Nursing Home Transparency and Improvement Act of 2008

H.R.7128 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.7110 - Making supplemental appropriations for job creation and preservation, infrastructure investment, and economic and energy assistance for the fiscal year ending September 30, 2009, and for other purposes. H.R. 2807 - To intensify stem cell research showing evidence of substantial clinical benefit to patients, and for other purposes. H.R. 1783 - To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, & for other purposes. H.R. 2521 - To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R.1046 - To amend titles XI and XVIII of the Social Security Act to modernize the quality improvement organization (QIO) program. H.R.1841 - To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R.4082 - To improve the quality of, and access to, long-term care. H.R.3784 - To amend title XVIII of the Social Security Act to improve the quality of care in skilled nursing facilities under the Medicare Program through requiring the reporting of expenditures for nursing. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.4854 - To amend the provisions of title 31, United States Code, relating to false claims to clarify and make technical amendments to those provisions, and for other purposes. H.R.3453 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding demonstration project for clinical laboratory services. H.R.3180 - To amend title 31, United States Code, to clarify who is an original source for purposes of bringing a qui tam action. H.R. 5480 - To repond to a Medicare funding warning. H.R.6337 - To amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.5878 - To authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. H.R.2705 - To amend the Compact of Free Association Amendments Act of 2003, and for other purposes. H.R.6252 - To amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. H.R. 5799 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.Res.1203 - Expressing support for designation of the week beginning May 11, 2008, as "National Nursing Home Week". S.Res.543 - A resolutioni designating the week beginning May 11, 2008, as "National Nursing Home Week". S. 2641 - A bill to amend title XVII and XIX of the Social Security Act to improve the transparenct of information on skilled nursing facilities and nursing facilities and to clarift and improce the targeting of the enforcement of requitements with respect to such facilities. S. 1980 - A bill to improve the quality of, and access to, long-term care. S. 2662 - A bill to respond to a Medicare funding warning. S. 2041 - A bill to amend the False Claims Act. S. 1693 - A bill to enhance the adoption of a nationwide interoperable health information technology system and to improce the quality and reduce the costs of health care in the United States. S. 1947 - A bill to amend title XI of the Social Security Act to improve the quality improvement organization (QIO) program. S. 2099 - A bill to amend title XVII of teh Social Security Act to repeal the medicare competitive bidding project for clinical laboratory services. S. 1070 - A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S. 1019 - A bill to provide comprehensive reform of the health care system of the United States, and for other purposes. S. 1814 - A bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health related information, promote the use of non-identifiabel information for health research, impose criminal and civil penalties for unauthorized use of protected health information, to provide for the strong enforcement of these rights, and to protect States' rights. S. 1615 - A bill to provide loans and grants for fire sprinkler retrofitting in nursing facilities. S. 845 - A bill to direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning elder falls. S. 334 - A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. S. 325 - A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S. 1980 - A bill to improve the quality of, and access to, long-term care. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. S. 3144 - A bill to amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.2603 - A bill to amend title XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare program and to increase the amount of the surety bond required for suppliers of durable medical equipment. S.2641- A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.1424 - A bill 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 and financial system and protecting taxpayers, to amend the Internal Revenue Code of 1986 to provide incentives for energy production and conservation, to extend certain expiring provisions, to provide individual income tax relief, and for other purposes.

Client expense: $390,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 1758/H.R. 3001 - CLASS Act, to establish a national insurance trust for long-term care - for S. 2708/HR 6337 - Caring for an Aging America Act, to recruit and retain health professionals for the field of long-term care - for S 2641/HR 5799, Nursing Home Transparency and Improvement Act - for requirements on reporting nursing home ownership and staffing. Opposed to provisions for increased penalties for survey deficiencies. HR 7128, Nursing Home Transparency and Quality of Care Improvement Act - for requirements on reporting nursing home ownership and staffing. Opposed to provisions for increased penalties for survey deficiencies.

Client expense: $100,140 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), SENATE

S. 543 Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007 H.R.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. 1107 Home and Community Services Copayment Equity Act of 2007 S. 1102 Part D Equity for Low-Income Seniors Act of 2007 S.2641 Nursing Home Transparency and Improvement Act of 2008 H.R.5799 Nursing Home Transparency and Improvement Act of 2008 H.R.7128 Nursing Home Transparency and Quality of Care Improvement Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Annual Update for Inpatient Hospital Prospective Payment System H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.5799 - Nursing Home Transparency and Improvement Act of 2008, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Implementation of DRA (Deficit Reduction Act) Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.2641 - Nursing Home Transparency and Improvement Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

Annual Update for Inpatient Hospital Prospective Payment System H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.5799 - Nursing Home Transparency and Improvement Act of 2008, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Implementation of DRA (Deficit Reduction Act) Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.2641 - Nursing Home Transparency and Improvement Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

HR 6126, H. Rept. 110-894, S. 2838, S. Rept. 110-190 Fairness in Nursing Home Arbitration Act-all provisions S. 1577, S. Rept. 110-474 Patient Safety and Abuse Prevention Act of 2007-all provisions S. 2641, HR 5799 Nursing Home Transparency Improvement Act-all provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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.

