Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008

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. 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

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 7110, S. 3604, S. 3688, The Job Creation, Infrastructure Investment, and Economic Assistance Package & HR 1424 The Emergency Economic Stabilization Act of 2008, relative to sections to temporarily increase the federal Medicaid matching rate (FMAP) for state Medicaid programs and require mental health parity for health insurance. HR 7067, Quality First (From Incentives, Reporting, Standards, and Technology) Act of 2008, provided Catholic hospitals prospective on Medicare value-based purchasing.

Client expense: $144,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, to amend 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; H.R. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program; H.R. 6912 and S. 3300 Rural Hospital Assistance Act of 2008, to amend title XVIII of the Social Security Act to provide for temporary improvements to the Medicare inpatient hospital payment adjustment for low-volume hospitals and to provide for the use of the non-wage adjusted PPS rate under the Medicare-dependent hospital (MDH) program, and for other purposes; S. 3327 Empowered at Home Act of 2008, to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; H.R. 6394 Border Health Care Relief Act of 2008, to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend Federal reimbursement of emergency health services furnished to undocumented aliens, and for other purposes; S. 3367, to amend title XVIII of the Social Security Act to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program; S. 3656 and H.R. 7241 Preserving Access to Healthcare (PATH) Act of 2008, a bill to preserve access to healthcare under the Medicare and Medicaid programs. The sections related to the Medicare indirect medical education adjustment factor and the delay in implementation of Medicaid outpatient hospital services regulation; S. 1595 Critical Access Hospital Flexibility Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; S. 2853, to amend title XVIII of the Social Security Act to remove the cap on disproportionate share adjustment percentages for certain rural hospitals; H. R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008, to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; H. R. 6966 and S. 3582 Safeguarding Our Hospitals' Futures Act of 2008, all provisions to require continued application of budget neutrality on a national basis in calculation of the Medicare urban hospital wage floor.

Client expense: $4,910,000 · 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), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA)

H.R. 1424/S.558 - Paul Wellstone Mental Health Parity & Addiction Act - Sect. 106 of House bill H.R. 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 - Entire bill H.R. 5613 - Protecting the Medicaid Safety Net Act of 2008 - Entire bill S. 2819 Economical Recovery in Health Care Act of 2008 - 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. 5924 - Emergency Nurse Supply Relief Act of 2008 - Entire bill H.R. 5942 - National Trauma Center Stabilization Act of 2008 - Entire bill H.R. 5998 - Protecting Children's Health Coverage Act of 2008 - Medicaid SCHIP Directive, Entire bill H.R. 6163 - Medicare Telehealth Enhancement Act - Entire bill. H.R. 6357 - PRO(TECH)T Act of 2008 - To amend Public Health - Entire bill H.R. 6331 - Medicare Improvements for Patients and Providers Act - Sections 121-125, 145, 205 H.R. 6898 - Health-e Information Technology Act of 2008 - Entire bill H.R. 6966 - Safeguarding Our Hospitals' Futures Act of 2008 - Entire bill H.R. 7067 - Quality FIRST Act of 2008 - Entire bill H.R. 7110 - Job Creation and Unemployement Relief Act of 2008 - Title III, Medicaid FMAP H.R. 7241 - Preserving Access to Healthcare (PATH) Act of 2008 - Entire bill S. 3656 - Preserving Access to Healthcare (PATH) Act of 2008 - Entire bill S. 3101 - Medicare Improvements for Patients and Providers Act - Rural Hospital Provisions

Client expense: $168,500 · Firm income: Not reported

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

H.R. 6201 Student to School Nurse Ratio Improvement 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. 6898 Health-e Information Technology Act H.R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act S. 2795 The Small Business Health Options Program Act Development of health care reform legislation Development of legislation to establish a Medicare value-based purchasing program for hospitals State Children's Health Insurance Program reauthorization

Client expense: $15,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.458 Physician Pathology Services Continuity Act, S. 558 The Mental Health Parity Act of 2007, S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act, S.969 Oppose Reversal of NLRB guidance on when charge nurses are classifed as supervisors, S.1041 Employee Free Choice Act-Oppose Card Check process, S.1604 Nursing Education and Quality of Health Care Act of 2007, S.1693 Health Information Exchange, S.2041 The False Claims Act Correction Act of 2007, S.2460 Extend S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers, S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007, S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP, S.3101 The Medicare Improvements for Patients and Providers Act S.3656 Preserving Access to Healthcare (PATH) Act of 2008 H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.2638 Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 continuing resolution 2009 H.R.2642, supplemental appropriations Act, 2008 H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5480 Medicare Funding Warning Response Act of 2008 H.R.5613 Extend and Establish Moratorium on Medicaid Rules H.R.5924 Emergency Nursing Supply Relief Act H.R.6331 Physician Medicare payment relief H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology H.R.6898 Health-e IT Act of 2008 H.R.7067 Quality FIRST Act of 2008 H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision H.R.7219 The Protecting Hospital Outpatient and Community Clinic Services Act of 2008 H.R.7241 Preserving Access to Healthcare (PATH) Act of 2008 H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas

Client expense: Not reported · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act-Oppose Card Check process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on medicaid regulations affecting intergovernmental transfers; S.2499 Medicare, medicaid, and SCHIP extension act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and establish moratorium on Medicaid rules; increase FMAP; S.3101 the Medicare improvements for patients and providers act; S.3656 Preserving access to healthcare (PATH) act of 2008; H.R.800 Employee free choice act (oppose card check process); H.R.866 Secret ballot protection act; H.R.976 Children's health insurance reauthoriation act of 2007; H.R.1105 Physician pathology services continuity act; H.R.1177 Sole commuunity hospital preservation act; H.R.1424 Paul Wellstone mental health and addiction equity act of 2007; H.R.1644 Oppose reversal of NLRB quidance on when charge nurses are classified as supervisors; H.R.1663 Medicare mental health modernization act of 2007; H.R.2159 Rural health services preservation act; H.R.2406 establishes NIST role in standard setting for health IT; H.R.2638 Consolidated security, disaster assistance, and continuing appropriations act, 2009; Continuing resolution 2009; H.R.2642 Supplemental appropriations act, 2008; H.R.3162 Children health and Medicare protection act of 2007; H.R.3326 Early treatment for HIV act; H.R.3533 Public and teaching hospital preservation Act; H.R.4105 One-year moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5480 Medicare funding warning response act of 2008; H.R.5613 Extend and establish moratorium on Medicaid rules; H.R.5924 Emergency nursing supply relief act; H.R.6331 Physician Medicare payment releif; H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology; H.R.6898 Health-E IT Act of 2008; H.R.7067 Quality FIRST Act of 2008; H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision; H.R.7219 the Protecting Hospital and outpatient and community clinic services act of 2008; H.R.7241 Preserving access to health care (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare prescription drug improvement and modernization act of 2003; FFY 2009 budget and budget resolutions/Medicare and Medicaid cuts; FFY 2009 Labor, health and human services, education and pension appropriations bill; FFY 2009 Medicare Inpatient hospital PPS rules; CY 2009 Medicare inpatient Psychiatric facility PPS rules; FFY 2009 Medicare inpatient rehabiltiation facility PPS and "75% rule," rules; CY 2009 Medicare otupatient PPS rules; FFY 2009 Medicare skilled nursing facility PPS rules; CY 2009 Medicare home health agency PPS rules; CY 2009 Medicare physician fee schedule update; CMS proposed rule to limit intergovernmental transfers and certified public expenditures; CMS proposed value-based purchasing program; CMS proposed rule on Medicad graduate medical education payments; State childrens health insurance program funding; IRS Form 990 revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; pay for performance/value based purchasing; health information technology; hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductibel health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; mental health parity; Limited service hospitals; Department of Housing and Urban Development's federal housing assistance mortage program for hospitals; Defiend benefit pension plans; National Institute of Health funding; Health care workforce recruting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340b drug pricing program; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; CMS directive to states establishing new requirements for increasing SCHIP coverage; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: $240,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

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

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

H.R. 7219, Protecting Hospital Outpatient and Community Clinic Services Act of 2008 H.R. 7110, Job Creation and Unemployment Relief Act of 2008 S. 3604, S. 3688, S. 3689, Economic Recovery Act of 2008 H.R. 7067, Quality First Act H.R. 7241 and S. 3656, Preserving Access to Healthcare (PATH) Act of 2008 H.R. 5268 and S. 2620, To Provide a Temporary FMAP Increase H.R. 676, United States Health Insurance Act H.R. 6898, Health e-information Technology Act of 2008 Baucus/Grassley Value-Based Purchasing Draft Bill

Client expense: $200,000 · Firm income: Not reported

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

H.R. 7219, Protecting Hospital Outpatient and Community Clinic Services Act of 2008; H.R. 7110, Job Creation and Unemployment Relief Act of 2008; S. 3604, S. 3688, S. 3689, Economic Recovery Act of 2008; H.R. 7067, Quality First Act Administration of the Section 1011 Program; H.R. 7241 and S. 3656, Preserving Access to Healthcare (PATH) Act of 2008; H.R. 5268, Enhanced Health Care Value for All Act of 2007; H.R. 676, United States Health Insurance Act; H.R. 6898, Health-e Information Technology Act of 2008; Baucus/Grassley Value-Based Purchasing Draft Bill

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

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

H.R. 7067, " Quality First Act", Draft Finance Committee language on value based purchasing. Issue: Linking Medicare hospital payments to quality measures.

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

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

S.1693 -- The Wired for Health Care Quality Act H.R. 2606 - To Amend Section 340B of the Public Health Service Act H.R. 5605 - Physicians Payments Sunshine Act H.R. 3533 - Public and Teaching Hospital Prevention Act Healthcare Group Purchasing Value-Based Medicare Purchasing Healthcare Acquired Infections Inpatient Prospective Payment System Health Information Technology IVIG Average Sales Price for Part B Drugs Medicare, Medicaid and SCHIP S. 2313 - Strategies to Address Antimicrobial Resistance Act H.R. 3697 - Strategies to Address Antimicrobial Resistance Act Unique Device Identification H.R. 5613 - Protecting the Medicaid Safety Net of 2008 S. 2819 - Economic Recovery in Health Care Act of 2008 S. 2029 - Physician Payments Sunshine Act of 2007 S. 2460 - Extends Medicaid Moratorium H.R. 5442 - Trust in Health Information Act of 2008 S. 1814 - Health Information Privacy and Security Act H.R. 7067 - Quality First Act H.R. 6898 - Health-e Information Technology Act of 2008 S. 3656 - Preserving Access to Healthcare Act Physician Self-Referral H.R. 6331 - Medicare Improvements for Patients and Providers Act H. R. 6357 - Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act H.R. 1424 - Emergency Economic Stabilization Act of 2008 Medicaid Outpatient Graduate Medical Education

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Office of Management & Budget (OMB), SENATE

H.R. 6898 Health-e Information Technology Act H.R. 7067 Quality FIRST Act S. 3560 QI Program Supplemental Funding Act of 2008

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

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

H.R. 1424/S.558 - Paul Wellstone Mental Health Parity & Addiction Act - Sect. 106 of House bill H.R. 4105 - Medicare Recovery Audit Contractor Program Moratorium Act of 2007 - Entire bill H.R. 5613 - Protecting the Medicaid Safety Net Act of 2008 - Entire bill S. 2819 Economical Recovery in Health Care Act of 2008 - 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. 5924 - Emergency Nurse Supply Relief Act of 2008 - Entire bill H.R. 5942 - National Trauma Center Stabilization Act of 2008 - Entire bill H.R. 5998 - Protecting Children's Health Coverage Act of 2008 - Medicaid SCHIP Directive, Entire bill H.R. 6163 - Medicare Telehealth Enhancement Act - Entire bill. H.R. 6357 - PRO(TECH)T Act of 2008 - To amend Public Health - Entire bill H.R. 6331 - Medicare Improvements for Patients and Providers Act - Sections 121-125, 145, 205 H.R. 6898 - Health-e Information Technology 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, Medicaid FMAP H.R. 7067 - Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008 - Entire bill S. 3101 - Medicare Improvements for Patients and Providers Act - Rural Hospital Provisions

Client expense: $157,000 · Firm income: Not reported

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

Medicare inpatient and outpatient hospital payments; Medicaid payments; H.R. 1177 and S. 2381 Sole Community Hospital Preservation Act of 2007, all provisions to amend title XVIII of the Social Security Act to extend and improve protections for sole community hospitals under the Medicare Program; H.R. 2159 and S. 630 Rural Health Services Preservation Act of 2007, all provisions to amend part C of title XVIII of the Social Security Act to provide for a minimum payment rate by Medicare Advantage organizations for services furnished by a critical access hospital and a rural health clinic under the Medicare Program; H.R. 1105 and S. 458 Physician Pathology Services Continuity Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide for the treatment of certain physician pathology services under the Medicare Program; H.R. 2050 Medicaid Emergency Psychiatric Care Act of 2007, all provisions to amend title XIX of the Social Security Act to permit States to obtain reimbursement under the Medicaid Program for care or services required under the Emergency Medical Treatment and Active Labor Act that are provided in a nonpublicly owned or operated institution for mental diseases; H.R. 2860 Health Care Access and Rural Equity (H-CARE) Act of 2007, all provisions related to TITLE I--MEDICARE HOSPITAL SERVICES, including Sec. 101. Fairness in the Medicare disproportionate share hospital (DSH) adjustment for rural hospitals, Sec. 102. Treatment of Medicare hospital reclassifications, Sec. 103. Critical access hospital improvements, Sec. 104. Rebasing for sole community hospitals, Sec. 105. Establishment of rural community hospital (RCH) program and Sec. 106. Hold harmless through 2012 for small rural hospitals and sole community hospitals under the prospective payment system for hospital outpatient department services under the Medicare program; S. 1277 Critical Access to Clinical Lab Services Act of 2007, all provisions to amend title XVIII of the Social Security Act to clarify the treatment of payment under the Medicare program for clinical laboratory tests furnished by critical access hospitals; H.R. 3057 Medicare Long-Term Patient Safety and Improvement Act of 2007, all provisions related to the steps to develop and implement criteria to differentiate long-term care hospitals from other post-acute care settings; H.R. 3453 The Community Clinical Laboratory Fairness in Competition Act of 2007, all provisions related to the Medicare competitive bidding demonstration project for clinical laboratory services; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008, all provisions to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009; S. 2819 Economic Recovery in Health Care Act,to enact moratoria on the Medicaid and CHIP regulations issued by the Administration over the last year and to provide targeted state fiscal relief; H.R. 4105 Medicare Recovery Audit Contractor Program Moratorium Act of 2007, all provisions relating to impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program; S. 1605 Craig Thomas Rural Hospital and Provider Equity Act of 2007 all provisions To amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program, and for other purposes; H.R. 615 Puerto Rico Medicare Reimbursement Act 2005, all provisions to increase of the Federal share of Medicare beneficiaries to 100% reimbursement for inpatient services; H.R. 5901Eliminating Disparities in Breast Cancer Treatment Act of 2008, to amend title XVIII of the Social Security Act to eliminate contributing factors to disparities in breast cancer treatment through the development of a uniform set of consensus-based breast cancer treatment performance measures for a 6-year quality reporting system and value-based purchasing system under the Medicare Program; H.R. 5721Strengthening the Safety Net Act of 2008, to amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured; H.R. 2642 Supplemental Appropriations Act of 2008, Title V Medicaid Provisions, all sections related to Medicaid Rules Moratorium, banning physician self-referral and August 17th directive (contained in domestic spending amendment); Section 1011 (MMA, P.L. 108-173) Medicare Modernization Act, two year extension; H.R. 5998 Protecting Children's Health Coverage Act of 2008, to nullify any effectiveness of the August 17, 2007, State health official letter issued by the Centers for Medicare & Medicaid Services; H.R. 5953 and S. 2962 MediFair Act of 2008, to amend title XVIII of the Social Security Act to improve the provision of items and services provided to Medicare beneficiaries residing in rural areas; S. 3116 Outpatient Mental Health Modernization Act of 2008, to amend title XVIII of the Social Security Act to stabilize and modernize the provision of partial hospitalization services under the Medicare program, and for other purposes; S. 3118 Preserving Access to Medicare Act of 2008, to amend titles XVIII and XIX of the Social Security Act to preserve beneficiary access to care by preventing a reduction in the Medicare physician fee schedule, to improve the quality of care by advancing value based purchasing, electronic health records, and electronic prescribing, and to maintain and improve access to care in rural areas, and for other purposes; H.R. 6212 and S. 3101 Medicare Efficiency and Development of Improvement of Care and Services Act (MEDICS Act) of 2008 and H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008, to amend 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; H.R. 6091Save Medicare Act of 2008, to amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program; S. 3164 Seniors and Taxpayers Obligation Protection Act of 2008, to amend title XVIII of the Social Security Act to reduce fraud under the Medicare program; H.R. 6912 and S. 3300 Rural Hospital Assistance Act of 2008, to amend title XVIII of the Social Security Act to provide for temporary improvements to the Medicare inpatient hospital payment adjustment for low-volume hospitals and to provide for the use of the non-wage adjusted PPS rate under the Medicare-dependent hospital (MDH) program, and for other purposes; S. 3327 Empowered at Home Act of 2008, to amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes; H.R. 6394 Border Health Care Relief Act of 2008, to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend Federal reimbursement of emergency health services furnished to undocumented aliens, and for other purposes; S. 3367, to amend title XVIII of the Social Security Act to revise the timeframe for recognition of certain designations in certifying rural health clinics under the Medicare program; S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, a bill to preserve access to healthcare under the Medicare and Medicaid programs. The sections related to the Medicare indirect medical education adjustment factor and the delay in implementation of Medicaid outpatient hospital services regulation; S. 1595 Critical Access Hospital Flexibility Act of 2007, all provisions to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; S. 2853, to amend title XVIII of the Social Security Act to remove the cap on disproportionate share adjustment percentages for certain rural hospitals; H. R. 7067 Quality FIRST (From Incentives, Reporting, Standards, and Technology) Act of 2008, to amend title XVIII of the Social Security Act to expand the development of quality measures for inpatient hospital services, to implement a performance-based payment methodology for the provision of such services under the Medicare Program; H. R. 6966 and S. 3582 Safeguarding Our Hospitals' Futures Act of 2008, all provisions to require continued application of budget neutrality on a national basis in calculation of the Medicare urban hospital wage floor.

Client expense: $3,950,000 · 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), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA)

H.R. 5721, Strengthening the Safety Net Act of 2008; H.R. 7219, Protecting Hospital Outpatient and Community Clinic Services Act of 2008; H.R. 1781 and S. 739, Children's Dental Health Improvement Act of 2007; H.R. 7110 and S. 3604, A bill making emergency supplemental appropriations for economic recovery for the fiscal year ending September 30, 2008, and for other purposes; H.R. 7067, the Quality FIRST Act; H.R. 6394, Border Health Care Relief Act of 2008; H.R. 2638, Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009; H.R. 7241 and S. 3656, Preserving Access to Healthcare (PATH) Act of 2008; H.R. 5268; H.R. 6444, Enhanced Health Care Value for All Act of 2007; H.R. 676, United States National Health Insurance Act; H.R. 6898, Health-e Information Technology Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 3656: Preserving Access to Healthcare (PATH) Act of 2008, sections relating to rural health clinics, hospices, and hospitals. HR 6873: Medicare Hospice Protection Act of 2008, entire bill. S 3484: Hospice Protection Act of 2008, entire bill. HR 1424: Emergency Economic Stabilization Act of 2008, Title V, Subsection B, mental health parity. 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 1343: Health Care Safety Net Act of 2008, section 7: Revision of Timeframe for RHCs; section 3: National Health Service Corps. HR 6966: Safeguarding our Hospitals' Futures Act of 2008, entire bill. S 3582: Safeguarding our Hospitals' Futures Act of 2008, entire bill. HR 6912: Rural Hospital Assistance Act of 2008, entire bill. S 3300: Rural Hospital Assistance Act of 2008, entire bill. HR 6652: Nurses' Higher Education and Loan Repayment Act of 2008, entire bill. HR 6331: Medicare Improvements for Patients and Providers Act of 2008, section 131 involving the physician-fix; section 122 involving rebasing for sole community hospitals, section 148, clarification of payment for clinical laboratory tests furnished by CAH. S 3101: Medicare Improvements for Patients and Providers Act of 2008, section 131 involving the physician-fix; section 122 involving rebasing for sole community hospitals, section 149, clarification of payment for clinical laboratory tests furnished by CAH. HR 6699: Health Security for All Americans Act of 2008, section 105 involving improvements to Medicare-dependent hospital program; section 106 involving payment adjustment for low-volume hospitals. HR 2583: Physician Workforce Enhancement Act of 2008, provisions relating to hospitals. HR 7067: Quality FIRST Act of 2008, provisions relating to hospitals and value-based purchasing. Other issues: Physician self-referral to physician-owned hospitals. Reject cuts in the indirect medical education adjustment for teaching hospitals' capital costs: Schumer,Specter,Clinton Senate letter and Marshall,King House letter. Critical Access Hospital contract/employment issue involving 485.635 CoP: Provision of services (CAH). Guidance for clinical integration programs. Medicaid DSH letter: Rep. John Sullivan letter requesting funding increases and to update the definition to Medicaid's Low DSH states. Value-based purchasing. CMS proposed rule for the FY2009 inpatient PPS: proposals relating to hospitals. CMS Recovery Audit Contractors program.

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

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)

S.1693 -- The Wired for Health Care Quality Act H.R. 2606 - To Amend Section 340B of the Public Health Service Act H.R. 5605 - Physicians Payments Sunshine Act H.R. 3533 - Public and Teaching Hospital Prevention Act Healthcare Group Purchasing Value-Based Medicare Purchasing Healthcare Acquired Infections Inpatient Prospective Payment System Health Information Technology IVIG Average Sales Price for Part B Drugs Medicare, Medicaid and SCHIP S. 2313 - Strategies to Address Antimicrobial Resistance Act H.R. 3697 - Strategies to Address Antimicrobial Resistance Act Unique Device Identification H.R. 5613 - Protecting the Medicaid Safety Net of 2008 S. 2819 - Economic Recovery in Health Care Act of 2008 S. 2029 - Physician Payments Sunshine Act of 2007 S. 2460 - Extends Medicaid Moratorium H.R. 5442 - Trust in Health Information Act of 2008 S. 1814 - Health Information Privacy and Security Act H.R. 7067 - Quality First Act H.R. 6898 - Health-e Information Technology Act of 2008 S. 3656 - Preserving Access to Healthcare Act Physician Self-Referral H.R. 6331 - Medicare Improvements for Patients and Providers Act H. R. 6357 - Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act H.R. 1424 - Emergency Economic Stabilization Act of 2008

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act-Oppose Card Check process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on medicaid regulations affecting intergovernmental transfers; S.2499 Medicare, medicaid, and SCHIP extension act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and establish moratorium on Medicaid rules; increase FMAP; S.3101 the Medicare improvements for patients and providers act; S.3656 Preserving access to healthcare (PATH) act of 2008; H.R.800 Employee free choice act (oppose card check process); H.R.866 Secret ballot protection act; H.R.976 Children's health insurance reauthoriation act of 2007; H.R.1105 Physician pathology services continuity act; H.R.1177 Sole commuunity hospital preservation act; H.R.1424 Paul Wellstone mental health and addiction equity act of 2007; H.R.1644 Oppose reversal of NLRB quidance on when charge nurses are classified as supervisors; H.R.1663 Medicare mental health modernization act of 2007; H.R.2159 Rural health services preservation act; H.R.2406 establishes NIST role in standard setting for health IT; H.R.2638 Consolidated security, disaster assistance, and continuing appropriations act, 2009; Continuing resolution 2009; H.R.2642 Supplemental appropriations act, 2008; H.R.3162 Children health and Medicare protection act of 2007; H.R.3326 Early treatment for HIV act; H.R.3533 Public and teaching hospital preservation Act; H.R.4105 One-year moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5480 Medicare funding warning response act of 2008; H.R.5613 Extend and establish moratorium on Medicaid rules; H.R.5924 Emergency nursing supply relief act; H.R.6331 Physician Medicare payment releif; H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology; H.R.6898 Health-E IT Act of 2008; H.R.7067 Quality FIRST Act of 2008; H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision; H.R.7219 the Protecting Hospital and outpatient and community clinic services act of 2008; H.R.7241 Preserving access to health care (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare prescription drug improvement and modernization act of 2003; FFY 2009 budget and budget resolutions/Medicare and Medicaid cuts; FFY 2009 Labor, health and human services, education and pension appropriations bill; FFY 2009 Medicare Inpatient hospital PPS rules; CY 2009 Medicare inpatient Psychiatric facility PPS rules; FFY 2009 Medicare inpatient rehabiltiation facility PPS and "75% rule," rules; CY 2009 Medicare otupatient PPS rules; FFY 2009 Medicare skilled nursing facility PPS rules; CY 2009 Medicare home health agency PPS rules; CY 2009 Medicare physician fee schedule update; CMS proposed rule to limit intergovernmental transfers and certified public expenditures; CMS proposed value-based purchasing program; CMS proposed rule on Medicad graduate medical education payments; State childrens health insurance program funding; IRS Form 990 revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; pay for performance/value based purchasing; health information technology; hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductibel health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; mental health parity; Limited service hospitals; Department of Housing and Urban Development's federal housing assistance mortage program for hospitals; Defiend benefit pension plans; National Institute of Health funding; Health care workforce recruting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340b drug pricing program; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; CMS directive to states establishing new requirements for increasing SCHIP coverage; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

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, Enire 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors;S.1041 Employee Free Choice Act-Oppose Card Check Process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R. 800 Employee Free Choice Act-Oppose Card Check Process; H.r. 866 Secret Ballot Protection Act; H.R. 976 Children's Health Insurance Reauthorization Act of 2007; H.R. 1105 Physician Pathology Services Continuity Act; H.R. 1177 Sole Community Hospital Preservation Act; H.R. 1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R. 1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R. 1663 Medicare Mental Health Modernization Act of 2007; H.R. 2159 Rural Health Services Preservation Act; H.R. 2406 Establishes NIST Role in Standard Setting for Health IT; H.R. 2642 Supplemental Appropriations Act, 2008; H.R. 3162 Children's Health and Medicare Protection Act of 2007; H.R. 3326 Early Treatment for HIV Act; H.R. 3533 Public and Teaching Hospital Preservation Act; H.R. 4105 One-Year Moratorium on the Recovery Audit Contractor (RAC) Program; H.R. 4854 False Claims Act Correction Act of 2007; H.R. 5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R. 5613 Extend and Establish Moratorium on Medicaid Rules; HR. 6331 Physician Medicare Payment Relief; H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations Bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule", Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance/Value Based Purchasing; Health Information Technology; Hospital Charity Care/Financial Aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration, Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Development's Federal Housing Assistance Mortgage program for Hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas; S.3101 The Medicare Improvements for Patients and Providers Act; S.3656 Preserving Access to Healthcare (PATH) Act of 2008; H.R. 2638 Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 (continuing resolution 2009); H.R. 5480 Medicare Funding Warning Response Act of 2008; H.R. 5924 Emergency Nursing Supply Relief Act; H.R. 6898 Health-e IT Act of 2008; HR. 7067 Quality FIRST Act of 2008; H.R. 7110 Job Creation and Unemployment Relief Act of 2008 (Title III includes FMAP provision); H.R. 7219 The Protecting Hospital Outpatient and Community Clinic Services Act of 2008; H.R. 7241 Preserving Access to Healthcare (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Client expense: Not reported · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

H.R. 7110 and S. 3604, A bill making emergency supplemental appropriations for economic recovery for the fiscal year ending September 30, 2008, and for other purposes H.R. 7067, the Quality FIRST Act H.R. 6394, Border Health Care Relief Act of 2008 H.R. 2638, Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 H.R. 5721, Strengthening the Safety Net Act of 2008 H.R. 7219, Protecting Hospital Outpatient and Community Clinic Services Act of 2008 S. 739, HR 1781 Children's Dental Health Improvement Act of 2007 S. 3656, Protecting Access to Healthcare (PATH) Act of 2008 H.R. 7241, Preserving Access to Healthcare (PATH) Act of 2008 H.R. 5268, no bill title- would increase FMAP H.R. 6444, Enhanced Health Care Value for All Act of 2007 H.R. 676, United States National Health Insurance Act H.R. 6898, Health-e Information Technology Act of 2008

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE