PRO(TECH)T Act of 2008

H.R. 1 - The American Recovery and Reinvestment Act; H.R. 1296 - Access for All America Act; H.R. 1343 - Health Care Safety Net Act; H.R. 1368 - Personalized Health Information Act; H.R. 2184 - Enhanced Health Care Value for All Act; H.R. 3014 - Health Equity and Accountability Act; H.R. 3200 - Affordable Health Choices Act; H.R. 6357 PRO(Tech)T Act of 2008; S. 334 - Healthy Americans Act; S. 486 - Access for All America Act; S. 1456 - Federal Employees Electronic Personal Health Records Act; S. 1576 - Minority Health Improvement and Health Disparities Elimination Act; S. 1693 - Wired for Health Care Quality Act; S. 1814 - Health Information Privacy and Security Act

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

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

False Claims Correction Act HR 6357 PRO(TECH)T Act of 2008 Issues related to Medicare requirements for the Advanced Beneficiary Notice

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

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

HR 897: LONG-TERM CARE AND RETIREMENT SECURITY ACT OF 2009; LTC IN CAFETERIA AND FSA; ABOVE THE LINE DEDUCTIONS FOR LTC PREMIUMS HR 1424: EMERGENCY ECONOMIC STABILIZATION ACT OF 2008; EXECUTIVE COMMISSION RESTRICTIONS AND 401 (K) ASSET RECOVERY HR 1721/S 697: COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS ACT; REFORM OF LTC FINANCING HR 1961: SAVINGS FOR AMERICAN FAMILIES' FUTURE ACT OF 2009; SAVER'S CREDIT HR 2419: FARM BILL EXTENSION ACT OF 2007; ROTH TREATMENTS FOR 457 CONTRACTS HR 2831: LEDBETTER FAIR PAY ACT OF 2007; CIVIL PENALTY IMPACT ON RETIREMENT PLANS HR 3185: FAIR DISCLOSURE FOR RETIREMENT SECURITY ACT OF 2007; RETIREMENT PLAN FEE DISCLOSURE HR 3361: PENSION PROTECTION TECHNICAL CORRECTIONS ACT OF 2007; TECHNICAL CORRECTIONS TO PPA HR 3765: DEFINED CONTRIBUTION PLAN FEE TRANSPARENCY ACT OF 2007; RETIREMENT PLAN FEE DISCLOSURE HR 3997: HEROES EARNINGS ASSISTANCE AND RELIEF TAX ACT OF 2007; MILITARY ACCESS TO RETIREMENT MONIES HR 5160: SMALL BUSINESSES ADD VALUES FOR EMPLOYEES ACT OF 2008; EXPAND PENSION COVERAGE HR 6143: PENSION PROTECTION ACT ERISA AMENDMENTS OF 2008; RETIREMENT PLAN MODIFICATION HR 6357: PRO (TECH) T ACT OF 2008; PROTECTING RECORDS; OPTIMIZING TREATMENTS; EASING COMMUNICATIONS THROUGH HEALTHCARE TECHNOLOGY; ALL PROVISIONS HR 6382: PENSION PROTECTION TECHNICAL CORRECTIONS ACT OF 2008; RETIREMENT PLAN MODICIATIONS HR 6708/S 3278: TO AMEND THE INTERNAL REVENUE CODE OF 1986 TO PROVIDE THAT NO LOAN MAY BE MADE FROM A QUALIFIED EMPLOYER PLAN USING REVOLVING CREDIT ARRANGEMENTS AND TO LIMIT THE NUMBER OF LOANS THAT MAY BE MADE FROM A QUALIFIED EMPLOYER PLAN TO A PARTICIPANT OR BENEIFICARY; LIMIT ON WITHDRAWAL OF RETIREMENT PLANS HR 3765: DEFINED CONTRIBUTION PLAN FEE TRANSPARENCY ACT OF 2007; RETIREMENT PLAN FEE DISCLOSURE HR 7242: PENSION PROTECTION ACT IRC AMENDMENTS OF 2008; LTC AND ANNUITY CLARIFICATION; TAX FREE EXCHANGE PROVISIONS OF LTC HR 7327: WORKER, RETIREE, AND EMPLOYER RECOVERY ACT OF 2008; RETIRMENT PLAN MODIFICATION SCR 13: AN ORIGINIAL CONCURRENT RESOLUTION SETTING FORTH THE BUDGET FOR THE UNITED STATES GOVERNMENT FOR FISCAL YEAR 2010; SAVER'S CREDIT; AUTO IRA'S. S 207: HEALTH INSURANCE TAX RELIEF ACT; ALLOW LONG TERM CARE INSURANCE TO BE OFFERED IN EMPLOYER SPONSORED CAFETERIA PLANS AND FSA. S 401: DEFINED CONTRIBUTION FEE DISCLOSURE ACT OF 2009; 401 (K) FEE DISCLOSURE S 434: EMPOWERED AT HOME ACT OF 2009; ALLOW ABOVE THE LINE TAX DEDUCTION FOR LTC PREMIUMS; ALLOW LTC TO BE OFFERED IN CAFETERIA/FSA PLANS S 1087: FAIR PAY ACT OF 2007; CIVIL PENALTY IMPACT ON RETIREMENT PLANS S 1974: PENSION PROTECTION TECHNICAL CORRECTIONS ACT OF 2007; TECHNICAL CORRECTIONS TO PPA S 2473: DEFINED CONTRIBUTION FEE DISCLOSURE ACT OF 2007; RETIREMENT PLAN FEE DISCLOSURE

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Followed legislation in a vareity of areas of interest to American Associatin of Homes and Services for the Aging, especially in support of S.908, To Establish a Consortium on the Impact of Technology in Aging Health Servcies. Followed and actively lobbied on HR 6357, the Protecting Records Optimizing Treatment and Easing Communication through Healthcare Technology Act of 2008, especially as relating to the inclusino of aspects of S.908, to establish a consortium on the Impact of Technology in Aging Health Services. Followed S.1693 Wired for Health Care Quality Act and H.R. 6898 technology to promote the adoption of meaning use of health information

Client expense: Not reported · Firm income: Not reported

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

S. 2041, False Claims Correction Act of 2007; H.R. 6357, PRO(TECH)T Act of 2008; Issues related to new Medicare requirements for the Advanced Beneficiary Notice.

