Advance Directive Promotion Act of 2008

S 2337/HR 3363 - Discussion of and support for Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. S 1070/HR 1783 Elder Justice Act/S 1577 Patient Safety and Abuse Prevention Act of 2007 - Support for both pieces of legislation, strategy for how they might both move forward this year, bill markup, background for score on S.1577. S 2708 Caring for an Aging America Act of 2008 - Provisions related to increasing the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill. Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. S 3230 Empowered at Home Act - Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. HR 7110/S 3604 Job Creation and Unemployment Relief Act - Lobbied for FMAP funding. HR 5613 Protecting the Medicaid Safety Net Act of 2008 - Supported this legislation, particularly provisions related to placing a moratorium on seven harmful Medicaid regulations. HR 6331 Medicare Improvements for Patients and Providers Act - Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries, and promote e-prescriptions in medicare. S 2408/HR 4296 Medicare Electronic Medication and Safety Protection (E-Meds) Act of 2007- Supported provisions related to requiring e-prescribing in Medicare Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. S 2641 Nursing Home Transparency and Improvement Act - Lobbied in support of the bill and to increase co-sponsors; criminal background checks for LTC employees; nursing home quality and proposed five star rating system cms; poor performing nursing homes, family caregiving initiative, nursing home compliance guidelines, Home Health CAHPS, LTC Partnership Program (under Medicaid data reporting requirements), status of Nursing Home Value Based Purchasing Demonstration, Prepare to Care for use in innovative employer caregiving programs satellite broadcast, LTC Quality Alliance. HR 2642 - Lobbied for inclusion of Medicaid Regulation Moratoriam in Military Construction and Veterans Affairs Appropriations Act of 2008, and on supplemental appropriations bill. To build support and obtain sponsors for Medicaid Family Caregiver Assessment Demonstration proposal (no Bill). S 2838/HR 6126 - Lobbied to support the Fairness in Nursing Home Arbitration Act and oppose amendments to weaken the bill. Discussion and input on legislation to improve the health/LTC workforce and support family caregivers (no bill). Advance directives and end-of-life care, education of the public about these issues, portability, and other issues relating to advance directives (no bill). S 1577- Support for Patient Safety and Abuse Prevention Act (S 1577) and marking up the bill; provided feedback and in testimony. HR 7114/S3613 Independence at Home Act/Chronic Care Coordination - Feedback on and support for legislation to provide chronic care coordination services to certain Medicare beneficiaries. S 1102 Part D Equity for Low-Income Seniors Act of 2007- Support for Medicare premium protection and modifications to Medicare Savings Programs/Part D Low-Income Subsidy. S. 3118 Preserving Access to Medicare Act - Lobbied in opposition to Grassley-McConnell bill - All provisions related to beneficiary access and Medicare improvements, including e-prescribing. S 3101- Urged support of the Medicare Improvements for Patients and Providers Act of 2008 to help improve Medicare. Green Houses and culture change in LTC facilities, person centered care and medical homes - testimony and input on draft bill - no bill number. Lobbied for appeal notices for Medicare beneficiaries in Medicare Advantage plans (no bill). S 1102 Part D Equity for Low-Income Services - Lobbied for legislation to increase Medicare Part D LIS. HR 1536 Prescription Coverage Now Act - Lobbied for legislation to increase Medicare Part D LIS asset limits. HR 5702 End-of-Life Care Advance Directive Promotion Act - Discussed ideas for end-of-life care legislation and how to help ensure patient wishes are respected; Advance Directive Promotion Act. Provided feedback on draft legislation regarding physician orders for life sustaining treatment. S.334 - Discussed long-term care broadly and including it in health care reform, including the Healthy Americans Act. Discussed voting in LTC facilities, such as nursing homes, current status and law on the issue (no bill). S 3327 - Provided input and support for the Empowered at Home Act to make improvements in Medicaid HCBS; LTC insurance tax incentives and consumer protection improvements and a caregiver tax credit. Invitations and information about a solutions forum on balancing of state LTC systems. HR 3363/S 2337 - Discussed consumer protections for LTC insurance, premium increases and claims denials, support for family caregivers including assessment, consumer complaints and support for the LTC Affordability and Security Act. HR 6033 - Discussed provisions of Home-Based Health Services Job Training and Caregiving Act. H.Con.Res 133 - Provided input on and support for new LTC Awareness Week resolution. LTC - General discussion of LTC, home and community based services, family caregiving, chronic care, workforce, quality and financing options.(no bill) CMS - Lobbied on the Medicare Medical Home Demo implementation.

