Medicare DMEPOS Competitive Acquisition Reform Act of 2008

S. 2029 - The Physician Payments Sunshine Act of 2007 H.R. 3023 - The Drug and Medical Device Company Gift Disclosure Act of 2007 S. 2662 / H.R. 5480 - The Medicare Funding Warning Response Act of 2008 H.R. 3162 - The Children's Health and Medicare Protection Act of 2007 S. 2313 / H.R. 3697 - The Strategies to address Antimicrobial Resistance Act of 2007 Medicare Reform Implementation Medicare Technology Reimbursement ICD-10 Implementation H.R. 6252 and S. 3144 - The Medicare DMEPOS Competitive Acquisition Reform Act of 2008 H.R. 6331 - The Medicare Improvements for Patients and Providers Act of 2008 CE bill (Baucus and Allen) - S. 3408 - Comparative Effectiveness Research Act; H.R. 2184 - Enhanced Health Care Value For All Act Wydam bill - S. 334 and H.R. 3163 - Healthy Americans Act and new chron care bill, S. 3613 - Independence At Home Act Ryan Tax / Health bill - H.R. 6110 - Roadmap For America's Future Act

Client expense: $870,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

S. 3101, the Medicare Improvements for Patients and Providers Act of 2008, Medicare reimbursement for home oxygen therapy. H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008, Medicare reimbursement for home oxygen therapy. H.R. 6252 and S. 3144, the Medicare DMEPOS Competitive Acquisition Reform Act, to delay the DMEPOS competitive bidding program. Technical corrections for the Medicare Improvements for Patients and Providers Act of 2008, Medicare reimbursement for home oxygen therapy. S. 3118, the Preserving Access to Medicare Act of 2008, Medicare reimbursement for home oxygen therapy. H.R. 621 and S. 1484, the Home Oxygen Patient Protection Act of 2007, home oxygen therapy issues, including repeal of the equipment title transfer requirement. H.R. 552 and S. 329, the Pulmonary and Cardiac Rehabilitation Act of 2007, pulmonary rehabilitation services and Medicare reimbursement issues. DMEPOS Competitive bidding program, including bidding and supplier enrollment standards for home oxygen therapy providers. CMS Rulemaking affecting coverage and reimbursement for inhalation drug and sleep disorder therapies provided under Part B of the Medicare program.

Client expense: Not reported · Firm income: $75,000

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

HR 1647/S 399 - Amend Title XIX of the Social Security Act; S 2785, HR 5545, S 2729, HR 6091,S 3101, S 3118, HR 6331, HR 6119, HR 6252, S 3236, S 3144, HR 4105, HR 6331 - Issues related to Physician Reimbursement, Scarcity Area Bonuses, Physician Quality Reporting, DME and DME competitive bidding, RAC Moratorium; HR 6898 - Issues related to health information technology

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3162, Children's Health and Medicare Protection (CHAMP) Act of 2007--home oxygen therapy reimbursements S. 3101/S. 6331, Medicare Improvements for Patients and Providers Act of 2008 H.R. 6252/S. 3144, Medicare DMEPOS Competitive Acquisition Reform Act of 2008

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3162, Children's Health and Medicare Protection (CHAMP) Act of 2007--home oxygen therapy reimbursements S. 3101/S. 6331, Medicare Improvements for Patients and Providers Act of 2008 H.R. 6252/S. 3144, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 General reform of home oxygen benefit