HR 2807 - To intensify stem cell research showing evidence of substantial clinical benefit to patients, and for other purposes. HR 1783 - To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, & for other purposes. H.R.2521 - To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R.3025 - To amend title XVIII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R.1046 - To amend titles XI and XVIII of the Social Security Act to modernize the quality improvement organization (QIO) program. H.R.1841 - To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R.4082 - To improve the quality of, and access to, long-term care. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.3784 - To amend title XVIII of the Social Security Act to improve the quality of care in skilled nursing facilities under the Medicare Program through requiring the reporting of expenditures for nursing. H.R.3453 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding demonstration project for clinical laboratory services. H.R.4854 - To amend the provisions of title 31, United States Code, relating to false claims to clarify and make technical amendments to those provisions, and for other purposes. H.R.3180 - To amend title 31, United States Code, to clarify who is an original source for purposes of bringing a qui tam action. H.R.5480 - To respond to a Medicare funding warning. S.1980 - A bill to improve the quality of, and access to, long-term care. S.2662 - A bill to respond to a medicare funding warning. S.2041 - A bill to amend the False Claims Act. S.1693 - A bill to enhance the adoption of a nationwide interoperable health information technology system and to improve the quality and reduce the costs of health care in the United States. S.2641 - A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S.1947 - A bill to amend title XI of the Social Security Act to improve the quality improvement organization (QIO) program. S.2099 - A bill to amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding project for clinical laboratory services. S.1070 - A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.1019 - A bill to provide comprehensive reform of the health care system of the United States, and for other purposes. S.1814 - A bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health related information, promote the use of non-identifiable information for health research, impose criminal and civil penalties for unauthorized use of protected health information, to provide for the strong enforcement of these rights, and to protect States' rights. S.1615 - A bill to provide loans and grants for fire sprinkler retrofitting in nursing facilities. S.845 - A bill to direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning elder falls. S.334 - A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. S.325 - A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S.1980 - A bill to improve the quality of, and access to, long-term care. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.6337 - To amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.5878 - To authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. H.R.2705 - To amend the Compact of Free Association Amendments Act of 2003, and for other purposes. H.R.6252 - To amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.3144 - A bill to amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.2603 - A bill to amend title XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare program and to increase the amount of the surety bond required for suppliers of durable medical equipment. S.2641 - A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.5799 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S.RES.543 - A resolution designating the week beginning May 11, 2008, as "National Nursing Home Week". H.RES.1203 - Expressing support for designation of the week beginning May 11, 2008, as "National Nursing Home Week".

Annual Update for Inpatient Hospital Prospective Payment System H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.5799 - Nursing Home Transparency and Improvement Act of 2008, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Implementation of DRA (Deficit Reduction Act) Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.2641 - Nursing Home Transparency and Improvement Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

Annual Update for Inpatient Hospital Prospective Payment System H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.562 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles H.R.5799 - Nursing Home Transparency and Improvement Act of 2008, all titles H.R.6331 - Medicare Improvements for Patients and Providers Act of 2008, all titles H.R.976 - Children's Health Insurance Program Reauthorization Act of 2007, all titles Implementation of DRA (Deficit Reduction Act) Implementation of Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.1958 - Medicare Long-Term Care Hospital Patient Safety and Improvement Act of 2007, all titles S.2221 - Transparency in Medical Device Pricing Act of 2007, all titles S.2641 - Nursing Home Transparency and Improvement Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.338 - Medicare Long-Term Care Hospital Improvement Act of 2007, all titles

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

S 1758/HR 3001: CLASS Act, to establish a national insurance trust to finance long-term care - for HR 6033, to train public housing residents to provide home-based health services for elders living in subsidized housing - for S 2708, to recruit and retain health care professionals to work in the long-term care field - for S 2641/HR 5799 - Nursing Home Transparency and Improvement Act - for provisions on reporting staffing expenditures and ownership transparency. Oppose increases in civil monetary penalties for nursing homes.

Client expense: $52,416 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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/S 1577 - Support for both pieces of legislation and strategy for how they might both move forward this year. S 1340 - Discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill. S 2708 - 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/S 1174 - Discussed with sponsors' staff potential endorsement of this legislation to require hospitals to report infection rates. HR 5140- Supported provisions providing rebates to older Americans who do not file income taxes, and potential for adding provisions to temporarily increase federal funding to state Medicaid programs. HR 5613- Supported this legislation, particularly provisions related to placing a moratorium on harmful Medicaid regulations. Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. Filed comment letters with HHS on proposed regulations involving cost sharing and flexibility in benefit packages. Medicaid Personal Assistance Services State Plan option- discussion of comment letter sending and receipt. Advocated for part B premium protection and asset test improvement. 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- Supported provisions related to requiring e-prescribing in 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; discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill. Advance directives and end-of-life care: discussed efforts to educate Medicare beneficiaries about advance directives; discussed, negotiated, and provided input on legislation regarding advance directives under Medicare and Medicaid;portability of advance directives, and public education around advance directives. 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.