR 2406 "Healthcare Information Technology Enterprise Integration Act;" HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007;" S334 and HR3163 "Healthy Americans Act;" S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007" Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007;" HR1424 as passed; sections pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" TAA; HR3801 and S1848 "TAA Health Coverage Improvement Act of 2007" Comparative Effectiveness Research: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Accounts/Medical Savings Accounts HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP" S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR758 "Breast Cancer Patient Protection Act of 2007"

Client expense: $130,000 · Firm income: Not reported

H.R.1256, Government Contribution toward FEHBP H.R.1110, Federal Retirees Health Insurance Premium Conversion Act S.773, Federal Retirees Health Insurance Premium Conversion Act H.R.1369, Family and Medical Leave Expansion Act H.R. 4838, Domestic Partner Benefits and Obligations Act S. 2521, Domestic Partner Benefits and Obligations Act H.R. 5550, FEHBP Dependent Coverage H.R. 6357, Health Information Technology Act

Client expense: $175,241 · Firm income: Not reported

Government targets: Federal Election Commission (FEC), Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Customs & Border Protection

Health Insurance Reform: S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards: HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act, "Healthcare Information Technology Enterprise Integration Act. Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System: Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act of 2008 Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007 Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007"; HR1424 as passed: sections pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" Coverage: HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP", S2041 "False Claim Act Correction of 2007", HR758 "Breast Cancer Patient Protection Act of 2007".

Client expense: $300,889 · Firm income: Not reported

Health Insurance Market Reform: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act of 2008. Coverage and Mandates: HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP", S2041 "False Claim Act Correction of 2007", HR758 "Breast Cancer Patient Protection Act of 2007".

Client expense: $300,889 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Mental health parity - S 558, Mental Health Parity Act of 2007; HR 1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007 AND To provide authority for the Federal Government to purchase and insure certain types of troubled assets for the purposes of providing stability to and preventing disruption in the economy; HR 4848, To extend for one year parity in the application of certain limits to mental health benefits; HR 6049, Energy Improvement and Extension Act of 2008; HR 6983, Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; S 3335, Jobs, Energy, Families, and Disaster Relief Act of 2008. Long-term care - Proposed legislation re this issue. Insurance issues - S 618, Insurance Industry Competition Act of 2007; HR 1081, Insurance Industry Competition Act of 2007; HR 241, To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees; S 46, Affordability in the Individual Market Act; HR 1282, Medigap Access Improvement Act of 2007; HR 758, Breast Cancer Patient Protection Act of 2007; S 459, Breast Cancer Patient Protection Act of 2007; HR 2412, Equity in Prescription Insurance and Contraceptive Coverage Act of 2007; S 616, HIPAA Recreational Injury Technical Correction Act; HR 1076, HIPAA Recreational Injury Technical Correction Act; S 40, National Insurance Act of 2007; HR 3200, National Insurance Act of 2007; S 1298, Healthy Businesses, Healthy Workers Reinsurance Act of 2007; S 400, Michelle's Law; HR 2851, Michelle's Law; S 1588, CARES Act; HR 2676, Access to Cancer Clinical Trials Act of 2007; HR 3425, Cancer Screening Coverage Act of 2007; S 2236, Preexisting Condition Exclusion Patient Protection Act of 2007; S 2268, Long Term Care Insurance Integrity Act of 2007; HR 4460, Health Care Choice Act of 2007; S 2477, Health Care Choice Act of 2007; S 1758, CLASS Act; HR 3001, CLASS Act; HR 5781, Federal Employees Paid Parental Leave Act of 2008; HR 3195, ADA Restoration Act of 2007; S 2795, SHOP Act; HR 6210, SHOP Act; S 3115, Children's Health Protection Act of 2008; HR 2842, Children's Health Protection Act of 2008; HR 5840, Insurance Information Act of 2008; HR 6142, To amend title I of the Employee Retirement Income Security Act of 1974 to provide, in the case of an employee welfare benefit plan providing benefits in the event of disability, an exemption from preemption under such title for State tort actions to recover damages arising from the failure of the plan to timely provide such benefits; HR 5550, To amend title 5, United States Code, to increase the maximum age to qualify for coverage as a `child' under the health benefits program for Federal employees; S 2948, Small Business Empowerment Act; S 2818, Small Business Health Plans Act of 2008; S 2999, Access to Cancer Clinical Trials Act of 2008; HR 6071, Health Care Consumer Protection Act of 2008; S 3068, Equity in Prescription Insurance and Contraceptive Coverage Act of 2007; S 3559, Continuing Coverage Act of 2008; S 3554, Affordable Coverage for Small Employers Act of 2008; HR 6908, Health Insurance Source of Injury Clarification Act of 2008; HR 6582, Small Business CHOICE Act of 2008; HR 6528, Health Insurance Coverage Protection Act; S 2706, Health Insurance Coverage Protection Act.

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007" Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007"; HR1424 as passed: sections pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" TAA; HR3801 and S1848 "TAA Health Coverage Improvement Act of 2007" Comparative Effectiveness Research: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Accounts/Medical Savings Accounts HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP" S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR758 "Breast Cancer Patient Protection Act of 2007"

Client expense: $87,939 · Firm income: Not reported

INS (Legislative): H.R. 241: Association Health Plans (Johnson); H.R. 758: Breast Cancer Patient Protection Act (DeLauro) (continued) INS (Legislative) (cont.) H.R. 1081: Insurance Industry Competition Act (DeFazio); H.R. 1282: Medigap Access Improvement Act (English); H.R. 1424: Paul Wellstone Mental Health and Addiction Equity Act (Kennedy); H.R. 2412: Equity in Prescription Insurance and Contraceptive Coverage Act (Lowey); H.R. 2676: Access to Cancer Clinical Trials Act (Pryce); H.R. 2842: Childrens Health Protection Act (Schwartz); H.R. 2851: Michelles Law (Hodes) (provisions relating to continuity of coverage for college students on medical leave); H.R. 3001: Community Living Assistance Services and Supports Act (Pallone); H.R. 3195: ADA Amendments Act (Hoyer); H.R. 3200: National Insurance Act (provisions relating to regulatory reform) (Bean); H.R. 3425: Cancer Screening Coverage Act (Maloney); H.R. 4460: Health Care Choice Act (provisions relating to health insurance reforms in individual market) (Shadegg); H.R. 5550: Coverage for Young Adult Dependents of Federal Employees (Davis); H.R. 5781: Federal Employees Paid Parental Leave Act (Maloney) (provisions relating to disability study); H.R. 5840: Insurance Information Act (Kanjorski) (provisions relating to federal Office of Insurance Information); H.R. 5938: Identity Theft Enforcement and Restitution Act (Conyers); H.R. 6049: Energy Improvement and Extension Act (provisions relating to mental health parity); H.R. 6071: Health Care Consumer Protection Act (Forbes) (provisions relating to reinstatement of health insurance following nonpayment of premiums); H.R. 6142: Lawsuits Against Employer-Sponsored Disability Benefit Plans (Andrews); H.R. 6210: Small Business Health Options Program Act (Kind-English); H.R. 6528: Health Insurance Coverage Protection Act (Eshoo) (provisions relating to limitations on lifetime limits); H.R. 6582: Small Business CHOICE Act (Velazquez) (provisions relating to health insurance); H.R. 6908: Health Insurance Restrictions and Limitations Clarifications Act (Burgess) (provisions relating to disclosure rules for coverage exclusions); H.R. 6983: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (Kennedy) (provisions relating to mental health parity); S. 40: National Insurance Act (provisions relating to regulatory reform) (Sununu); S. 46: Affordability in the Individual Market Act (provisions relating to HSAs) (Ensign); S. 239: Notification of Risk to Personal Data Act (Feinstein); S. 400: Michelle's Law (provisions relating to continuity of coverage for college students on medical leave) (Sununu); S. 459: Breast Cancer Patient Protection Act (Snowe); S. 495: Personal Data Privacy and Security Act (Leahy); S. 558: Mental Health Parity Act (Domenici); S. 616: HIPAA Recreational Injury Technical Correction Act (Collins); S. 618: Insurance Industry Competition Act (Leahy); S. 1076: HIPAA Recreational Injury Technical Correction Act (Burgess); S. 1178: Identity Theft Protection Act (Inouye); S. 1260: Data Security Act (Carper); S. 1298: Healthy Businesses, Healthy Workers Reinsurance Act (Kerry); S. 1588: Children's Access to Reconstructive Evaluation and Surgery Act (Landrieu); S. 1758: Community Living Assistance Services and Supports Act (Kennedy); S. 1814: Health Information Privacy and Security Act (Leahy); S. 2168: Identify Theft Enforcement and Restitution Act (Leahy); S. 2236: Preexisting Condition Exclusion Patient Protection Act (Rockefeller); S. 2268: Long Term Care Insurance Integrity Act (Klobuchar); S. 2477: Health Care Choice Act (DeMint); S. 2706: Health Insurance Coverage Protection Act (Dorgan); S. 2795: Small Business Health Options Program Act (Durbin-Snowe); S. 2818: Small Business Health Plans Act (Enzi); S. 2948: Small Business Empowerment Act (Brown) (provisions relating to health coverage for small employers); S. 2999: Access to Cancer Clinical Trials Act (Brown); S. 3068: Equity in Prescription Insurance and Contraceptive Coverage Act (Snowe); S. 3115: Childrens Health Protection Act (Lautenberg); S. 3335: Jobs, Energy, Families, and Disaster Relief Act (provisions relating to mental health parity); S. 3554: Affordable Coverage for Small Employers Act (Smith) (provisions relating to insurance reforms, tax credits); S. 3559: Continuing Coverage Act (Coleman) (relating to third party review for rescission decisions). INS (Regulatory) Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; crossover fees for Medigap claims; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials.

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007 Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007"; HR1424 as passed: sections pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008" TAA; HR3801 and S1848 "TAA Health Coverage Improvement Act of 2007" Comparative Effectiveness Reseaarch: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Accounts/Medical Savings Accounts HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP" S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR758 "Breast Cancer Patient Protection Act of 2007"

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007 Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007" TAA; HR3801 and S1848 "TAA Health Coverage Improvement Act of 2007" Comparative Effectiveness Reseaarch: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Accounts/Medical Savings Accounts; SCHIP S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP"

Client expense: $2,400,000 · Firm income: Not reported

See attached addendum for General Lobbying Issue Area: HCR - Healthcare Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards: HIT Privacy; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783 and S1693 "Wired for Health Care Quality Act"; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act"; HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured: S1019 "Health Care Choice Act of 2007"; S334 and HR3163 "Healthy Americans Act"; S2795 "Small Business Health Options Program Act of 2008" Genetic Non-discrimination: HR493 and S358 "Generic Information Nondiscrimination Act of 2007" Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007"; HR1424 as passed: sections pertaining to the "Paul Wellstone and Pete Domenici Mental Health Parity and Addition Equity Act of 2008" Comparative Effectiveness Research: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Account/Medical Savings Accounts HR2851 and S400 "Michelle's Law" HR5550 "To amend title 5 USC to increase the maximum age to qualify for coverage as a 'child' under FEHBP" S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims HR758 "Breast Cancer Patient Protection Act of 2007"

Client expense: Not reported · Firm income: Not reported

H.R.. 4089/S 2824 - Protecting Collective Bargaining Rights for VA Nurses H.R. 5550 - Raising Maximum Children's Age for Health Coverage in FEHBP

Client expense: $18,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

MMM (Legislative Issues): H.R. 4: Medicare Prescription Drug Price Negotiation Act (Dingell); H.R. 976: Childrens Health Insurance Program Reauthorization Act (Rangel); H.R. 1535: Children's Health First Act (Dingell); H.R. 1663: Medicare Mental Health Modernization Act (Stark) (continued) H.R. 1990: Medicare Cost Contract Extension and Refinement Act (Pomeroy); H.R. 2147: Healthy Kids Act (Emanuel); H.R. 2945: Medicare Advantage Truth in Advertising Act (Stark); H.R. 2642: Supplemental Appropriations Act (provisions relating to moratoria on Medicaid regulations); H.R. 2842: Childrens Health Protection Act (Schwartz); H.R. 3025: Medicare Prescription Drug Savings for Our Seniors Act (Doggett); H.R. 3061: Medicare Part D Drug Class Protection Act (Doggett); H.R. 3162: Childrens Health and Medicare Protection Act (Dingell); H.R. 3195: ADA Amendments Act (Hoyer); H.R. 3932: Medicare Prescription Drug Savings and Choice Act (Berry); H.R. 3963: Childrens Health Insurance Program Reauthorization Act (Dingell); H.R. 4296: Medicare Electronic Medication and Safety Protection Act (Schwartz); H.R. 5268: Medicaid FMAP (Pallone); H.R. 5480: Medicare Funding Warning Response Act (Hoyer-Boehner); H.R. 5550: Coverage for Young Adult Dependents of Federal Employees (Davis); H.R. 5613: Protecting the Medicaid Safety Net Act (Dingell); H.R. 5683: GAO Act (provisions relating to access to Medicare part C/part D data) (Davis); H.R. 5781: Federal Employees Paid Parental Leave Act (Maloney); H.R. 5840: Insurance Information Act (Kanjorski); H.R. 5918: Small Business Health Options Program Act (Barrow); H.R. 5923: Patients Health Care Reform Act (Shadegg); H.R. 5955: Making Health Care More Affordable Act (Walberg); H.R. 5998: Protecting Children's Health Coverage Act (Pallone); H.R. 6071: Health Care Consumer Protection Act (provisions relating to reinstatement of health insurance following nonpayment of premiums) (Forbes); H.R. 6081: Heroes Earning Assistance and Relief Tax Act (mental health parity and FSA provisions); H.R. 6142: Lawsuits Against Employer-Sponsored Disability Benefit Plans (Andrews); H.R. 6210: Small Business Health Options Program Act (Kind-English); H.R. 6331: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, and electronic prescribing) (Rangel-Dingell); H.R. 6388: GAO Improvement Act (provisions relating to access to Medicare part C/part D data) (Waxman); H.R. 6359: Medicare Beneficiary Protection Act (Biggert); H.R. 6365: Medicare Special Needs Plans Extension and Amendments Act (Kind); S. 3: Medicare Prescription Drug Price Negotiation Act (Reid); S. 130: Medicare Cost Contract Extension and Refinement Act (Allard); S. 401: Keep Children Covered Act (Rockefeller); S. 706: Medicare Advantage Stabilization Fund (Feingold); S. 799: Community Choice Act (Harkin); S. 895: Children's Health First Act (Clinton); S. 1102: Part D Equity for Low-Income Seniors Act (Bingaman); S. 1103: Helping Fill the Medicare Rx Gap Act (Bingaman); S. 1107: Home and Community Services Copayment Equity Act (Smith); S. 1108: Medicare Part D Outreach and Enrollment Enhancement Act (Smith); S. 1200: Indian Health Care Improvement Act (includes Medicaid/MA provisions); S. 1224: Children's Health Insurance Program Reauthorization Act (Rockefeller); S. 1507: Access to Medicare Data Act (Grassley); S. 1544: Medicare Quality Enhancement Act (Gregg); S. 1827: Pharmacist Access and Recognition in Medicare Act (Cochran); S. 1893: Childrens Health Insurance Program Reauthorization Act (Baucus); S. 1954: Pharmacy Access Improvement Act (Baucus); S. 2219: Medicare Prescription Drug Savings and Choice Act (Durbin); S. 2408: Medicare Electronic Medication and Safety Protection Act (Kerry); S. 2620: Medicaid FMAP (Rockefeller); S. 2662: Medicare Funding Warning Response Act (Baucus-Gregg); S. 2795: Small Business Health Options Program Act (Durbin-Snowe); S. 2819: Economic Recovery in Health Care Act (provisions relating to Medicaid funding) (Rockefeller); S. 2948: Small Business Empowerment Act (Brown); S. 2818: Small Business Health Plans Act (Enzi); S. 2999: Access to Cancer Clinical Trials Act (Brown); S. 3068: Equity in Prescription Insurance and Contraceptive Coverage Act (Snowe); S. 3101: Medicare Improvements for Patients and Providers Act (provisions relating to Medicare Advantage, Medicare Part D, Medigap, Medicaid, health care disparities, electronic prescribing) (Baucus); S. 3115: Childrens Health Protection Act (Lautenberg); S. 3118: Preserving Access to Medicare Act (provisions relating to Medicare Advantage, Medicare Part D, Medicaid, and electronic prescribing)(Grassley). MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology and data issues, (including encounter data issues) bidding and payment issues (including MA coding intensity, Part D reinsurance, low income subsidies, application process, and audits), application process, and audits, benefit design rules, SSA and CMS premium withhold processing issues, systems issues affecting enrollment and disenrollment processing, enrollment rules, marketing materials review and approval, marketing activities, including conduct of brokers and agents and plan sponsor marketing staff and issues raised by CMS about Private Fee-for-Service (PFFS) plan marketing, measurement and oversight of plan performance including Special Needs Plans (SNPs); grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration issues for Special Needs Plans (SNPs); Federal premption of State authorization over MA and Part D plans, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval, systems issues affecting enrollment and disenrollment processing, payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting inititiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs) and federal matching funds for graduate medical education; coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related State Childrens Health Insurance Program (SCHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

Mental health parity - S 558, Mental Health Parity Act of 2007; HR 1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007; HR 4848, To extend for one year parity in the application of certain limits to mental health benefits. Genetic non-discrimination - HR 493, Genetic Information Nondiscrimination Act of 2007; S 358, Genetic Information Nondiscrimination Act of 2007. Insurance issues - S 618, Insurance Industry Competition Act of 2007; HR 1081, Insurance Industry Competition Act of 2007; HR 241, To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees; S 46, Affordability in the Individual Market Act; HR 1282, Medigap Access Improvement Act of 2007; HR 758, Breast Cancer Patient Protection Act of 2007; S 459, Breast Cancer Patient Protection Act of 2007; HR 2412, Equity in Prescription Insurance and Contraceptive Coverage Act of 2007; S 616, HIPAA Recreational Injury Technical Correction Act; HR 1076, HIPAA Recreational Injury Technical Correction Act; S 40, National Insurance Act of 2007; HR 3200, National Insurance Act of 2007; S 1298, Healthy Businesses, Healthy Workers Reinsurance Act of 2007; S 400, Michelle's Law; HR 2851, Michelle's Law; S 1588, CARES Act; HR 2676, Access to Cancer Clinical Trials Act of 2007; HR 2948, Increased Access to Health Insurance Act of 2007; HR 3425, Cancer Screening Coverage Act of 2007; HR 3997, Heroes Earnings Assistance and Relief Tax Act of 2007; S 2236, Preexisting Condition Exclusion Patient Protection Act of 2007; S 2268, Long Term Care Insurance Integrity Act of 2007; HR 4460, Health Care Choice Act of 2007; S 2477, Health Care Choice Act of 2007; S 1758, CLASS Act; HR 3001, CLASS Act; S 2706, Health Insurance Coverage Protection Act; HR 3799, Federal Employees Paid Parental Leave Act of 2007; HR 4986, National Defense Authorization Act for Fiscal Year 2008; HR 5781, Federal Employees Paid Parental Leave Act of 2008; HR 3195, ADA Restoration Act of 2007; S 2795, SHOP Act; HR 6210, SHOP Act; HR 5918, SHOP Act; S 3115, Children's Health Protection Act of 2008; HR 2842, Children's Health Protection Act of 2008; HR 5840, Insurance Information Act of 2008; HR 6081, Heroes Earnings Assistance and Relief Tax Act of 2008; HR 6142, To amend title I of the Employee Retirement Income Security Act of 1974 to provide, in the case of an employee welfare benefit plan providing benefits in the event of disability, an exemption from preemption under such title for State tort actions to recover damages arising from the failure of the plan to timely provide such benefits; HR 5550, To amend title 5, United States Code, to increase the maximum age to qualify for coverage as a `child' under the health benefits program for Federal employees; S 2948, Small Business Empowerment Act; HR 5955, Making Health Care More Affordable Act of 2008; HR 5923, Patients' Health Care Reform Act; S 2818, Small Business Health Plans Act of 2008; S 2999, Access to Cancer Clinical Trials Act of 2008; HR 6071, Health Care Consumer Protection Act of 2008; S 3068, Equity in Prescription Insurance and Contraceptive Coverage Act of 2007.

H.R.1256, Government Contribution toward FEHBP H.R.1110, Federal Retirees Health Insurance Premium Conversion Act S.773, Federal Retirees Health Insurance Premium Conversion Act H.R.1369, Family and Medical Leave Expansion Act H.R.4838, Domestic Partner Benefits and Obligations Act S.2521, Domestic Partner Benefits and Obligations Act H.R.5550, FEHBP Dependent Coverage

Client expense: $151,710 · Firm income: Not reported

Government targets: Federal Election Commission (FEC), Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Customs & Border Protection

H.R.. 4089/S 2824 - Protecting Collective Bargaining Rights for VA Nurses H.R. 5550 - Raising Maximum Children's Age for Health Coverage in FEHBP

Client expense: $18,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1256, GOVERNMENT Contribution toward FEHBP H.R.1110, Federal Retirees Health Insurance Premium Conversion Act S.773, Federal Retirees Health Insurance Premium Conversion Act H.R.1369, Family and Medical Leave Expansion Act H.R.4838, Domestic Partner Benefits and Obligations Act S.2521, Domestic Partner Benefits and Obligations Act H.R.5550, FEHBP Dependent Coverage

Client expense: $168,263 · Firm income: Not reported

Government targets: Federal Election Commission (FEC), Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Customs & Border Protection

H.R.1256, GOVERNMENT Contribution toward FEHBP H.R.1110, Federal Retirees Health Insurance Premium Conversion Act S.773, Federal Retirees Health Insurance Premium Conversion Act H.R.1369, Family and Medical Leave Expansion Act H.R.4838, Domestic Partner Benefits and Obligations Act S.2521, Domestic Partner Benefits and Obligations Act H.R.5550, FEHBP Dependent Coverage

Client expense: $168,263 · Firm income: Not reported

Government targets: Federal Election Commission (FEC), Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Customs & Border Protection