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Ending the Medicare Disability Waiting Period Act, H 154, S 2101 to end Medicare's 24-month waiting period. Medicare Improvements for Patients & Providers Act of 2008 , HR 6331, and related bills, HR 6252, S 3118, including provisions to fix the physician payment rate, delay Medicare competitive bidding for durable medical equipment and exempt complex rehabilitation from competitive bidding altogether -- because of impacts on people who need wheelchairs and other durable medical equipment. cont. S. 3327 - to improve the state plan option under Medicaid providing for home & community-based services -- cjamges tje home and community-based services option in the 2005 Deficit Reduction Act to allow more people to access these services. HR 1845 & S. 6252 - Medicare DMEPOS Competitive Acquisition Reform Act of 2007 regarding competitive bidding for durable medical equiptment. HR 1809/ S 2103 -- Medicare Independent Living Act -- to reverse Medicare regulations and policies that restrict payment for power mobility devices (wheelchairs) to those needed "in the home" rather than in the community -- such as for going to work, school, grocery shopping, medical appointments, places of worship and to accompany childred to school and activities. HR 1621/ S 799 - Community Choice Act of 2007 -- to support Medicaid coverage of community based services such as personal care, activities of daily living, etc. HR 1279 -- Direct Support Professional's Fairness & Security Act -- to support equalization of wages between privately and publicly employed direct support professionals. Community Living Assistance and Supports, CLASS Act S. 1758, Senators Edward Kennedy (D-MA) and Tom Harkin (D-IA) H.R. 3001, Reps. Frank Pallone (D-NJ) and John Dingell (D-MI) Both bills provide for a cash benefit to help obtain services and support. They would establish a national insurance plan to be financed by voluntary payroll deductions to provide benefits to adults who become severely functionally impaired. Participants would not be required to impoverish themselves in order to qualify for benefits. Center for Medicare and Medicaid Services (CMS) -- oppose the Rhode Island 1115 Waiver application that would essentially block grant Medicaid to Rhode Island -- which would jeopardize Medicaid services. Discussions with senior CMS officials about what will be happening with competitive bidding following enactment of HR 6331 that delayed competitive bidding temporarily and exempted complex rehabilitation from competive bidding altogether. Discussions about possible future legislation in the 111th Congress regarding: - physician payment rate - Medicare competitive bidding for durable medical equipment - make permanent some of the temporary delays/moratoria that were included in HR 6331 and related bills - seek permanent repeals of Medicaid rules that were delayed by legislation (e.g. enactment of HR 5613) - increasing the federal share of Medicaid (known as FMAP) including increased FMAP for direct support workers.

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

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

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.1845 - Medicare Durable Medical Equipment Access Act of 2007, all titles H.R.2231 - Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007, all titles H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3195 - ADA Restoration Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.6252 - Medicare DMEPOS Competitive Acquisition Reform 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 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1428 - Medicare Durable Medical Equipment Access Act of 2007, all titles S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.2603 - Medicare Fraud Prevention Act of 2008, all titles S.2786 - Medicare Rural Health Access Improvement Act of 2008, all titles S.2931 - Medicare Access to Complex Rehabilitative and Assistive Technology Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.3144 - Medicare DMEPOS Competitive Acquisition Reform Act of 2008, all titles

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R.1845 - Medicare Durable Medical Equipment Access Act of 2007, all titles H.R.2231 - Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007, all titles H.R.3162 - Children's Health and Medicare Protection Act of 2007, all titles H.R.3195 - ADA Restoration Act of 2007, all titles H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007, all titles H.R.6252 - Medicare DMEPOS Competitive Acquisition Reform 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 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.1428 - Medicare Durable Medical Equipment Access Act of 2007, all titles S.1893 - Children's Health Insurance Program Reauthorization Act of 2007, all titles S.2603 - Medicare Fraud Prevention Act of 2008, all titles S.2786 - Medicare Rural Health Access Improvement Act of 2008, all titles S.2931 - Medicare Access to Complex Rehabilitative and Assistive Technology Act of 2008, all titles S.3101 - Medicare Improvements for Patients and Providers Act of 2008, all titles S.3144 - Medicare DMEPOS Competitive Acquisition Reform Act of 2008, all titles

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

S. 2029 - The Physician Payments Sunshine Act of 2007 H.R. 3023 - The Drug and Medical Device Company Gift Disclosure Act of 2007 S. 2662 / H.R. 5480 - The Medicare Funding Warning Response Act of 2008 H.R. 3162 - The Children's Health and Medicare Protection Act of 2007 S. 2313 / H.R. 3697 - The Strategies to address Antimicrobial Resistance Act of 2007 Medicare Reform Implementation Medicare Technology Reimbursement ICD-10 Implementation H.R. 6252 and S. 3144 - The Medicare DMEPOS Competitive Acquisition Reform Act of 2008 H.R. 6331- The Medicare Improvements for Patients and Providers Act of 2008 CE bill (Baucus and Allen) - S. 3408 - Comparative Effectiveness Research Act; H.R. 2184 - Enhanced Health Care Value For All Act Wydan bill - S. 334 and H.R. 3163 - Healthy Americans Act; and new chron care bill, S. 3613 - Independence At Home Act. Ryan Tax/Health bill - H.R. 6110 - Roadmap For America's Future Act

Client expense: $740,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

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

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

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

H. R. 1424, Paul Wellstone Mental Health and Addiction Equity Act, Sec. 105, Medicaid Drug Rebate H. R. 3162, Children's Health and Medicare Protection Act of 2007 H. R. 5605, Physician Payments Sunshine Act of 2008 S. 2029, Physician Payments Sunshine Act of 2007 S. 2221, Transparency in Medicare Device Pricing Act S. 3118, Preserving Access to Medicare Act of 2008, Sec. 142 H.R. 6252, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 S. 3144, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 Medicare Coverage of Bariatric Surgery