Client expense: $7,330,000 · Firm income: Not reported

Government targets: Administration on Aging, Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), Federal Reserve System, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

HR 3001/ S 1340 - Shared and discusssed actuarial analysis of the CLASS Act regarding creation of a public insurance program for long-term services. S 2337/HR 3363 - Discussion of and support for Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. S 1070 Elder Justice Act/S 1577 Patient Safety and Abuse Prevention Act of 2007 - Support for both pieces of legislation and strategy for how they might both move forward this year. S 1340 Geriatric Assessment and Chronic Care Coordination Act of 2007- Discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill. S 2708 Caring for an Aging America Act of 2008 - Provisions related to increasing the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill. Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. HR 1174 Healthy Hospitals Act of 2007- Discussed with sponsors' staff potential endorsement of this legislation to require hospitals to report infection rates. HR 5613 Protecting the Medicaid Safety Net Act of 2008 - Supported this legislation, particularly provisions related to placing a moratorium on seven harmful Medicaid regulations. Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. Medicaid Personal Assistance Services State Plan option- discussion of comment letter sending and receipt. Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries. S 2480/HR 4296 Medicare Electronic Medication and Safety Protection (E-Meds) Act of 2007- Supported provisions related to requiring e-prescribing in Medicare Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. S 2641/ HR 5799 Nursing Home Quality and Transparency Legislation Act - To protect residents and support for the Nursing Home Transparency and Improvement Act. Discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill. Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality; poor performing nursing homes, family caregiving, nursing home compliance guidelines, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured - steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration. HR 5702 Advance Directive Promotion Act of 2008 - Negotiated provisions on portability of advance directives. HR 2642 - Lobbied for inclusion of Medicaid Regulation Moratoriam in Military Construction and Veterans Affairs Appropriations Act of 2008, and on supplemental appropriations bill. To build support for Medicaid Family Caregiver Assessment Demonstration proposal (no Bill). S 2838/HR 6126 - Input on draft legislation to make arbitration clauses between LTC facilities and their residents or representatives unenforceable; support for this legislation once it was introduced as the Fairness in Nursing Home Arbitration Act, including support letter. Discussion and input on legislation to improve the health/LTC workforce and support family caregivers. Advance directives and end-of-life care, education of the public about these issues, portability, and other issues relating to advance directives. S 1577/HR 3078 - Support for Patient Safety and Abuse Prevention Act (S 1577) and moving the issue forward; provided feedback and in testimony. S 2921 Caring for Wounded Warriors Act of 2008 - Services and supports for family caregivers of certain veterans. Feedback on draft legislation to provide chronic care coordination services to certain Medicare beneficiaries; approaches to improving chronic care for Medicare beneficiaries; discussion of chronic care and Special Needs Plans. S 1102 Part D Equity for Low-Income Seniors Act of 2007- Support for Medicare premium protection and modifications to Medicare Savings Programs/Part D Low-Income Subsidy. S 1758 - Long-term care financing proposals, including the CLASS Act, a public LTC financing program. S. 3164 - Lobbied on Medicare Fraud bill (Martinez and Cornyn) - All provisions related to protecting participants and the Medicare program from fraud and abuse. S. 3118 - Lobbied in opposition to Grassley-McConnell bill - All provisions related to beneficiary access and Medicare improvements, including e-prescribing. S 3101- Urged support of the Medicare Improvements for Patients and Providers Act of 2008 to help improve Medicare. Long Term Care/Reverse Mortgages - To protect consumers when reverse mortgages are used as a LTC financing tool. Green Houses and culture change in LTC facilities. HR 2642 - To keep moratorium on all seven Medicaid regulations in the supplemental appropriations bill. Lobbied on appeal notices for Medicare beneficiaries in Medicare Advantage plans. S 1102 - Lobbied for legislation to increase Medicare Part D LIS. HR 1536 - Lobbied for legislation to increase Medicare Part D LIS asset limits. S 3101/HR 6331 - (Medicare) Lobbied for legislation to protect part B premiums, increase LIS and MSP asset limits, and promote e-prescribing in Medicare. HR 2642 - (Medicaid) Lobbied for inclusion of Medicaid regulation moratorium in Iraq Supplemental.

Client expense: $6,480,000 · Firm income: Not reported

Government targets: Administration on Aging, Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office