To extend certain immigration programs.

- Health Reform: Reduction of DSH payments as a funding source for health reform; the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560 - Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- Health Reform: Reduction of DSH payments as a funding source for health reform; and the importance of DSH payments to Missouri hospitals - MCO provider tax - S. 1099 - Patients' Choice Act (Burr/Coburn Health Plan) - H.R. 444 - 340B Program Improvement and Integrity Act - possible amendment on reauthorizing Section 1011 of the Medicare Modernization Act - reviewed hospital financial performance under Medicares payment system - discussed principals for health care reform legislation - Medicare Physician Payment Fix - H.R. 1409 & S. 560, Employee Free Choice Act Card Check - Physician Self-Referral to Specialty Hospitals - Rural Health Care Issues: H.R. 362 - Rural Hospital Assistance Act of 2009; S. 318 - Medicare Rural Health Access Improvement Act of 2009; S. 307/H.R. 668 - Critical Access Hospital Flexibility Act of 2009; and S. 628/H.R. 1127 - J1-Visa Waiver Program - H.R. 444 - 340B Program Improvement and Integrity Act of 2009 - Consistency of Regulatory Standards Application - requested action to protect Medicare capital indirect medical education payments

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

Worked with other members of an informal coalition of religious organizations to lobby for legislation to extend the special immigrant nonminister religious worker program beyond March 6, 2009. HR 1127, a bill to extend certain immigration programs, was introduced on February 23, passed the House on March 4, passed the Senate on March 11, and on March 20 became Public Law No: 111-9.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 182, To provide discretionary authority to an immigration judge to determine that an alien parent of a United States citizen child should not be ordered removed, deported, or excluded from the United States, all provisions H.R. 738, Death in Custody Reporting Act of 2009, all provisions H.R. 1024, Uniting American Families Act of 2009, all provisions H.R. 1127, To extend certain immigration programs, all provisions H.R. 1215, Immigration Oversight and Fairness Act, all provisions H.R. 1751, American Dream Act, all provisions, all provisions S. 424, Uniting American Families Act of 2009, all provisions S. 729, DREAM Act of 2009, all provisions Unnumbered, Reuniting Families Act, all provisions

Client expense: $302,724 · Firm income: Not reported

Government targets: Energy, Dept of, HOUSE OF REPRESENTATIVES, Natl Security Council (NSC), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID)

H.R. 182, To provide discretionary authority to an immigration judge to determine that an alien parent of a United States citizen child should not be ordered removed, deported, or excluded from the United States, all provisions H.R. 738, Death in Custody Reporting Act of 2009, all provisions H.R. 1024, Uniting American Families Act of 2009, all provisions H.R. 1127, To extend certain immigration programs, all provisions H.R. 1215, Immigration Oversight and Fairness Act, all provisions H.R. 1751, American Dream Act, all provisions, all provisions S. 424, Uniting American Families Act of 2009, all provisions S. 729, DREAM Act of 2009, all provisions Unnumbered, Reuniting Families Act, all provisions

Client expense: $302,724 · Firm income: Not reported

Government targets: Energy, Dept of, HOUSE OF REPRESENTATIVES, Natl Security Council (NSC), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID)

H.R.1/S.1 American Recovery and Reinvestment Act of 2009; H.R.1176/S.478 Secret Ballot Protection Act of 2009; H.R.1409/S.560 Employee Free Choice Act of 2009; H.R.2/S.275 Children's Health Insurance Program Reauthorization Act of 2009; HConRes85--FY 2010 Budget Resolution; SConRes 13--FY 2010 Budget Resolution; S.386 Fraud Enforcement and Recovery Act of 2009; H.R.1748 Fight Fraud Act of 2009; H.R.1105 Omnibus Apprpriations Act, 2009; H.R.1127 To extend certain immigration programs--six month extension to J-1 Visa program (Conrad Program); H.Res.5 Adopting rules for the 111th Congress--nullifies Medicare trigger for 2 years; 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; FFY 2010 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Outpatient PPS Rules; RY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule," Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; FFY 2009 Hospice PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; FFY 2010 President's Budget; Enhanced federal medical assistance percentage (FMAP) Health information technology; Capital Indirect Medical Education payments to teaching hospitals Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation, and school based health; 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; National Health Service Corp. funding; Public Health Service Act nursing and allied health professions program funding; Immigration; Hospice reimbursement; Comparative effectiveness funding; Preventative health and wellness programs funding; Community health center funding; Coverage for the uninsured; Hospital fundraising and recipient "opt-out"; Medicaid DSH Allocations to States; Children's Health Insurance Program funding; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; Secret ballot process for hospital employee unionization; Hospital Pay-for-Performance/Value-based purchasing; Hospital pay-for-performance quality measure reporting; Hospital readmissions; Bundling of hospital and physician and/or post-acute care provider payments; Health care-associated infections reporting; Medical error reporting; Medicare Graduate Medical Education (GME) payments to hospitals; Medicare Disproportionoate Share Hospital (DSH) payments; Tax deductibility of charitable contributions; False Claims Act expansion addressing fraud related to federal assistance and relie programs that could expose hospitals to liability for receiving and retaining overpayments; Medicare funding warning/"trigger"; Medicare wage index; Recovery Audit Contractor program; IRS Form 990 Revision; Not-for-profit hospital tax-exempt status; Community benefit reporting; "Stark" and physician self-referral regulations; Hospital pricing transparency; Coverage for undocumented immigrants; Hospital charity care/financial aid; Associated health plans; Emergency preparedness; Mental health parity; Limited service hospitals; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340B drug pricing program

See attached. H.R.1 Rep. David Obey (D-WI) - American Recovery and Reinvestment Act of 2009 (Provisions that would greatly expand taxpayer-funded benefits to legal and illegal aliens) H.R.2 Rep. Frank Pallone (D-NJ) - Children's Health Insurance Program Reauthorization Act of 2009 (SCHIP) (Provisions relating to extending taxpayer-funded health care to certain legal immigrants who were not previously eligible for the program) H.R.19 Rep. Ken Calvert (R-CA) - To require employers to conduct employment eligibility verification. (Provisions that requires entities hiring individuals for employment in the United States to participate in such System) H.R.373 Rep Flake, Jeff (R-AZ) - To amend the Immigration and Nationality Act to render inadmissible and deportable certain aliens convicted of drunk driving, and for other purposes. (Provisions mandating deportation if such alien has been convicted of three offenses for driving under the influence and at least one of the offenses is a felony under federal or state law for which the alien was sentenced to more than one year in prison) H.R.898 Rep Gingrey (R-GA) - Phil Nuclear Family Priority Act (Provisions relating to amending the Immigration and Nationality Act to make changes related to family-sponsored immigrants and to reduce the number of such immigrants) H.R.892 Rep Myrick, Sue Wilkins (R-NC) - Secure Education for Americans Today Act of 2009 (Provisions that would deny certain Federal funds to any institution of higher education that admits as students aliens who are unlawfully present in the United States) H.R.1105 Rep. David Obey (D-WI) - Omnibus Appropriations Act of 2009 (Provisions pertaining to extending short-term, six-month extension of E-Verify) H.R.1029 Rep. Baron Hill - Alien Smuggling and Terrorism Prevention Act of 2009 (Provisions that would amend the Immigration and Nationality Act and title 18, United States Code, to combat the crime of alien smuggling and related activities, and for other purposes) H.R.1127 Representative Zoe Lofgren (D-CA) - To extend certain immigration programs (Provisions relating to the Immigration and Nationality Act to extend the special immigrant program for non-minister religious) H.R.1148 Rep. Gus Bilirakis (R-FL) - To require the Secretary of Homeland Security to conduct a program in the maritime environment for the mobile biometric identification of suspected individuals, including terrorists, to enhance border security. (All Provisions) H.R.1751 Representative Howard Berman (D-CA) - The Development, Relief, and Education for Alien Minors (DREAM) Act of 2009 (Provisions aimed at granting amnesty to a broad range of individuals who meet certain minimal educational requirements and broad definitions relating to student status) S.9 Senator Harry Reid (D-NV) - Stronger Economy, Stronger Borders Act of 2009 (Provisions relating to continued support for amnesty by, among other things, "reforming and rationalizing" avenues for immigration) S.203 Sen. Feinstein, Dianne (D-CA) - Strengthening the Visa Waiver Program to Secure America Act (Provisions that would amend the Immigration and Nationality Act to modify the requirements for participation in the visa waiver program and for other purposes) S.339 Sen. Bingaman, Jeff (R-UT) - Border Law Enforcement Relief Act of 2009 (Provisions that would provide financial aid to local law enforcement officials along the Nation's borders, and for other purposes) S.729 Senator Dick Durbin (D-IL) - The Development, Relief, and Education for Alien Minors (DREAM) Act of 2009 (Provisions that would grant amnesty to a broad range of individuals who meet certain minimal educational requirements and broad definitions relating to student status)