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

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

Competitive Bidding, H.R. 6252/S. 3144: Medicare DMEPOS Competitive Acquisition Reform Act H.R. 2567/S. 3505: Medicare Home Infusion Therapy Coverage Medicare Program Regulation Re: Part B Home Oxygen Therapy 42 CFR 414.226(g)(2)

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

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

-H.R. 1190, "Community Cancer Care Preservation Act of 2007," regarding amending title XVIII of the Social Security Act to preserve access to community cancer care by Medicare beneficiaries; -Proposed Rule (CMS-1404-P), "CY 2009 Outpatient Prospective Payment System Rules". -H.R. 1321,Medicare Advanced Laboratory Diagnostics Act of 2007, regarding amending title XVIII of the Social Security Act to improve payments under the Medicare clinical laboratory fee schedule; -H.R. 1663, Medicare Mental Health Modernization Act of 2007, regarding amending title XVIII of the Social Security Act to expand and improve coverage of mental health services under the Medicare Program; -H.R. 1845 / S 1428, Medicare Durable Medical Equipment Access Act of 2007, regarding amending part B of title XVIII of the Social Security Act to assure access to durable medical equipment under the Medicare Program; -H.R. 2770, To amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price, all provisions; -H.R. 3011, To amend title XVIII of the Social Security Act to ensure adequate payment amounts for drugs and biologicals under part B of the Medicare Program, regarding all provisions; -H.R. 3061, Medicare Part D Drug Class Protection Act of 2007, regarding amending title XVIII of the Social Security Act to require that Medicare prescription drug plans using formularies cover all drugs included in 6 specified therapeutic categories and to establish protective requirements for coverage determinations; -H.R. 4 / S 3, Medicare Prescription Drug Price Negotiation Act of 2007, regarding amending part D of title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate lower covered part D drug prices on behalf of Medicare beneficiaries; -H.R. 976 / S 1893, Children's Health Insurance Program Reauthorization Act of 2007; -H.R. 3162, Children's Health and Medicare Protection Act of 2007, regarding improving enrollment and retention of eligible children; -S. 1887, Medicare Access to Critical Medications Act of 2007, regarding amending title XVIII of the Social Security Act in order to ensure access to critical medications under the Medicare part D prescription drug program; -S. 631, Remote Monitoring Access Act of 2007, regarding amending title XVIII of the Social Security Act to provide for coverage of remote patient management services for chronic health care conditions under the Medicare Program; -S. 860, Early Treatment for HIV Act of 2007, regarding amending title XIX of the Social Security Act to permit States the option to provide Medicaid coverage for low-income individuals infected with HIV; -CMS-1270-F, Medicare Program; Competitive Acquisition for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Other Issues, regarding a final rule establishing competitive bidding programs for certain Medicare Part B covered items of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) throughout the United States in accordance with sections 1847(a) and (b) of the Social Security Act; issues regarding competitive bidding, demonstrations for clinical lab services and competitive Medicare payments for lab services; issues regarding Medicare national coverage determination for the use of erythropoiesis stimulating agents in cancer and related neoplastic conditions; -CMS-2238-FC, regarding the Medicaid program, and prescription drugs; -S. 2499, "Medicare, Medicaid, and SCHIP Extension Act of 2007," all provisions. -S. 2029, "Physician Payments Sunshine Act of 2007," regarding amending title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, or medical supplies for which payment is made under Medicare, Medicaid or SCHIP; -H.R. 5765 / S. 631, "Medicare Remote Monitoring Access Act of 2008," regarding amending title XVIII of the Social Security Act to cover remote patient management services for certain chronic health conditions under the Medicare Program; -H.R. 6252, "Medicare DMEPOS Competitive Acquisition Reform Act of 2008", 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, regarding all provisions; -S. 2404, "Medicare Advanced Laboratory Diagnostics Act of 2007", A bill to amend title XVIII of the Social Security Act to improve payments under the Medicare clinical laboratory fee schedule, regarding all provisions; -H.R. 6331/ S. 3101, "Medicare Improvements for Patients and Providers Act of 2008", A bill to amend titles XVIII and XI of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes, regarding all provisions; -H.R. 2770, "To amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price", regarding all provisions.