Client expense: Not reported · Firm income: $10,000

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

HR 897: LONG-TERM CARE AND RETIREMENT SECURITY ACT OF 2009; LTC IN CAFETERIA AND FSA; ABOVE THE LINE DEDUCTIONS FOR LTC PREMIUMS HR 1424: EMERGENCY ECONOMIC STABILIZATION ACT OF 2008; EXECUTIVE COMMISSION RESTRICTIONS AND 401 (K) ASSET RECOVERY HR 1721/S 697: COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS ACT; REFORM OF LTC FINANCING HR 1961: SAVINGS FOR AMERICAN FAMILIES' FUTURE ACT OF 2009; SAVER'S CREDIT HR 2419: FARM BILL EXTENSION ACT OF 2007; ROTH TREATMENTS FOR 457 CONTRACTS HR 2831: LEDBETTER FAIR PAY ACT OF 2007; CIVIL PENALTY IMPACT ON RETIREMENT PLANS HR 3185: FAIR DISCLOSURE FOR RETIREMENT SECURITY ACT OF 2007; RETIREMENT PLAN FEE DISCLOSURE HR 3361: PENSION PROTECTION TECHNICAL CORRECTIONS ACT OF 2007; TECHNICAL CORRECTIONS TO PPA HR 3765: DEFINED CONTRIBUTION PLAN FEE TRANSPARENCY ACT OF 2007; RETIREMENT PLAN FEE DISCLOSURE HR 3997: HEROES EARNINGS ASSISTANCE AND RELIEF TAX ACT OF 2007; MILITARY ACCESS TO RETIREMENT MONIES HR 5160: SMALL BUSINESSES ADD VALUES FOR EMPLOYEES ACT OF 2008; EXPAND PENSION COVERAGE HR 6143: PENSION PROTECTION ACT ERISA AMENDMENTS OF 2008; RETIREMENT PLAN MODIFICATION HR 6357: PRO (TECH) T ACT OF 2008; PROTECTING RECORDS; OPTIMIZING TREATMENTS; EASING COMMUNICATIONS THROUGH HEALTHCARE TECHNOLOGY; ALL PROVISIONS HR 6382: PENSION PROTECTION TECHNICAL CORRECTIONS ACT OF 2008; RETIREMENT PLAN MODICIATIONS HR 6708/S 3278: TO AMEND THE INTERNAL REVENUE CODE OF 1986 TO PROVIDE THAT NO LOAN MAY BE MADE FROM A QUALIFIED EMPLOYER PLAN USING REVOLVING CREDIT ARRANGEMENTS AND TO LIMIT THE NUMBER OF LOANS THAT MAY BE MADE FROM A QUALIFIED EMPLOYER PLAN TO A PARTICIPANT OR BENEIFICARY; LIMIT ON WITHDRAWAL OF RETIREMENT PLANS HR 3765: DEFINED CONTRIBUTION PLAN FEE TRANSPARENCY ACT OF 2007; RETIREMENT PLAN FEE DISCLOSURE HR 7242: PENSION PROTECTION ACT IRC AMENDMENTS OF 2008; LTC AND ANNUITY CLARIFICATION; TAX FREE EXCHANGE PROVISIONS OF LTC HR 7327: WORKER, RETIREE, AND EMPLOYER RECOVERY ACT OF 2008; RETIRMENT PLAN MODIFICATION SCR 13: AN ORIGINIAL CONCURRENT RESOLUTION SETTING FORTH THE BUDGET FOR THE UNITED STATES GOVERNMENT FOR FISCAL YEAR 2010; SAVER'S CREDIT; AUTO IRA'S. S 207: HEALTH INSURANCE TAX RELIEF ACT; ALLOW LONG TERM CARE INSURANCE TO BE OFFERED IN EMPLOYER SPONSORED CAFETERIA PLANS AND FSA. S 401: DEFINED CONTRIBUTION FEE DISCLOSURE ACT OF 2009; 401 (K) FEE DISCLOSURE S 434: EMPOWERED AT HOME ACT OF 2009; ALLOW ABOVE THE LINE TAX DEDUCTION FOR LTC PREMIUMS; ALLOW LTC TO BE OFFERED IN CAFETERIA/FSA PLANS S 1087: FAIR PAY ACT OF 2007; CIVIL PENALTY IMPACT ON RETIREMENT PLANS S 1974: PENSION PROTECTION TECHNICAL CORRECTIONS ACT OF 2007; TECHNICAL CORRECTIONS TO PPA S 2473: DEFINED CONTRIBUTION FEE DISCLOSURE ACT OF 2007; RETIREMENT PLAN FEE DISCLOSURE

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attachment. RET First Quarter Report 2009 H.R. 519 The Elder Caregiver Support and Information Enhancement Act of 2009. Issue: LTC additional appropriations for LTC Information clearinghouse. H.R. 897 The Long Term Care and Retirement Security Act of 2009. Issue: LTC in cafeteria and FSA and above the line deductions for LTC premiums. H.R. 1424 Emergency Economic Stabilization Act of 2008. Issue: executive com restrictions and 401(k) asset recovery. H.R. 1961 - Savings for American Families Future Act Issue: savers' credit H.R. 2205/ S 1010 Retirement Security for Life Act. Issue: Tax Incentive for Non Qualified Annuities H.R. 2419 Farm Bill Extension Act. Issue: Roth treatment for 457 contracts. H.R. 3185 - The 401(k) Fair Disclosure for Retirement Security Act of 2007. Issue: Retirement plan fee disclosure. H.R. 3361 -To make technical corrections related to the Pension Protection Act of 2006. Issue: technical corrections to PPA. H.R. 3997 Defenders of Freedom Tax Act/ Heroes Earnings Assistance and Relief Act. Issue: military access to retirement monies. H.R. 5160 Small Business Add Value for Employees Act of 2008. Issue: expand pension coverage. H.R. 6143 Pension Protection Act ERISA Amendments of 2008. Issue: Retirement plan modifications. H.R. 6357 Protecting Records, Optimizing Treatments, and Easing Communications Through Healthcare Technology Act of 2008 (ProTECHt Act) H.R. 6382 Pension Protection Act Technical Corrections. Issue: Retirement plan modifications H.R. 7242 Pension Protection Act IRC Amendments of 2008. Issue: LTC and annuity clarification; Tax free exchange provisions for LTC. H.R. 7327 Worker, Retiree and Employer Recovery Act. Issue: Retirement plan modification. S. 207 Long Term Care Affordability and Security Act of 2009. Issue: allows long term care insurance to be offered in employer sponsored cafeteria plans and FSA. S. 391 Healthy Americans Act. Issue: private health insurance including LTC. S. 401 - Defined Contribution Fee Disclosure Act Issue: 401(k) fee disclosure S. 434 Empowered at Home Act of 2008. Issue: Allows above the line tax deduction for LTC premiums. Allows LTC to be offered in cafeteria/ FSA plans. S. 697/ HR 1721 Community Living Assistance Services and Supports Act. Issue: reform of LTC financing. RET - First Quarter Report 2009 continued S. 1288 - Women's Retirement Act of 2007. Issue: federal tax treatment of annuities. S. 1693 The Wired for Healthcare Quality Act. Issue: affects of LTC ERISA preemption. S. 1974- the Pension Protection Technical Corrections Act of 2007. Issue: technical corrections to PPA. S. 2473 Defined Contribution Fee Disclosure Act. Issue: retirement plan fee disclosure. S. 3278/ HR 6708 - A bill which would limit the use of 401(k) debit cards and limit withdrawals from 401(k) plans. Issue: limit of withdrawals on retirement plans. S. 3952 - Automatic IRA Act of 2007. Issue: expand pension coverage. S. Con Res 13 - 2010 Senate Budget Resolutions Issue: savers' credit, Auto-IRAs

Client expense: $1,237,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1 - The American Recovery and Reinvestment Act; HR 1296 - Access for All America Act; HR 1343 - Health Care Safety Net Act; HR 1368 - Personalized Health Information Act; HR 2184 - Enhanced Health Care Value for All Act; HR 3014 - Health Equity and Accountability Act; HR 6357 - PRO (TECH)T Act of 2008; S 334 - Healthy Americans Act; S 486 - Access for all America Act; S 1456 - Federal Employees Electronic Personal Health Records Act; S 1576 - Minority Health Improvement and Health Disparities Elimination Act; S 1693 - Wired for Health Care Quality Act; S 1814 - Health Information Privacy and Security Act Health care delivery system reform and cost containment

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

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

Healthcare Information Technology Legislation Issues - H.R. 6357: PRO(TECH)T Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General Medicare/Medicaid Issues - H.R. 6331: Medicare Improvement for Patients and Providers Act of 2008 H.R. 6357: PRO(TECH)T Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Education and support for population-based health programs, such as disease and care management in FFS Medicare and Medicare Advantage, including Special Needs Plans (specifically, the reauthorization of Chronic Care Special Needs Plans, or C-SNPs, the incorporation of reasonable process measures and standards for SNP evaluation, and recommendations for CMS' Chronic Conditions SNP Panel); Medicare pilots and demonstrations such as the Medicare Medical Home Demonstration, Senior Risk Reduction Dem- onstration, Medicare Physician Group Practice Demonstration, Medicare Electronic Health Records Demonstration, the Medicare Coordinated Care Demonstration (MCCD, as authorized under Section 4016 of the Balanced Budget Act of 1997), and Medicare Health Support (as authorized under Section 721 of the Medicare Prescription Drug, Improvement and Modernization Act (MMA), which created the "Voluntary Chronic Care Improvement Program" now called Medicare Health Support) - specifically, the 18-month Report to Congress on Medicare Health Support. Provision of suggestions and recommendations for consideration of the broader inclusion of coordinated chronic care and health service stakeholder expertise in the feasibility study of a Medicare Chronic Care Practice Research Network demonstration program and in outcomes reporting for comparative effectiveness research (authorized in the Medicare Improvements for Patients and Providers Act of 2008). Analysis and discussions regarding the expanded hospital re-admission reporting requirements included in Final IPPS & OPPS Rules. Analysis of Congressional Budget Office reports on health care reform key issues and budget options, and promotion of successful outcomes in population health improvement programs as a component of national reform of care delivery, financing and design, particularly in public sector programs. Promotion of alternative modeling might more fully capture the true costs and savings associated with innovative prevention and treatment techniques in health care. Promotion of consideration of alternative models to assess and adjust risk scores related to the illnesses of beneficiaries in the Medicare program. Support for funding of prevention and wellness programs and initiatives as provided for in the American Recovery and Reinvestment Act of 2009 as passed by the House and Senate. Support for modifying provisions related to HIPAA Privacy rule and security for personal health information as established in the Health-e Information Technology Act (HITECH Act) as part of the American Recovery & Reinvestment Act (ARRA). Encouragement of efforts to preserve HIPAA provisions permitting exchange of protected health information for care coordination and disease management, efforts to advance health information technology deployment, particularly as it would affect individuals with chronic conditions, including e-prescribing, and the creation of interoperability standards and priority use cases and best practices for technology deployment and promotion in care coordination. Support for the exemption of disease management and care coordination efforts from economic stimulus provision that would have required the HHS Secretary to issue new health care operations rules. Analysis and submission of comments regarding the Genetic Information Nondiscrimination Act (GINA) and the creation of regulations by the EEOC defining the employer wellness program exception as provided for in GINA. Education regarding effectiveness of chronic condition care and its benefits to Medicaid and other populations via the sharing of published quality improvement studies that reported cost or utilization outcomes from the intervention and which are target clinical conditions relevant for Medicaid programs. Advocacy for priorities of all stakeholders providing services along the care continuum toward the goal of population health improvement in proposed and realized legislation, including S. 3613 & H.R. 7114, the Independence at Home Act of 2008; S. 631 & H.R. 5765, the Remote Monitoring Access Act of 2007; S. 334, the Healthy Americans Act; S. 1340, the Geriatric Assessment and Chronic Care Coordination Act of 2007; S. 1753, the Healthy Workforce Act of 2007; H.R. 3800, the Wired for Healthcare Quality Act; H.R. 6357, Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology PRO(TECH)T Act of 2008; H.R. 6898, the Health-e Information Technology Act of 2008 (HITECH Act); H.R. 5442, TRUST in Health Information Act of 2008; S. 3101, Medicare Improvements for Patients and Providers Act of 2008; S. 3118, Preserving Access to Medicare Act of 2008; H.R. 853, Wellness and Prevention Act of 2007; H.R.6331, Medicare Improvements for Patients and Providers Act of 2008; the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA); the American Recovery & Reinvestment Act (ARRA); initiatives pertaining to the treatment and prevention of obesity as a chronic disease generally and as a component of population health improvement approaches to addressing the obesity epidemic. Advocacy and support for expansion of Medicare-covered clinical preventive services as recommended by the U.S. Preventive Services Task Force and provided for in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). Endorsement of the Healthy Workforce Act of 2009 and promotion of the legislation through the Healthy Workplace Alliance. General advocacy for population health improvement as a tool to improve the quality of health care and health care outcomes, and reduce preventable health care costs, and promotion of health promotion, wellness, and care coordination programs at the White House Regional Health Reform Summits.

Client expense: $135,000 · Firm income: Not reported

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), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Insurance Market Reform and Healthy Choice Act Mental Health Parity HIT: Standards, ICD-10 Implementation HR.1368 Wired for Health Care Act S.1783 and S.1693 Comparative Effectiveness Research HR.3162 TAA HR.3801 and S.1848 Genetic Non Discrimination HR.493 and S.358 Michelle Law HR.2851 and S.400 SCHIP HR.976 and HR.3963 "Extension Bill" HR.6357 Pro (Tech) Act of 2008

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2205/ S 1010 Retirement Security for Life Act. Issue: Tax Incentive for Non Qualified Annuities S. 1288 - Women's Retirement Act of 2007. Issue: federal tax treatment of annuities. S. 3952 - Automatic IRA Act of 2007. Issue: expand pension coverage. H.R.3361 -To make technical corrections related to the Pension Protection Act of 2006. Issue: technical corrections to PPA. S.1974- the Pension Protection Technical Corrections Act of 2007. Issue: technical corrections to PPA. H.R. 3185, the 401(k) Fair Disclosure for Retirement Security Act of 2007. Issue: Retirement plan fee disclosure. S. 207 Long Term Care Affordability and Security Act of 2009. Issue: allows long term care insurance to be offered in employer sponsored cafeteria plans and FSA. H.R. 3765 Defined Contribution Plan Fee Transparency Act of 2007. Issue: retirement plan fee disclosure. S. 697/ HR 1721 Community Living Assistance Services and Supports Act. Issue: reform of LTC financing. S. 2473 Defined Contribution Fee Disclosure Act. Issue: retirement plan fee disclosure. S. 1087 Fair Pay Act. Issue: civil penalty impact on retirement plans. H.R. 2831 Lilly Ledbetter Fair Pay Act. Issue: civil penalty impact on retirement plans. H.R. 2419 Farm Bill Extension Act. Issue: Roth treatment for 457 contracts. H.R. 3997 Defenders of Freedom Tax Act/ Heroes Earnings Assistance and Relief Act. Issue: military access to retirement monies. H.R. 5160 Small Business Add Value for Employees Act of 2008. Issue: expand pension coverage. H.R. 897 The Long Term Care and Retirement Security Act of 2009. Issue: LTC in cafeteria and FSA and above the line deductions for LTC premiums. S. 1693 The Wired for Healthcare Quality Act. Issue: affects of LTC ERISA preemption. H.R. 6357 Protecting Records, Optimizing Treatments, and Easing Communications Through Healthcare Technology Act of 2008 (ProTECHt Act) H.R. 6382 Pension Protection Act Technical Corrections. Issue: Retirement plan modifications H.R. 6143 Pension Protection Act ERISA Amendments of 2008. Issue: Retirement plan modifications. H.R. 7242 Pension Protection Act IRC Amendments of 2008. Issue: LTC and annuity clarification; Tax free exchange provisions for LTC. S. 3278/ HR 6708 - A bill which would limit the use of 401(k) debit cards and limit withdrawals from 401(k) plans. Issue: limit of withdrawals on retirement plans. H.R. 1424 Emergency Economic Stabilization Act of 2008. Issue: executive com restrictions and 401(k) asset recovery. H.R. 3765 Defined Contribution Plan Fee Transparency Act of 2007. Issue: retirement plan fee disclosure. S. 434 Empowered at Home Act of 2008. Issue: Allows above the line tax deduction for LTC premiums. Allows LTC to be offered in cafeteria/ FSA plans. H.R. 7327 Worker, Retiree and Employer Recovery Act. Issue: Retirement plan modification. S. 391 Healthy Americans Act. Issue: private health insurance including LTC. H.R. 519 The Elder Caregiver Support and Information Enhancement Act of 2009. Issue: LTC additional appropriations for LTC Information clearinghouse. H.R. 1961 - Savings for American Families Future Act Issue: savers' credit S. 401 - Defined Contribution Fee Disclosure Act Issue: 401(k) fee disclosure S. Con Res 13 - 2010 Senate Budget Resolutions Issue: savers' credit, Auto-IRAs

Client expense: $1,867,075 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, Transportation, Dept of (DOT), Treasury, Dept of

Followed legislation in a variety of areas of interest to American Association of Homes and Services for the Aging, especially in support of S. 908, To Establish a Consortium on the Impact of Technology in Aging Health Services. Followed and actively lobbied on HR 6357, the Protecting Records Optimizing Treatment and Easing Communication through Healthcare Technology Act of 2008, especially as relating to the inclusion of aspects of S.908, to establish a consortium on the (continued) Impact of Technology in Aging Health Services. Followed S. 1693 Wired for Health Care Quality Act and H.R. 6898 technology to promote the adoption of meaningful use of health information

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

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

S. 2041, False Claims Correction Act of 2007; H.R. 6357, PRO(TECH)T Act of 2008; Issues related to new Medicare requirements for the Advanced Beneficiary Notice.