Client expense: $1,440,000 · Firm income: Not reported

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

HR 6331/S.3101 Medicare Improvements for Patients and Providers Act of 2008; S.3144/HR 6252 Medicare DMEPOS Competitive Acquisition Reform Act of 2008; Delay in competitive bidding for DME and supplies; Medicare Advantage; Comparative Effectiveness; ESRD; E-Prescribing; HR 4296/S 2408 Medicare Electronic Medication and Safety Protection Act of 2007 (E-MEDS); S. 691/HR 1193 Kidney Care Quality & Education Act of 2007; Special Need Plans (SNPs); H.R. 5613 Protecting the Medicaid Safety Net Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6331/S.3101 Medicare Improvements for Patients and Providers Act of 2008; S.3144/HR 6252 Medicare DMEPOS Competitive Acquisition Reform Act of 2008; Delay in competitive bidding for DME and supplies; HR 4296/S 2408 Medicare Electronic Medication and Safety Protection Act of 2007 (E-MEDS); E-prescribing.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6331/S.3101 Medicare Improvements for Patients and Providers Act of 2008; Medicare Advantage; Comparative Effectiveness; ESRD; E-Prescribing; HR 4296/S 2408 Medicare Electronic Medication and Safety Protection Act of 2007 (E-MEDS). S. 3144/HR 6252 Medicare DMEPOS Competitive Acquisition Reform Act of 2008; Delay in competitive bidding for DME and supplies; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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. H.R. 5268 H.R. 5613 H.R. 6331 S. 2820

Client expense: $460,000 · 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

**see addendum page Medicare Physician Reimbursement, Medicare Oxygen Reimbursement, DME Competitive Bidding S. 1484/H.R. 621 - Home Oxygen Patient Protection Act of 2007 S. 329/H.R. 552 - Pulmonary and Cardiac Rehabiltion Act of 2007 H.R. 6252/S. 3144 - Medicare DMEPOS Competitive Acquisition Reform Act of 2008 ***, no speicific bill(s), Medicare Inhalation Drug Therapies and Oxygen Reimbursement, provider enrollment standards, DME Competitive Bidding, CPAP coverage & reimbursement

Client expense: Not reported · Firm income: $70,000

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

HR 1424 Paul Wellstone Mental Health and Addiction Equity Act, sec 105, provisions related to Medicaid Drug Rebate; HR 5606 Physicians Payments Sunshine Act of 2008; S 2029 Physician Payments Sunshine Act of 2007; HR 6631 Medicare Improvements for Patients and Providers Act; S 3101 Medicare Improvements for Patients and Providers Act of 2008/S 3118 Preserving Access to Medicare Act 2008 HR 5765 Medicare Remote Monitoring Access Act of 2008; S 3144/HR 6252, Medicare DMEPOS Competitive Acquisition Reform Act 2008; S 2221 Transparency in Medical Device Pricing Act; Issues related to oxygen provisions, competitive bidding and bariatric surgery.

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

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

H.R. 6252/S. 3144, a bill to delay and reform the Medicare Competitive Acquisition Program for the purchase of durable medical equipment, prosthetics, orthotics, and supplies H.R. 6331/S. 3101, Medicare Improvements for Patients and Providers Act of 2008, as it pertains to the delay of the Medicare Competitive Acquisition Program for durable medical equipment

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

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

H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008 S. 3144, "Medicare DMEPOS Competitive Acquisition Reform Act of 2008" H.R. 6252, "Medicare DMEPOS Competitive Acquisition Reform Act of 2008" S. 3101, Medicare Improvements for Patients and Providers Act of 2008

Client expense: $51,485 · Firm income: Not reported

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

HR 1845 & S 1428 - Durable Medical Equipment Access Act of 2007; all provisions; HR 3162 - Children's Health and Medicare Protection Act; all provisions; HR 621 & S 1484 - Home Oxygen Patient Protection Act; all provisions; S 2603 - Medicare Fraud Prevention Act of 2008; all provisions HR 2231 - Medicare Access to Complex Rehabilitation and Assistive Technology; all provisions; HR 6252 - Medicare DME Competitive Acquistion Reform Act of 2008; all provisions; S 3114 - Medicare DME Competitive Acquistion Reform Act of 2008; all provisions; S 3164 - Seniors & Taxpayers Obligation & Protection Act of 2008; all provisions; HR 6331 - Competitive Bidding Provisions; Medicare Improvements for Patients and Providers Act of 2008; General issues related to Home Medical Equipment.

Client expense: $90,000 · Firm income: Not reported

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

CMS reimbursement of orthotics and general Medicare issues including. Physician Payments Sunshine Act of 2007 (S 2029), and Medicare Improvements for Patients and Providers Act of 2008 (S 3101). Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331). Medicare DMEPOS Competitive Acquisition Reform Act of 2008 (H.R. 6252), Medicare DMEPOS Competitive Acquisition Reform Act of 2008 (S 3144).

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 5765, "Medicare Remote Monitoring Access Act of 2008", regarding amendments to Title XVIII of the Social Security Act to cover remote patient management services for certain chronic health conditions under the Medicare Program; -H.R. 4218, "Medicare Diabetes Self-Management Training Act of 2007", regarding amendments to title XVIII of the Social Security Act to improve access to diabetes self-management training by designating certain certified diabetes educators as certified providers for purposes of outpatient diabetes self-management training services under part B of the Medicare Program. -H.R. 6252/S. 3144, "Medicare DMEPOS Competitive Acquisition Reform Act of 2008" regarding provisions 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. 6331, "Medicare Improvements for Patients and Providers Act of 2008", regarding amendments to titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. Comparative Effectiveness: Potential legislation that would create a mechanism for the government to assess the merits of two comparable therapeutic agents.

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3162, Children's Health and Medicare Protection (CHAMP) Act of 2007--home oxygen therapy reimbursements; S. 3101/S. 6331, Medicare Improvements for Patients and Providers Act of 2008; H.R. 6252/S. 3144, Medicare DMEPOS Competitive Acquisition Reform Act of 2008

Client expense: $230,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3162, Children's Health and Medicare Protection (CHAMP) Act of 2007--home oxygen therapy reimbursements; S. 3101/S. 6331, Medicare Improvements for Patients and Providers Act of 2008; H.R. 6252/S. 3144, Medicare DMEPOS Competitive Acquisition Reform Act of 2008

Client expense: $230,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Competitive Bidding, H.R. 6252/S. 3144: Medicare DMEPOS Competitive Acquisition Reform Act Home Oxygen Reimbursement, H. Con. Res. 312/S. Con. Res. 70: Budget Resolution FY 2009 H.R. 2419/S. 2302: Food and Energy Security Act of 2007 H.R. 6331/S. 3101: Medicare Improvements for Patients and Providers Act of 2008

Client expense: $140,000 · Firm income: Not reported

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

H.R. 6331/S.3101 - Medicare Improvements for Patients and Providers Act of 2008, Section 153, 154 S.3118 - Preserving Access to Medicare Act of 2008, Section 152 H.R. 6252/S. 3144 Medicare DMEPOS Competitive Acquisition Reform Act of 2008 Protection of private sector delivery H.R. 1321 - Medicare Advanced Laboratory Diagnostics Act of 2007 Proposal to repeal CMS's Least Costly Alternative reimbursement policy for selected medicines H.R. 638/S. 3398 - Medicaid Device Safety Act of 2008 H.R.3162 - Children's Health and Medicare Protection Act of 2007 H.R.4854 - False Claims Act Correction Act of 2007 HR 3326 - Early Treatment for HIV Act of 2007

Client expense: $1,780,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR)

HR6252 (Medicare DMEPOS Competitive Acquisition Program Reform Act); support the 18 month delay of competitive bidding; HR6331 (Medicare Improvements for Patients and Providers Act of 2008); support the 18 month delay of national competitive bidd.

Client expense: $114,800 · Firm income: Not reported

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

Medicare Improvements for Patients & Providers Act of 2008, HR 6331, and related bills, HR 6252, S. 3118, including provisions to fix the physician payment rate, delay Medicare competitive bidding for durable medical equipment and exempt complex rehabilitation from competitive bidding altogether (because of impacts on popel who need wheelchairs and other durable medical equipment), provider Medicare mental health parity, delay cuts to Medicare therapies, require Medicare Part D to cover cont. certain drugs, strengthen CMS authority to require Part D plans to ensure broad coverage on prescription durg plan formularies, improve access to the Medicare Savings Program, eliminate Medicare Part D enrollment penalties, limit out-of-pocket costs for people who are qualified Medicare beneficiaries and people who are eligible for both Medicare and Medicaid (dual eligibles), simplify and align Medicare low-income assistance programs, bring outdated asset limits in line with today's cost of living, improve outreach and participation for those people currently eligible. S 3327 -- to improve the state plan option under Medicaid providing for home and community-based services -- changes the home and community-based services option in the 2005 Deficit Reduction Act to allow more people to access these services. HR 1845 & S. 6252 - Medicare DMEPOS Competitive Acquisition Reform Act of 2007 regarding competitive bidding for durable medical equiptment. HR 1809/ S 2103 -- Medicare Independent Living Act -- to reverse Medicare regulations and policies that restrict payment for power mobility devices (wheelchairs) to those needed "in the home" rather than in the community -- such as for going to work, school, grocery shopping, medical appointments, places of worship and to accompany childred to school and activities. HR 1621/ S 799 - Community Choice Act of 2007 -- to support Medicaid coverage of community based services such as personal care, activities of daily living, etc. HR 1279 -- Direct Support Professional's Fairness & Security Act -- to support equalization of wages between privately and publicly employed direct support professionals. Discussions with senior CMS officials about what will be happening with competitive bidding following enactment of HR 6331 that delayed competitive bidding temporarily and exempted complex rehabilitation from competive bidding altogether. Discussions about possible future legislation to: -- make permanent some of the temporary delays/moratoria that were included in HR 6331 and related bills -- protect the Medicaid waiver application process and require transparency on behalf of states and CMS. -- delay the Medicare 24-month waiting period -- seek permanent repeal of Medicaid rules that were delayed by legislation (e.g. enactment of HR 5613)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

S. 3101, the Medicare Improvements for Patients and Providers Act of 2008, Medicare reimbursement for home oxygen therapy. H.R. 6331, the Medicare Improvement for Patients and Providers Act of 2008, Medicare reimbursement for home oxygen therapy. H.R. 6252 and S. 3144, the Medicare DMEPOS Competitive Acquisition Reform Act, to delay the DMEPOS competitive bidding program. S. 3118, the Preserving Access to Medicare Act of 2008, Medicare reimbursement for home oxygen therapy. H.R. 3162, the Children's Health and Medicare Protection Act of 2007, home oxygen therapy reimbursement issues, including the cap on monthly Medicare payments. H.R. 621 and S. 1484, the Home Oxygen Patient Protection Act of 2007, home oxygen therapy issues, including repeal of the equipment title transfer requirement. H.R. 552 and S. 329, the Pulmonary and Cardiac Rehabilitation Act of 2007, pulmonary rehabilitation services and Medicare reimbursement issues. DMEPOS Competitive bidding program, including bidding and supplier enrollment standards for home oxygen therapy providers. Reimbursement for inhalation drug and sleep disorder therapies provided under Part B of the Medicare program.

Client expense: Not reported · Firm income: $75,000

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

HR.3162, Children's Health and Medicare Protection Act of 2007 S.3101, Medicare Improvements for Patients and Providers Act of 2008 S.3118, Preserving Access to Medicare Act of 2008 S. 3144, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 HR.6252, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 HR.6331, Medicare Improvements for Patients and Providers Act of 2008

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 1424 Paul Wellstone Mental Health and Addiction Equity Act, sec. 105, provisions related to Medicaid Drug Rebate; HR 5605 Physician Payments Sunshine Act of 2008; S 2029 Physician Payments Sunshine Act of 2007; HR 6331 Medicare Improvements for Patients and Provides Act; S 3101 Medicare Improvements for Patients and Providers Act of 2008/ S 3118 Preserving Access to Medicare Act 2008; HR 5765 Medicare Remote Monitoring Access Act of 2008; S 3144/HR 6252, Medicare DMEPOS Competitive Acquisition Reform Act 2008; Issues related to oxygen provisions, competitive bidding and bariatric surgery.

Client expense: $450,000 · Firm income: Not reported

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

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. 1190, "Community Cancer Care Preservation Act of 2007," regarding amending title XVIII of the Social Security Act to preserve access to community cancer care by Medicare beneficiaries; -Proposed Rule (CMS-1404-P), "CY 2009 Outpatient Prospective Payment System Rules". -H.R. 1321,Medicare Advanced Laboratory Diagnostics Act of 2007, regarding amending title XVIII of the Social Security Act to improve payments under the Medicare clinical laboratory fee schedule; -H.R. 1663, Medicare Mental Health Modernization Act of 2007, regarding amending title XVIII of the Social Security Act to expand and improve coverage of mental health services under the Medicare Program; -H.R. 1845 / S 1428, Medicare Durable Medical Equipment Access Act of 2007, regarding amending part B of title XVIII of the Social Security Act to assure access to durable medical equipment under the Medicare Program; -H.R. 2770, To amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price, all provisions; -H.R. 3011, To amend title XVIII of the Social Security Act to ensure adequate payment amounts for drugs and biologicals under part B of the Medicare Program, regarding all provisions; -H.R. 3061, Medicare Part D Drug Class Protection Act of 2007, regarding amending title XVIII of the Social Security Act to require that Medicare prescription drug plans using formularies cover all drugs included in 6 specified therapeutic categories and to establish protective requirements for coverage determinations; -H.R. 4 / S 3, Medicare Prescription Drug Price Negotiation Act of 2007, regarding amending part D of title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate lower covered part D drug prices on behalf of Medicare beneficiaries; -H.R. 976 / S 1893, Children's Health Insurance Program Reauthorization Act of 2007; -H.R. 3162, Children's Health and Medicare Protection Act of 2007, regarding improving enrollment and retention of eligible children; -S. 1887, Medicare Access to Critical Medications Act of 2007, regarding amending title XVIII of the Social Security Act in order to ensure access to critical medications under the Medicare part D prescription drug program; -S. 631, Remote Monitoring Access Act of 2007, regarding amending title XVIII of the Social Security Act to provide for coverage of remote patient management services for chronic health care conditions under the Medicare Program; -S. 860, Early Treatment for HIV Act of 2007, regarding amending title XIX of the Social Security Act to permit States the option to provide Medicaid coverage for low-income individuals infected with HIV; -CMS-1270-F, Medicare Program; Competitive Acquisition for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Other Issues, regarding a final rule establishing competitive bidding programs for certain Medicare Part B covered items of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) throughout the United States in accordance with sections 1847(a) and (b) of the Social Security Act; issues regarding competitive bidding, demonstrations for clinical lab services and competitive Medicare payments for lab services; issues regarding Medicare national coverage determination for the use of erythropoiesis stimulating agents in cancer and related neoplastic conditions; -CMS-2238-FC, regarding the Medicaid program, and prescription drugs; -S. 2499, "Medicare, Medicaid, and SCHIP Extension Act of 2007," all provisions. -S. 2029, "Physician Payments Sunshine Act of 2007," regarding amending title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, or medical supplies for which payment is made under Medicare, Medicaid or SCHIP; -H.R. 5765 / S. 631, "Medicare Remote Monitoring Access Act of 2008," regarding amending title XVIII of the Social Security Act to cover remote patient management services for certain chronic health conditions under the Medicare Program; -H.R. 6252, "Medicare DMEPOS Competitive Acquisition Reform Act of 2008", 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, regarding all provisions; -S. 2404, "Medicare Advanced Laboratory Diagnostics Act of 2007", A bill to amend title XVIII of the Social Security Act to improve payments under the Medicare clinical laboratory fee schedule, regarding all provisions; -H.R. 6331/ S. 3101, "Medicare Improvements for Patients and Providers Act of 2008", A bill to amend titles XVIII and XI of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes, regarding all provisions; -H.R. 2770, "To amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price", regarding all provisions.

Client expense: $1,500,000 · Firm income: Not reported

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

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. 2029 - The Physician Payments Sunshine Act of 2007 H.R. 3023 - The Drug and Medical Device Company Gift Disclosure Act of 2007 S. 2662 / H.R. 5480 - The Medicare Funding Warning Response Act of 2008 H.R. 3162 - The Children's Health and Medicare Protection Act of 2007 S. 2313 / H.R. 3697 - The Strategies to address Antimicrobial Resistance Act of 2007 Medicare Reform Implementation Medicare Technology Reimbursement ICD-10 Implementation H.R. 6252 and S. 3144 - The Medicare DMEPOS Competitive Acquisition Reform Act of 2008 H.R. 6331 - The Medicare Improvements for Patients and Providers Act of 2008 CE bill (Baucus and Allen) - S. 3408 - Comparative Effectiveness Research Act; H.R. 2184 - Enhanced Health Care Value For All Act. Wydan bill - S. 334 and H.R. 3163 - Healthy Americans Act; and new chron care bill, S. 3613 - Independence At Home Act. Ryan Tax/Health bill - H.R. 6110 - Roadmap For America's Future Act.

Client expense: $220,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

Antitrust H.R.971/S.885: Community Pharmacy Fairness Act of 2007 S.2161: Community Pharmacy Fairness Act of 2007 Pharmacy Reimbursement H.R.1474: Fair and Speedy Treatment of Medicare Dug Claims Act S.1954: Pharmacy Access Improvement Act of 2007 Medicare Part B H.R.2914/S.2990: medicare IVIG Access Act Medicare Competitive Bidding H.R.6252/S.3144: Medicare DMPEOS Competitive Acquisition Reform Act E-Prescribing S.2408: medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 Physician SGR Fix H.R.6331/S.3101: Medicare Improvements for Patients and Providers Act

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

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

H.R. 6331/ S. 3101 - Medicare Improvements for Patients and Providers Act of 2008 (P.L. 110-275) Sections on Medicaid AMP, Medicare Part D prompt payment, DME Competitive Bidding, Prescription Drug pricing, and e-prescribing H.Res. 1368 - Relating to the House procedures contained in section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 H.R. 4296/ S. 2408 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 H.R. 3700/ S. 1951 - Fair Medicaid Drug Payment Act of 2007 H.R. 3140 - Saving Our Community Pharmacies Act of 2007 H.R. 6252/S. 3144 - Medicare DMEPOS Competitive Acquisition Reform Act of 2008 H.R. 5780 - Medicare Clinical Practitioner Services Coverage Act of 2008 H.R. 5613 - Medicaid Safety Net Act of 2008 H.R. 2408/ S. 2408 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 H.R. 971 - Community Pharmacy Fairness Act S. 1827 - Pharmacist Access and Recognition in Medicare (PhARM) of 2007 S. 1474 - Fair and Speedy Treatment (FAST) of Medicare Prescription Drug Claims Act of 2007 H.R. 3025 - Medicare Prescription Drug Savings for Our Seniors Act of 2007 S. 1954 Pharmacy Access Improvement Act (PhAIM) of 2007 (Docket Number: CMS-4121-F) CMS Final Rule on Prohibiting Midyear Changes to Medicare Advantage Plans (Docket Number: CMS 4131-P) CMS Proposed Changes to Medicare Program; Revisions to the Medicare Advantage and Prescription Drug Benefits Programs (Docket Number: CMS 4131F) CMS Final Rule on Medicare Program; Medicare Advantage and Prescription Drug Benefit Programs: Final Marketing Provisions (Docket Number: CMS-1403-P) CMS Amendment on Medicare Program; Revisions to Amendment of the E-Prescribing Exemption for Computer-Generated Facsimiles (Docket Number: CMS-1405-N) CMS Notice on Medicare Provider Feedback Group Town Hall Meeting (Docket Number: CMS-7011-N) CMS Notice on Medicare Program: Request for Cosponsors for E-prescribing Educational Conference (Public Law 110-28 and Public Law 110-90) Medicaid's Tamper-Resistance Prescription Pad Requirement (Public Law 109-171) Deficit Reduction Act of 2005 Section on Average Manufacturers Price (AMP)

Client expense: $196,642 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

Antitrust H.R.971/S.885: Community Pharmacy Fairness Act of 2007 S.2161: Community Pharmacy Fairness Act of 2007 Pharmacy Reimbursement H.R.1474: Fair and Speedy Treatment of Medicare Dug Claims Act S.1954: Pharmacy Access Improvement Act of 2007 Medicare Part B H.R.2914/S.2990: medicare IVIG Access Act Medicare Competitive Bidding H.R.6252/S.3144: Medicare DMPEOS Competitive Acquisition Reform Act E-Prescribing S.2408: medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 Physician SGR Fix H.R.6331/S.3101: Medicare Improvements for Patients and Providers Act

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

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

Issues related to pharmacy payments, the Medicare Part D and competitive bidding. H.R. 1474, Fair and Speedy Treatment (FAST) Act S. 1827, Pharmacist Access and Recognition in Medicare Act of 2007 S. 1954, Pharmacy Access Improvement PhAIm) Act of 2007 S. 1951, Fair Medicaid Drug Payment Act of 2007 HR 3700, Fair Medicaid Drug Payment Act of 2007 HR 3140, Saving Our Community Pharmacies Act of 2007 S 3101 and HR 6331 the Medicare Improvements for Patients Providers Act of 2008 HR 6252, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 S. 3144, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 S 3118, Preserving Access to Medicare Act of 2008

Client expense: $1,316,532 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H. R. 1424, Paul Wellstone Mental Health and Addiction Equity Act, Sec. 105, Medicaid Drug Rebate H. R. 3162, Children's Health and Medicare Protection Act of 2007 H. R. 5605, Physician Payments Sunshine Act of 2008 S. 2029, Physician Payments Sunshine Act of 2007 S. 2221, Transparency in Medicare Device Pricing Act S. 3118, Preserving Access to Medicare Act of 2008, Sec. 142 S. 3101, Medicare Improvements for Patients and Providers Act of 2008, Sec. 144 H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, Sec 154 H.R. 6252, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 S. 3144, Medicare DMEPOS Competitive Acquisition Reform Act of 2008 Medicare Coverage of Bariatric Surgery

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

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

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

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

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

Reversal of CMS decision to subject "complex rehab" devices to competitive bidding processes HR 2231/S 2931 Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007 HR 6331/S 3101 Medicare Improvements for Patients and Providers Act of 2008 HR 6252/S 3144 Medicare DMEPOS Competitive Acquisition Reform Act of 2008

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

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