Client expense: Not reported · Firm income: $10,000

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

Medicare and Medicaid reimbursement issues, reversal of CMS regulations; speciality hospital moratorium; S. 558 and H.R. 1421, H.R. 6983: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; H.R. 6331 Medicare Improvement for Patients and Providers Act of 2008; H.R. 6357 and H.R. 6898 Health Information Technology; H.R. 2583-Physician Worforce Enhancement Act of 2008; H.R. 6394 Border Health Care Relief Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6331/S 3101 The Medicare Improvement for Patients and Providers Act, Sections 121, 122, 123, 124, 131, 132, 135, 145, 149, 150, 151, 161, 205. HR 1424 Paul Wellstone Mental Health Parity and Addictions Act, Section 106 in House bill, S 558 Mental Health Parity Act 2007, entire bill H 5998 Medicaid SHCIP Directive, entire bill HR 6357, to amend the Public Health Service Act. S 2819 Economical Recovery in Health Care Act 2008, entire bill HR 4105 RAC, entire bill HR 5924, Emergency Nursing Supply Relief Act, entire bill HR 5882 to recapture employment base immigrant visas lsot to bureacratic delawys to prevent losses of family and employemnts based immigrant visas in the future, entire bill Hr 6163 - Medicare Telehelaht enhancemetn Act of 2008 entire bill HR 6966 Safeguarding Our Hospitals' Future Acto fo 2008, entire bill HR 7110 Job Creation and Unemployment Relief Acces of Healthcare Act 2008, Title III-FMAP HR 7067 Qualtiyf FIRST, entire bill HR 7241/S 3656 Preserving Access to Health Care, entire bill HR 5613 Protect Medicaid Safety Net, entire bill HR 5942 National Trauma Center Stablizaiton Act, entire bill S 3103 the Medicare Improvement for Patiens and Providers Act, Rural Hospitals provisions, HR 4355/S 2460 to ompose moratoriium on certains Medicaid payments restrictions, entire bill. Hr 3533 Public and Teaching Hospitals Preservation Act, entire bill HR.1174 Health Hospital Act of 2007, entire bill S 1842/HR 2122 Safe Nursing and Patient Care Act of 2007, entire bill S 3656 Preserving Access to Healthcare Act of 2008, entire bill HR 7067 Quality First Act, entire bill

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6331/S 3101 The Medicare Improvement for Patients and Providers Act, Sections 121, 122, 123, 124, 131, 132, 135, 145, 149, 150, 151, 161, 205. HR 1424 Paul Wellstone Mental Health Parity and Addictions Act, Section 106 in House bill, S 558 Mental Health Parity Act 2007, entire bill H 5998 Medicaid SHCIP Directive, entire bill HR 6357, to amend the Public Health Service Act. S 2819 Economical Recovery in Health Care Act 2008, entire bill HR 4105 RAC, entire bill HR 5924, Emergency Nursing Supply Relief Act, entire bill HR 5882 to recapture employment base immigrant visas lsot to bureacratic delawys to prevent losses of family and employemnts based immigrant visas in the future, entire bill Hr 6163 - Medicare Telehelaht enhancemetn Act of 2008 entire bill HR 6966 Safeguarding Our Hospitals' Future Acto fo 2008, entire bill HR 7110 Job Creation and Unemployment Relief Acces of Healthcare Act 2008, Title III-FMAP HR 7067 Qualtiyf FIRST, entire bill HR 7241/S 3656 Preserving Access to Health Care, entire bill HR 5613 Protect Medicaid Safety Net, entire bill HR 5942 National Trauma Center Stablizaiton Act, entire bill S 3103 the Medicare Improvement for Patiens and Providers Act, Rural Hospitals provisions, HR 4355/S 2460 to ompose moratoriium on certains Medicaid payments restrictions, entire bill. Hr 3533 Public and Teaching Hospitals Preservation Act, entire bill HR.1174 Health Hospital Act of 2007, entire bill S 1842/HR 2122 Safe Nursing and Patient Care Act of 2007, entire bill

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 4355/S 2460, To impose moratorium on certain Medicaid payment restrictions, entire bill HR 3533, Public and Teaching Hospitals Preservation Act, Entire Bill HR 5613, Protecting the Medicaid Safety Net Act of 2008, Entire Bill S 2819, Economical Recovery in Heatlh Care Act 2008, Entire Bill HR 5942, National Trauma Center Stablizations Act, Entire Bill, HR 5998, Medicaid SCHIP Directive, entire bill HR 4105 Medicare Recovery in Audit Contractor Program Moratorium Act od 2007, entire bill, HR 1424/ S 558, Paul Wellstone Mental Health and Addictions Equity Act of 2007, Section 206 Limitations on Physcian Ownership of Hosptials. HR 1174, Health Hospital Act of 2007, entire bill, S 1842/HR/2122, Safe Nursing and Patient Care Act of 2007, entire bill. Social Security Income Days- Disproportionate Share Hospitals Payments, Miscalulatios of SSI days by CMS. HR 6357, to amend the Public Health Service Act.

Client expense: $9,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid reimbursement issues; reversal of CMS regulations; specialty hospital moratorium; S. 558, H.R. 1424, H.R. 6983, Mental Health Parity/Addiction Equity; H.R. 6331, Medicare Improvement for Patients & Providers Act; H.R. 6357 & H.R. 6898, Health Information Technology; H.R. 2583, Physician Workforce Enhancement Act; H.R. 6394 Border Health Care Relief Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid reimbursement issues; reversal of CMS regulations; specialty hospital moratorium; S. 558, H.R. 1424 & H.R. 6983, Mental Health Parity Act; H.R. 6331, Medicare Improvement for Patients & Providers Act; H.R. 6357 & H.R. 6898, Health Information Technology; H.R. 2583, Physician Workforce Enhancement Act; H.R. 6394 Border Health Care Relief Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1424 Paul Wellstone Mental Health and Addiction Equity Act H.R. 5501 Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act H.R. 5918 Small Business Health Options Program Act H.R. 6210 Small Business Health Options Program Act H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act H.R. 7016 Susan B. Anthony Prenatal Nondiscrimination Act H.R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act S. 558 Mental Health Parity Act S. 1693 Wired for Health Care Quality Act S. 2731 Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act S. 2795 Small Business Health Options Program Act S. 3408 Comparative Effectiveness Research Act H. Con. Res. 342 Expressing the sense of Congress that the Food and Drug Administration's (FDA) new policy restricting women's access to medications containing estriol does not serve the public interest. S. Con. Res. 88 Expressing the sense of Congress that the Food and Drug Administration's (FDA) new policy restricting women's access to medications containing estriol does not serve the public interest. Docket No. DEA 218 Electronic Prescriptions for Controlled Substances, CFR Parts 1300, 1304, 1306, 1311 RIN 0991-AB48 Provider Conscience Regulations Request for language in the standards governing ICE detention practices that prohibits the use of shackles or restraints on pregnant women in ICE custody

Client expense: $25,000 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, U.S. Immigration & Customs Enforcement (ICE)

H.R. 493 Genetic Information Nondiscrimination Act H.R. 2642 Supplemental Appropriations Act H.R. 6210 Small Business Health Options Program Act H.R. 6345 Patient-Controlled Health IT Act H.R. 6357 PRO(TECH)T Act S. 334 Healthy American Act S. 1693 Wired for Health Care Quality Act S. 2795 Small Business Health Options Program Act S. 3230 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act

Client expense: $45,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

H.R. 275, Global Online Freedom Act, all provisions having to do with data transfer; Federal Cyber Security Initiative, all provisions having to do with federal contracting and purchasing issues and foreign investment/ownership; S. 1693, Wired for Healthcare Quality Act, H.R. 6357, PRO(TECH)T Act, all provisions relating to health information technology, including, data breach notification, business associate and privacy consent.

Client expense: $260,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Trade Representative (USTR)

S. 1693, Wired for Healthcare Quality Act, H.R. 6357, PRO(TECH)T Act, all provisions relating to health information technology including, data breach notification, business associate liabilities, privacy consent.

Client expense: $260,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Trade Representative (USTR)

H.R. 6331/S. 3101 The Medicare Improvements for Patients and Providers Act, Sections 121, 122, 123, 124, 131, 132, 135, 145, 149, 150, 151, 161, 205. H.R. 1424 Paul Wellstone Mental Health Parity and Addiction Act, Section 106 in House Bill. S. 558 Mental Health Parity Act 2007, Entire Bill. H.R. 5998 Medicaid SCHIP Directive, Entire Bill. H.R. 6357 To amend the Public Health Service Act. S. 2819 Economical Recovery in Health Care Act of 2008, Entire Bill. H.R. 4105 RAC, Entire Bill. H.R. 5924 Emergency Nursing Supply Relief Act, Entire Bill. H.R. 5882 To recapture employment-based immigrant visas lost to bureaucratic delays and to prevent losses of family-and employment-based immigrant visas in the future, Entire Bill. H.R. 6163 Medicare Telehealth Enhancement Act of 2008, Entire Bill. H.R. 6966 Safeguarding Our Hospitals' Futures Act of 2008, Entire Bill. H.R. 7110 Job Creation and Unemployment Relief Act of 2008, Title III-FMAP. H.R. 7067 Quality FIRST, Entire Bill. H.R. 7241/S. 3656 Preserving Access to Healthcare Act of 2008, Entire Bill. H.R. 5613 Protect Medicaid Safety Net, Entire Bill. H.R. 5942 National Trauma Center Stabilization Act, Entire Bill. S. 3101 The Medicare Improvements for Patients and Providers Act, Rural Hospital provisions. H.R. 4355/S. 2460 To impose moratorium on certain Medicaid payment restrictions, Entire Bill. H.R. 3533 Public and Teaching Hospital Preservation Act, Entire Bill. H.R. 1174 Health Hospitals Act of 2007, Entire Bill. S. 1842/H.R. 2122 Safe Nursing and Patient Care Act of 2007, Entire Bill. S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, Entire Bill. H.R. 7241 Preserving Access to Heatlhcare (PATH) Act of 2008, Entire Bill. H.R. 7067 Quality First Act, Entire Bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 110-24, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Increased funding for the Agency for Healthcare Research and Quality in Fiscal Year 2009, Adequate funding for NHSC to relieve student debt. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

Client expense: $755,699 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-204, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 1695, Follow-on Biologics, Determine AAFP position. S. 2029, Physician Payments Sunshine Act, To discourage requiring pharmaceutical companies from having to report unrestricted grants for CME. H.R. 5605, Physician Payments Sunshine Act, To discourage requiring pharmaceutical companies from having to report unrestricted grants for CME. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Preserving Patient Access to Primary Care Act, To provide support for medical training for primary care and for primary care physician practices. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for AHRQ. No Bill, Prevents cuts to the National Health Services Corps in FY 2009, Adequate funding for NHSC to relieve student debt. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care.

Client expense: $755,699 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

Client expense: $755,699 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-329 (H.R. 2638), Increased funding for Agency for Healthcare Research and Quality (AHRQ) FY 2009 Appropriations, Adequate funding for Health Information Technology and Comparable Effectiveness Research. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2029, Physician Payments Sunshine Act, To discourage requiring pharmaceutical companies from having to report unrestricted grants for CME. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5605, Physician Payments Sunshine Act, To discourage requiring pharmaceutical companies from having to report unrestricted grants for CME. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6983, Mental Health Parity, To require health plans to cover mental health services on a par with how they cover physical health. No Bill, Health care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Promoting the US health delivery system reform to a Patient Centered Medical Home model of care, Promoting health care reform base on the PCMH model of care. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care.

Client expense: $755,146 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, CMS Meetings regarding Medicare payment, PCMH Pilot, GME. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas.

Client expense: $755,146 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Agency for Healthcare Research and Quality (AHRQ) FY 2009 Appropriations, Adequate funding for Health Information Technology and Comparable Effectiveness Research. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Antitrust issues related to health care plan consolidation and physician collective bargaining, Oppose anticompetitive insurance consolidation. Allow physicians to bargain collectively; remove antitrust barriers on physicians; reform Federal Trade Commission regulation. No Bill, Collective Negotiation by Physicians with Health Plans, To allow physicians to bargain collectively with health plans. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Physician Quality Reporting Initiative; Value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Promoting the US health delivery system reform to a Patient Centered Medical Home model of care, Promoting health care reform based on the PCMH model of care. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas. No Bill, Title VII Health Professions Grants for Primary Care Medicine Training Reauthorization, Promote Title VII Health Professions Grants for Primary Care Training programs.

Client expense: $755,146 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

S.Con.Res. 70, Increase Discretionary Health Spending under F. 550 of the House and Senate Budget Resolutions, Adequate funding for HHS agencies: HRSA, AHRQ, Rural Health, NIH. S. 2408, Health Information Technology, To include provisions that will make the adoption of HIT less onerous and expensive. S, 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments and repeal medicare sustainable growth rate formula, provide positive update for medicare physician payments. Extend payment rate for physicians to 18 months. S. 4296, Health Information Technology, To include provisions that will make the adoption of HIT less onerous and expensive. H.R. Con. Res. 312, Increase Discretionary Health Spending under F. 550 of the House and Senate Budget Resolutions, Adequate funding for HHS agencies: HRSA, AHRQ, Rural Health, NIH. H.R. 3800, Health Information Technology, To include provisions that will make the adoption of HIT less onerous and expensive. H.R. 5442, Health Information Technology, To include provisions that will make the adoption of HIT less onerous and expensive. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments and repeal medicare sustainable growth rate formula, provide positive update for medicare physician payments. Extend payment rate for physicians to 18 months. H.R. 6357, Health Information Technology, To include provisions that will make the adoption of HIT less onerous and expensive. No Bill, Attended FTC Health Care Clinical Integration Workshop, Allow physicians to bargain collectively; remove antitrust barriers on physicians; reform Federal Trade Commission regulation. No Bill, Health care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committees and to promote additional support. No Bill, Health Information Technology; Electronic Health Records; Electronic Prescribing, To educate Congress on the value, cost and obstacles associated with health information technology in family practices. No Bill, Increased funding for Agency for Healthcare Research and Quality (AHRQ) FY 2009 Appropriations, Adequate funding for Health Information Technology and Comparable Effectiveness Research. No Bill, Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health programs. No Bill, Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. No Bill, Out of pocket costs for health care, To make sure out-of-pocket costs for health care (especially drugs) does not prevent patients' access to health care. No Bill, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Physician Quality Reporting Initiative; Value-base purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care.

Client expense: $934,646 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

Health Information Technology, S. 1693/H.R. 3800, Wired for Health Care Quality Act, H.R. 1952, National Health Information Incentive Act, HR 5442, TRUST in Health Information Act, Regulation of Tobacco, HR 1108, Family Smoking Prevention and Tobacco Control Act, Physician Workforce Shortages, Disparities in Health Care, HR 6357, Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008, S. 2029, Physician Payments Sunshine Act, HR 6898, the Health-e Information Technology Act of 2008

Client expense: $750,000 · Firm income: Not reported

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

HR 3963 Children's Health Insurance Program Reauthorization Act of 2007 S 2499 Medicare, Medicaid and SCHIP Extension Act of 2007 S 558 Mental Health Parity Act of 2007 S 1693 Wired for Health Care Quality Act S 1695 Biologics Price Competition and Innovation Act of 2007 HR 4460 Health Care Choice Act S 1883 Accountability and Transparency in Medicare Marketing Act of 2007 HR 976 Children's Health Insurance Program Reauthorization Act of 2007 HR 5629 Pathway for Biosimilars Act HR 1424 Paul Wellstone Mental Health and Addiction Equity Act HR 3162 Children's Health and Medicare Protection Act of 2007 HR 493 Genetic Information Non-Discrimination Act of 2008 HR 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 HR 4460 Health Care Choice Act of 2007 HR 633 Medicare Improvements for Patients and Providers Act of 2008 - provisions relating to Medicare Advantage and Part D HR 6444 Healthy Americans Act HR 1424 Emergency Economic Stabilization Act of 2008 S 3101 Medicare Improvements for Patients and Providers Act of 2008 - provisions relating to Medicare Advantage and Part D S 3118 Preserving Access to Medicare Act of 2008 - provisions relating to Medicare Advantage and Part D S 334 Healthy Americans Act

Client expense: $510,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, SENATE, White House Office

S 1338, The Access to Medical Imaging Act of 2007 HR 1293, The Access to Medical Imaging Act of 2007 S 1693, Wired for Health Care Quality Act of 2007 HR 6331, Medicare Improvement for Patients and Providers Act of 2008 S 2029, Physician Sunshine Act S 1695, Wired for HC Act HR 6898, Health-e Technology Act of 2008 MIPPA implementation HR 6357, Pro(TECH)t Act HR 6331, Medicare Improvements for Patients and Providers Act HR 3610, FDA Globalization Act of 2008 S334, Healthy Americans Act Bioterrorism Health Information Technology

Client expense: $4,260,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Consumer Product Safety Commission (CPSC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Natl Aeronautics & Space Administration (NASA), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA)

S. 2041, False Claims Correction Act of 2007; H.R. 6357, PRO(TECH)T Act of 2008; Issues related to new Medicare requirements for the Advanced Beneficiary Notice.

Client expense: Not reported · Firm income: $10,000

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

HR 971, the "Community Pharmacy Fairness Act of 2007"; S. 2161, the "Community Pharmacy Fairness Act of 2007"; HR 2900, provision related to pedigree requirements; HR 4 and S.3, the "Medicare Prescription Drug Price Negotiation Act of 2007"; HR 1474, the "Fair and Speedy Treatment (FAST) of Medicare Prescription Drug Claims Act of 2007; potential legislation related to Medicare DMEPOS accreditation and surety bond requirements; Sec. 913 of FDAAA of 2007, relating to development of a standard numerical drug identifier; HR 5839, the "Safeguarding America's Pharmaceuticals Act of 2008," provisions relating to pedigree and track and trace requirements; HR 6852, the "Small Business Cooperative for Health Care Options to Improve Coverage for Employees (CHOICE) Act of 2008; potential amendments to S. 1693, the "Wired for Health Care Quality Act," re privacy issues; S. 980, the "Ryan Haight Online Pharmacy Consumer Protection Act of 2008"; HR 3140, "Saving Our Community Pharmacies Act of 2007"; S. 1951, the "Fair Medicaid Drug Payment Act of 2007"; S. 1954, the "Pharmacy Access Improvement (PhAIm) Act of 2007"; HR 3700, the "Fair Medicaid Drug Payment Act of 2007"; HR 6357, the "PRO(TECH)T Act of 2008", provisions impacting health technology requirements for pharmacies; HR 6331, the "Medicare Improvements for Patients and Providers Act of 2008," Sec. 154 related to Medicare DMEPOS competitive acquisition program, Sec. 171 related to prompt payment of Part D reimbursements to pharmacies, Sec. 203, related to pharmacy reimbursement under Medicaid.

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

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

Generic Biologics (S. 623; S. 1695; H.R. 1038); Health system / insurance / ERISA reform (H.R. 676; H.R. 506; H.R. 2034; H.R. 3163; S. 334; S. 1783; S. 1019; S. 2818; S. 1886; S. 2795; H.R. 6210); Health cost savings / comparative effectiveness / wellness promotion (H.R. 2184; H.R. 3162; S. 1342; S. 1753; S. 1754; H.R. 3717; H.R. 853; H.R. 2633; S. 3408); Health IT (S. 1693; H.R. 5442; H.R. 6357; H.R. 6898); High Risk Pools (S. 3230, Labor-HHS Approps.); Medicare (Medicare Advantage, electronic prescribing, sales and marketing of Medicare private insurance products (H.R. 3162, S 3101, HR 6331, HR 4296, S. 2408); medcal liability reform (S. 243, S 2662, HR 2580, HR 5480, insurance regulation (S 40, HR 5611, HR 5840), long term care (S 1758, S 2337, HR 3363); SCHIP reauthorization (HR 976, HR 3963); Health insurance tax treatment (HRAs, HSAs, FSAs, Health Care Tax Credit--HR 3920, HR 3943, HR 4341, S 1739, S 1848, HR 5719); Small business / national pooling of insurance health reform (S. 2795; H.R. 6210; H.R. 6582)

Client expense: $250,000 · Firm income: Not reported

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

See attached addendum for General Lobbying Issue Area: HCR-Healthcare Health Information Technology Standards; HIT Privacy; Electronic Health Records; ICD 10 Implementation: HR1368 "Personalized Health Information Act of 2007;" S1783 and S1693 "Wired for Health Care Quality Act;" HR3800 "Promoting Health Information Technology Act;" HR2406 "Healthcare Information Technology Enterprise Integration Act;" HR6357 "Pro(Tech)t Act of 2008" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Small Group Market/Small Business Healthcare; Uninsured; Health Disparities; Connectors/Virtual Connectors; S1019 "Health Care Choice Act of 2007;" S334 and HR3163 "Healthy Americans Act;" S2795 "Small Business Health Options Program Act of 2008" Comparative Effectiveness Funding: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act;" S3408 "Comparative Effectiveness Research Act of 2008" SCHIP; HR976 and HR3963 "SCHIP Extension Bill"

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

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

HR 7110: Job Creation & Unemployment Relief Act of 2008, Title III, Temporary increase in FMAP. HR 2583: Physician Workforce Enhancement Act of 2008, provisions relating to hospitals. HR 6912: Rural Hospital Assistance Act of 2008, entire bill. S 3300: Rural Hospital Assistance Act of 2008, entire bill. S 3582: Safeguarding our Hospitals' Futures Act of 2008, entire bill. HR 6966: Safeguarding our Hospitals' Futures Act of 2008, entire bill. HR 7067: Quality FIRST Act of 2008, provisions relating to hospitals and value-based purchasing. S 3656: Preserving Access to Healthcare (PATH) Act of 2008, sections relating to hospitals, rural health clinics, hospices. HR 6873: Medicare Hospice Protection Act of 2008, entire bill. S 3484: Hospice Protection Act of 2008, entire bill. HR 6652: Nurses Higher Education and Loan Repayment Act of 2008, entire bill. HR 1424: Emergency Economic Stabilization Act of 2008, section 512, mental health parity. HR 1343: Health Care Safety Net Act of 2008, section 3: National Health Service Corps., section 7: Revision of Timeframe for RHCs. S 3367: Rural Health Clinic bill to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program, entire bill. HR 6699: Health Security for All Americans Act of 2008, section 105 involving improvements to MDH program; section 106 involving payment adjustment for low-volume hospitals. S 1693: Wired for Health Care Quality Act, provisions related to hospitals. HR 6898: Health-e Information Technology Act, provisions related to hospitals. HR 6867: Unemployment Compensation Extension Act of 2008, provisions related to hospitals. S 3507: Unemployment Compensation Extension Act of 2008, provisions related to hospitals. HR 6357: PRO(TECH)T Act of 2008, provisions related to hospitals. HR 1823: Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, entire bill. S 2250: Ambulatory Surgical Center Medicare Payment Modernization Act of 2007, entire bill. HR 800: Employee Free Choice Act of 2007, entire bill. S 1041: Employee Free Choice Act of 2007, entire bill. Other Issues: CAH conditions of participation, section 485.635 Healthcare reform Value-based purchasing, including Grassley/Baucus VBP discussion drafts Guidance for clinical integration Electronic health records and Health IT Payment updates for physicians and hospital inpatient/outpatient services CMS DME and oxygen payment rules Self-referral and physician-owned hospitals HHS provider conscience regulations Capital IME CMS guidelines related to use of providers contracted through a locum service CMS recovery audit contractor program Wage index reclassification ICD-10-CM and ICD-10-PCS medical data code sets

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2184 - Enhanced Health Care Value for All Act; HR 1343 - Health Care Safety Net Act; HR 1368 - Personalized Health Information Act; HR 3014 - Health Equity and Accountability Act; HR 6357 - PRO(TECH)T Act of 2008; S 334 - Healthy Americans Act; S 1456 - Federal Employees Electronic Personal Health Records Act; S 1693 - Wired for Health Care Quality Act; S 1576 - Minority Health Improvement and Health Disparities Elimination Act; S 1814 - Health Information Privacy and Security Act

Client expense: $840,000 · Firm income: Not reported

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

S 1343, HR 2241, S 2479, HR 3373, HR 3544, S 755 - supporting diabetes treatment and prevention; HR 1952, HR 2377, HR 3800, S 1693, HR 6357, S 1408, S 1814 - supporting development of HIT and infrastructure; HR 2580, HR 5480, S 2662 - seeking professional liability reform; HR 5559, HR 5543, HR 6110, S 158, S 2050 - ensuring parity for podiatric physicians in statutory definitions of physician and services; HR 3163, S 334 - supporting national health care reform

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health reform, health information technology, Wired for Health Care Quality Act (S.1693) , (H.R.3800). Pro (Tech) T Act (HR 6357).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE