Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009

S 756, Prostate Research Imaging and Men's Education Act S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act HR 3652, Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy Act of 2009 S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act HR 3138 Physician Payments Sunshine Act HR 2502, Comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S 1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Health Choices Act of 2009 S 1679, Affordable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Health Information Technology Healthcare Reform MedPAC Reform Mammography Guidelines HR 3962, Affordable Healthcare for America Act HR 3590, Patient Protection and Affordable Care Act HR 4872, Healthcare and Education Affordability Reconciliation Act of 2010 USPSTF Transparency HR 5461, Virtual Screening for Colorectal Cancer Act of 2010 HR 1213, Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 Labor, HHS Appropriations

Client expense: $15,460,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), 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), Labor, Dept of (DOL), 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)

None: Tax Reform -- Repatriated foreign earnings at reduced rate - Support President's Budget -- Limitation or repeal of the deferral of foreign income - Oppose HR 2454/S1733: Climate Change Legislation -- Cap & Trade proposals - Various None: Income Tax Credit -- For Cellulosic Biofuels - Support HR 1213: R & D Tax Credit -- Provisions to Simplify Qualifying and to Extend - Support PL 111-148: Provision for excise tax on medical devices -- Reduce or Modify with a Cap - Support None: Capital gains and dividend rate -- Increase the rates - Oppose HR 3202: Tax on toilet tissue -- Federal Clean Water Tax - Oppose HR 4994: Cell phone -- Repeal of listed property designation - Support

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

None: Tax Reform -- Repatriated foreign earnings at reduced rate - Support President's Budget -- Limitation or repeal of the deferral of foreign income - Oppose HR 2454/S1733: Climate Change Legislation -- Cap & Trade proposals - Various None: Income Tax Credit -- For Cellulosic Biofuels - Support HR 1213: R & D Tax Credit -- Provisions to Simplify Qualifying and to Extend - Support HR3590: Excise tax on medical devices -- New tax - Oppose None: Capital gains and dividend rate -- Increase the rates - Oppose HR 3202: Tax on toilet tissue -- Federal Clean Water Tax - Oppose HR 4994: Cell phone -- Repeal of listed property designation - Support

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)

S 756, Prostate Research Imaging and Men's Education Act S 301, Physician Payments Sunshine Act of 2009 HR 759, FDA Globalization Act HR 3652, Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy Act of 2009 S 1695 Wired for Healthcare Act S 391, Healthy Americans Act S 391 HR 1346, Medical Device Safety Act of 2009 S 540, Medical Device Safety Act of 2009 Colorectal Cancer Prevention Early Detection and Treatment Act of 2009 Access to Medical Imaging HR 1894, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 HR 3200, America's Affordable Health Choices Act HR 3138 Physician Payments Sunshine Act HR 2502, Comparative Effectiveness Research Act of 2009 S 1213, Patient Centered Outcomes Research Act of 2009 S 1131, Independence at Home Act of 2009 HR 2962, Integrity in Medicare Advanced Diagnostic Imaging Act of 2009 HR 3276, American Medical Isotopes Production Act of 2009 HR 3200, America's Affordable Health Choices Act of 2009 S 1679, Affordable Health Choices Act S 769, Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 S 1100, Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 Medical Imaging Appropriateness Criteria Medical Device Fees Comparative Effectiveness Research Health Information Technology Healthcare Reform MedPAC Reform Mammography Guidelines HR 3962, Affordable Healthcare for America Act HR 3590, Patient Protection and Affordable Care Act HR 4872, Healthcare and Education Affordability Reconciliation Act of 2010 USPSTF Transparency HR 5461, Virtual Screening for Colorectal Cancer Act of 2010 HR 1213, Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 Labor, HHS Appropriations

Client expense: $8,300,000 · Firm income: Not reported

None: Tax Reform -- Repatriated foreign earnings at reduced rate - Support President's Budget -- Limitation or repeal of the deferral of foreign income - Oppose HR 2454/S1733: Climate Change Legislation -- Cap & Trade proposals - Various None: Income Tax Credit -- For Cellulosic Biofuels - Support HR 1213: R & D Tax Credit -- Provisions to Simplify Qualifying and to Extend - Support HR3590: Excise tax on medical devices -- New tax - Oppose None: Capital gains and dividend rate -- Increase the rates - Oppose HR 3202: Tax on toilet tissue -- Federal Clean Water Tax - Oppose HR 4994: Cell phone -- Repeal of listed property designation - Support

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1213- SAAAVE Act of 2009- Provides technical corrections to the original legislation which unlinks AAA screening from the Welcome to Medicare Physical Exam and extends the one-time benefit to 65-75 year old at-risk Medicare beneficiaries, and other provisions.

Client expense: $1,065,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1346 - To amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. S. 540 - A bill to amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. HR 756- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. S 660- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. HR 3090-Health Equity & Accountability Act of 2009- Provides for the elimination of racial and ethnic health disparities. HR 1213- SAAAVE Act of 2009- Provides technical corrections to the original legislation which unlinks AAA screening with the Welcome to Medicare Physical Exam and extends the one-time benefit to 65-75 year old at-risk Medicare beneficiaries. HR 2749- Food Safety Enhancement Act of 2009- Grants FDA the authority and resources it needs to better oversee the safety of the nations food supply. Includes provisions related to device import safety fee, registration fees and unique identifier provisions HR 759- FDA Globalization Act- Grants FDA the authority and resources it needs to better oversee the safety of the nations food, cosmetic, drug and device supply. Includes provisions related to device import safety fee, registration fees and unique identifier provisions S 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes - provisions related to comparative effectiveness research. S. 1796 - America's Healthy Future Act of 2009 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Contains provisions related to medical device excise tax. S.1679 - Affordable Health Choices Act - contains provisions related to health care reform. H.R. 3200, Americas Affordable Health Choices Act of 2009, H.R. 3590, the Patient Protection and Affordable Care Act, and H.R. 3962, The Affordable Health Care for Americans Act, as they relate to the Independent Payment Advisory Commission, Comparative Effectiveness Research, National Device Registry, Pain Care Management, Medicare Prevention Screening Benefits, Medicare Shared Saving Pilots and Physician Payment Disclosure. H.R. 3590, Patient Protection and Affordable Care Act and H.R. 4872, Health Care and Education Reconciliation Act of 2010 as they relate to device excise tax, comparative effectiveness research, Independent Payment Advisory Board, AAA provisions, prevention and wellness, pain management, health disparity provisions, delivery and payment system reforms, physician-payment disclosure.

Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590: provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Parts B and D, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Part C, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services establishing a Medicare Commission, providing expanded Medicaid coverage for home and community-based services, expanding Medicaid coverage of attendant and other home services and supports, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio for insurance premiums, inclusion of patient-centered quality reporting requirements for providers, creating new claims reviews processes and provider certification, requiring reporting by practitioners of gifts received from pharmaceutical and medical device manufacturers. Medicare/Commission. P.L. 111-148, P.L. 111-152, H.R. 4872: creating an independent commission authorized to establish Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Prescription Drug Plan. S. 330, H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. P.L. 111-148, P.L. 111-152, H.R. 4872, S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 27: relating to provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 43, S. 46: repealing or extending exceptions to outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authorizing coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894, S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 1407, S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700, H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458, S. 565: provision related to continued coverage for immunosuppressive drugs furnished to beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765, S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574, S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 1131, H.R. 2560: provisions establishing pilot care coordination programs. Medicaid/Home and Community-based Long Term Care. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 434, S.1257, H.R. 28552: provisions to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid; provisions to provide a single point of entry to long term services; provisions to support nursing home diversion programs. Medicaid/Community-based Attendant Services and Supports. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid. P.L. 110-275, P.L. 108-173: implementation of regulations and guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and appeals processes under Medicare Parts C and D.

HR 1213- SAAAVE Act of 2009- Provides technical corrections to the original legislation which unlinks AAA screening with the Welcome to Medicare Physical Exam and extends the one-time benefit to 65-75 year old at-risk Medicare beneficiaries.

Client expense: $964,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1346 - To amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. S. 540 - A bill to amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. HR 756- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. S 660- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. HR 3090-Health Equity & Accountability Act of 2009- Provides for the elimination of racial and ethnic health disparities. HR 1380- Josh Miller Hearts Act- Provides federal grants and training for automated external defibrillators in elementary and secondary schools. S. 1197 Josh Miller Hearts Act- Provides federal grants and training for automated external defibrillators in elementary and secondary schools. S 660- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. HR 1213- SAAAVE Act of 2009- Provides technical corrections to the original legislation which unlinks AAA screening with the Welcome to Medicare Physical Exam and extends the one-time benefit to 65-75 year old at-risk Medicare beneficiaries. HR 2749- Food Safety Enhancement Act of 2009- Grants FDA the authority and resources it needs to better oversee the safety of the nations food supply. Includes provisions related to device import safety fee, registration fees and unique identifier provisions HR 759- FDA Globalization Act- Grants FDA the authority and resources it needs to better oversee the safety of the nations food, cosmetic, drug and device supply. Includes provisions related to device import safety fee, registration fees and unique identifier provisions S 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes - provisions related to comparative effectiveness research. S. 1796 - America's Healthy Future Act of 2009 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Contains provisions related to medical device excise tax. S.1679 - Affordable Health Choices Act - contains provisions related to health care reform. H.R. 3200, Americas Affordable Health Choices Act of 2009, H.R. 3590, the Patient Protection and Affordable Care Act, and H.R. 3962, The Affordable Health Care for Americans Act, as they relate to the Independent Payment Advisory Commission, Comparative Effectiveness Research, National Device Registry, Pain Care Management, Medicare Prevention Screening Benefits, Medicare Shared Saving Pilots and Physician Payment Disclosure.

Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. H.R. 3590, H.R. 3962, H.R. 3200, S. 1679: provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Parts B and D, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Part C, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services establishing a Medicare Commission, providing expanded Medicaid coverage for home and community-based services, expanding Medicaid coverage of attendant and other home services and supports, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio for insurance premiums, inclusion of patient-centered quality reporting requirements for providers, creating new claims reviews processes and provider certification, requiring reporting by practitioners of gifts received from pharmaceutical and medical device manufacturers. Medicare/Commission. S. 1110 and S. 1380: authorizing an enhanced MedPAC as an executive branch commission with authority to implement Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Prescription Drug Plan. S. 330/H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices and to use the savings to reduce the coverage gap. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. H.R. 27: relating to additional provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. H.R. 43/S. 46: repealing outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authoring coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894/S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. H.R. 1407/S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700/H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458/S. 565: provision related to continued coverage for immunosuppressive drugs furnished beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765/S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574/S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. S. 1131, H.R. 2560: provisions establishing pilot care coordination program.

-- HR 1213 / draft Senate legislation (Screening Abdomincal Aortic Aneurysms Very Efficiently (SAAVE)) -- Legislation to de-link the abdominal aortic aneurysm (AAA) screening from the Welcome to Medicare Physical Exam and extend the one-time screening benefit to 65-75 year-old Medicare beneficiaries who are at risk for a rupture. -- HR 3200 / prior discussion draft (America's Affordable Health Choices Act) -- Section on prevention, incorporating HR 1213 or similar language that would de-link the benefit, ensuring that ultrasound practice expense equipment utilization rate is not cut in the final HR 3200 and medicare physician reimbursement. -- America's Healthy Future Act / previous Finance Committee health care reform discussion papers -- Language in prevention section to allow the Secretary of HHS to de-link AAA screening from Welcome to Medicare Physical Exam, ensuring that reimbursement for ultrasound procedures is not cut and Medicare physician reimbursement.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1213- SAAAVE Act of 2009- Provides technical corrections to the original legislation which unlinks AAA screening with the Welcome to Medicare Physical Exam and extends the one-time benefit to 65-75 year old at-risk Medicare beneficiaries.

Client expense: $962,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1346 - To amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. S. 540 - A bill to amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. HR 756- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. S 660- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. HR 3090-Health Equity & Accountability Act of 2009- Provides for the elimination of racial and ethnic health disparities. HR 1380- Josh Miller Hearts Act- Provides federal grants and training for automated external defibrillators in elementary and secondary schools. S. 1197 Josh Miller Hearts Act- Provides federal grants and training for automated external defibrillators in elementary and secondary schools. S 660- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. HR 1213- SAAAVE Act of 2009- Provides technical corrections to the original legislation which unlinks AAA screening with the Welcome to Medicare Physical Exam and extends the one-time benefit to 65-75 year old at-risk Medicare beneficiaries. HR 2749- Food Safety Enhancement Act of 2009- Grants FDA the authority and resources it needs to better oversee the safety of the nations food supply. Includes provisions related to device import safety fee, registration fees and unique identifier provisions HR 759- FDA Globalization Act- Grants FDA the authority and resources it needs to better oversee the safety of the nations food, cosmetic, drug and device supply. Includes provisions related to device import safety fee, registration fees and unique identifier provisions HR 3200- Americas Affordable Health Choices Act of 2009 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Interests include comparative effectiveness research, physician payment disclosure requirements, device registries, AAA benefit, and pain management. S 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes - provisions related to comparative effectiveness research. S. 1796 - America's Healthy Future Act of 2009 - An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Contains provisions related to medical device excise tax. S.1679 - Affordable Health Choices Act - contains provisions related to health care reform.

See page three for specific Medicare/Medicaid issues. H. R. 3200 - America's Affordable Health Choices Act of 2009 H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 H.R. 2718/S. 1110/S. 1380 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 1679 - Affordable Health Choices Act

Client expense: $59,412 · Firm income: Not reported

See page five for specific Health Care issues. H. R. 3200 - America's Affordable Health Choices Act of 2009 H. R. 914 - Physician Workforce Enhancement Act of 2009 H. R. 1678 - Mitigating the Impact of Uncompensated Service and Time Act of 2009 H. R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 H. R. 1016 - Veterans Health Care Budget Reform and Transparency Act of 2009 H. R. 84 - Veterans Timely Access to Health Care Act H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2891 - Access to Frontline Health Care Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2251/S. 973 - Resident Physician Shortage Reduction Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 H. R. 1377 - To amend title 38, United States Code, to expand veteran eligibility for reimbursement by the Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility, and for other purposes. H.R. 2718/S. 1110/S. 1380 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 S. 733- National Trauma Center Stabilization Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 252 - Veterans Health Care Authorization Act of 2009 S. 597 - Women Veterans Health Care Improvement Act of 2009 S. 658 - Rural Veterans Health Care Improvement Act of 2009 S. 734 - Rural Veterans Health Care Access and Quality Act of 2009 S. 1679 - Affordable Health Choices Act

Client expense: $59,412 · Firm income: Not reported

See page five for specific Health Care issues. H. R. 3200 - America's Affordable Health Choices Act of 2009 H. R. 914 - Physician Workforce Enhancement Act of 2009 H. R. 1678 - Mitigating the Impact of Uncompensated Service and Time Act of 2009 H. R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 H. R. 1016 - Veterans Health Care Budget Reform and Transparency Act of 2009 H. R. 84 - Veterans Timely Access to Health Care Act H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2891 - Access to Frontline Health Care Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2251/S. 973 - Resident Physician Shortage Reduction Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 H. R. 1377 - To amend title 38, United States Code, to expand veteran eligibility for reimbursement by the Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility, and for other purposes. H.R. 2718/S. 1110/S. 1380 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 S. 733- National Trauma Center Stabilization Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 252 - Veterans Health Care Authorization Act of 2009 S. 597 - Women Veterans Health Care Improvement Act of 2009 S. 658 - Rural Veterans Health Care Improvement Act of 2009 S. 734 - Rural Veterans Health Care Access and Quality Act of 2009 S. 1679 - Affordable Health Choices Act

Client expense: $32,952 · Firm income: Not reported

See page three for specific Medicare/Medicaid issues. H. R. 3200 - America's Affordable Health Choices Act of 2009 H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 H.R. 2718/S. 1110/S. 1380 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 1679 - Affordable Health Choices Act

Client expense: $32,952 · Firm income: Not reported

See page three for specific Medicare/Medicaid issues. H. R. 3200 - America's Affordable Health Choices Act of 2009 H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 H.R. 2718/S. 1110/S. 1380 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 1679 - Affordable Health Choices Act

Client expense: $59,412 · Firm income: Not reported

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

See page five for specific Health Care issues. H. R. 3200 - America's Affordable Health Choices Act of 2009 H. R. 914 - Physician Workforce Enhancement Act of 2009 H. R. 1678 - Mitigating the Impact of Uncompensated Service and Time Act of 2009 H. R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 H. R. 1016 - Veterans Health Care Budget Reform and Transparency Act of 2009 H. R. 84 - Veterans Timely Access to Health Care Act H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2891 - Access to Frontline Health Care Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2251/S. 973 - Resident Physician Shortage Reduction Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 H. R. 1377 - To amend title 38, United States Code, to expand veteran eligibility for reimbursement by the Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility, and for other purposes. H.R. 2718/S. 1110/S. 1380 - Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 S. 733- National Trauma Center Stabilization Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 252 - Veterans Health Care Authorization Act of 2009 S. 597 - Women Veterans Health Care Improvement Act of 2009 S. 658 - Rural Veterans Health Care Improvement Act of 2009 S. 734 - Rural Veterans Health Care Access and Quality Act of 2009 S. 1679 - Affordable Health Choices Act

Client expense: $59,412 · Firm income: Not reported

Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. H.R. 3200, S. 1679, Senate Finance Committee Mark of Americas Healthy Futures Act: provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Part D, reducing the Part A deductible, establishing an out-of-pocket maximum under Medicare, establishing a voluntary comprehensive benefit option under Medicare, authorizing a Medicare-operated Part D drug plan, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Parts D and C, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services, integrating mental health services in primary care and community settings, eliminating the 45 percent funding trigger provision, establishing a Medicare Commission, providing Medicaid coverage for home and community-based services, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio and clarifying the Medicare Secondary Payer statute. Medicare/Commission. S. 1110 and S. 1380: authorizing an enhanced MedPAC as an executive branch commission with authority to implement Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Prescription Drug Plan. S. 330/H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices and to use the savings to reduce the coverage gap. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. H.R. 27: relating to additional provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. H.R. 43/S. 46: repealing outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authoring coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894/S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. H.R. 1407/S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700/H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458/S. 565: provision related to continued coverage for immunosuppressive drugs furnished beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765/S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574/S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. S. 1131, H.R. 2560: provisions establishing pilot care coordination program. Medicaid/Home and Community-based Long Term Care. S. 434, S.1257, H.R. 28552: provisions to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid; provisions to provide a single point of entry to long term services; provisions to support nursing home diversion programs. Medicaid/Community-based Attendant Services and Supports. S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid.

Prevention - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009, H.R. 1213 Health Care and Medicare Physician Payment Reform - America's Affordable Health Choice Act, H.R. 3200/America's Healthy Future Act Quality - Physician Quality Reporting Initiative and use of registries for reporting quality measures

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation of the deferred deposit industry including H.R. 1213 Payday Loan Reform Act; H.R. 1846, the CLEAR Act of 2009; H.R. 1640, the Interest Rate Reduction Act; H.R. 1608 and S. 500, the Protecting Consumers from Unreasonable Credit Rates Act; and the interest rate cap amendment to H.R. 627, the Card Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation of the deferred deposit industry including H.R. 1213 Payday Loan Reform Act; H.R. 1846, the CLEAR Act of 2009; H.R. 1640, the Interest Rate Reduction Act; H.R. 1608 and S. 500, the Protecting Consumers from Unreasonable Credit Rates Act; and the interest rate cap amendment to H.R. 627, the Card Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-- HR 1213/draft Senate legislation: Screening Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act of 2009 - Legislation to unlink the abdominal aortic aneurysm (AAA) screening from the Welcome to Medicare Physical Exam and extend the one-time screening benefit to 65-75 year-old Medicare beneficiaries who are at risk for a rupture. -- HR 3200: America's Affordable Health Choices Act of 2009 and its previous discussion draft - Section on prevention, incorporate HR 1213 or similar language to unlink the screening benefit, ensure that ultrasound practice expense equipment utilization rate is not cut in the final HR 3200, and Medicare physician reimbursement. -- Senate health care reform discussion papers - Unlink AAA screening from Welcome to Medicare Phyisical Exam, ensure that reimbursement for ultrasound procedures is not cut, and Medicare physican reimbursement.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1213- SAAAVE Act of 2009- Provides technical corrections to the original legislation which unlinks AAA screening with the Welcome to Medicare Physical Exam and extends the one-time benefit to 65-75 year old at-risk Medicare beneficiaries.

Client expense: $1,030,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1346 - To amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. S. 540 - A bill to amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. HR 756- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. S 660- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. HR 3090-Health Equity & Accountability Act of 2009- Provides for the elimination of racial and ethnic health disparities. HR 1390- Josh Miller Hearts Act- Provides federal grants and training for automated external defibrillators in elementary and secondary schools. HR 1390- Josh Miller Hearts Act- Provides federal grants and training for automated external defibrillators in elementary and secondary schools. S. 1197 Josh Miller Hearts Act- Provides federal grants and training for automated external defibrillators in elementary and secondary schools. S 660- National Pain Care Policy Act of 2009- Addresses important barriers to proper pain management by improving pain care research, education, outreach and care. HR 1213- SAAAVE Act of 2009- Provides technical corrections to the original legislation which unlinks AAA screening with the Welcome to Medicare Physical Exam and extends the one-time benefit to 65-75 year old at-risk Medicare beneficiaries. HR 2749- Food Safety Enhancement Act of 2009- Grants FDA the authority and resources it needs to better oversee the safety of the nations food supply. Includes provisions related to device import safety fee, registration fees and unique identifier provisions HR 759- FDA Globalization Act- Grants FDA the authority and resources it needs to better oversee the safety of the nations food, cosmetic, drug and device supply. Includes provisions related to device import safety fee, registration fees and unique identifier provisions HR 3200- Americas Affordable Health Choices Act of 2009 - To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. Interests include comparative effectiveness research, physician payment disclosure requirements, device registries, AAA benefit, and pain management. S 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research and to amend the Internal Revenue Code of 1986 to establish a Patient-Centered Outcomes Research Trust Fund, and for other purposes - provisions related to comparative effectiveness research

Prevention - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009, H.R. 1213 Health care and Medicare physician payment reform - America's Affordable Health Choice Act, H.R. 3200 Physician Payments Sunshine Act, S. 301 Quality - Physician Quality Reporting Initiative and use of registries for reporting quality measures

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

See page six for specific Health Care issues. H. R. 914 - Physician Workforce Enhancement Act of 2009 H. R. 1678 - Mitigating the Impact of Uncompensated Service and Time Act of 2009 H. R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 H. R. 1016 - Veterans Health Care Budget Reform and Transparency Act of 2009 H. R. 84 - Veterans Timely Access to Health Care Act H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2891 - Access to Frontline Health Care Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2251/S. 973 - Resident Physician Shortage Reduction Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 H. R. 1377 - To amend title 38, United States Code, to expand veteran eligibility for reimbursement by the Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility, and for other purposes. S. 733- National Trauma Center Stabilization Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 252 - Veterans Health Care Authorization Act of 2009 S. 597 - Women Veterans Health Care Improvement Act of 2009 S. 658 - Rural Veterans Health Care Improvement Act of 2009 S. 734 - Rural Veterans Health Care Access and Quality Act of 2009 Affordable Health Choices Act

Client expense: $17,638 · Firm income: Not reported

See page four for specific Medicare/Medicaid issues. H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act Affordable Health Choices Act

Client expense: $17,638 · Firm income: Not reported

See page four for specific Medicare/Medicaid issues. H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act Affordable Health Choices Act

Client expense: $72,555 · Firm income: Not reported

See page six for specific Health Care issues. H. R. 914 - Physician Workforce Enhancement Act of 2009 H. R. 1678 - Mitigating the Impact of Uncompensated Service and Time Act of 2009 H. R. 2 - Children's Health Insurance Program Reauthorization Act of 2009 H. R. 1016 - Veterans Health Care Budget Reform and Transparency Act of 2009 H. R. 84 - Veterans Timely Access to Health Care Act H. R. 1213 - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009 H. R. 2891 - Access to Frontline Health Care Act of 2009 H. R. 2350 - Preserving Patient Access to Primary Care Act of 2009 H. R. 2251/S. 973 - Resident Physician Shortage Reduction Act of 2009 H. R. 2844/S. 1249/H. R. 3074 - Medicare Payment Improvement Act of 2009 H. R. 1377 - To amend title 38, United States Code, to expand veteran eligibility for reimbursement by the Secretary of Veterans Affairs for emergency treatment furnished in a non-Department facility, and for other purposes. S. 733- National Trauma Center Stabilization Act of 2009 S. 330 - Medicare Prescription Drug Savings and Choice Act of 2009 S. 179 - Health Information Technology Act of 2009 S. 717 - 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 252 - Veterans Health Care Authorization Act of 2009 S. 597 - Women Veterans Health Care Improvement Act of 2009 S. 658 - Rural Veterans Health Care Improvement Act of 2009 S. 734 - Rural Veterans Health Care Access and Quality Act of 2009 Affordable Health Choices Act

Client expense: $72,555 · Firm income: Not reported

Comprehensive Health Care Reform. House Tri-Committee Discussion Draft, Senate Health, Education, Labor and Pensions Committee draft bill, Senate Finance Committee Description of Policy Options (No bill numbers as of this date): provisions related to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, reducing the Part A deductible, establishing an out-of-pocket maximum under Medicare, establishing a voluntary comprehensive benefit option under Medicare, authorizing a Medicare-operated Part D drug plan, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improvement of the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services, elimination of the 45 percent funding trigger provision, providing Medicaid coverage for home and community-based services, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements, reducing permitted age rating ratio and clarifying the Medicare Secondary Payer statute. Medicare/Prescription Drug Plan. S.330/H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices and to use the savings to reduce the coverage gap. Medicare/Part D Means Testing. S. Amdt. 805 (to S. Con. Res. 13), S. 677: requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Part D. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Combating Waste, Fraud, Abuse. H.R. 27: relating to additional provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. H.R. 43/S. 46: repealing outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authoring coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894/S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. H.R. 1407/S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700/H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458/S. 565: provision related to continued coverage for immunosuppressive drugs furnished beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765/S. 701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574/S. 254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Comparative Effectiveness. S. Amdt. 793 (to S. Con. Res. 13): prohibiting research information comparing the effectiveness of different treatments to deny coverage of products or services under federal health care programs including Medicare. Medicare/Care Coordination Services. S. 1131, H.R. 2560: provisions establishing pilot care coordination program. Medicare/Medicaid Reimbursement. S. Amdt. 799 (to S. Con. Res. 13): addressing the systemic inequities of Medicare and Medicaid reimbursement in rural areas. Medicaid/Home and Community-based Long Term Care. S. 434, S.1257, H.R. 28552: provisions to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid; provisions to provide a single point of entry to long term services; provisions to support nursing home diversion programs. Medicaid/Community-based Attendant Services and Supports. S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid.

HR 1346 - To amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. S. 540 - A bill to amend the Federal food, Drug, and Cosmetic Act with respect to liability under State and local requirements respecting devices- provision related to federal preemption. HR 756 - To amend the Public Health Service Act with respect to pain care - provisions related to pain care management and treatment S. 660 - A bill to amend the Public Health Service Act with respect to pain care - provisions related to pain care management and treatment S.391- A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. H.R.1321- To provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. HR 759 - To amend the Federal Food, Drug, and Cosmetic Act to improve the safety of food, drugs, devices, and cosmetics in the global market, and for other purposes - provisions related to proposed user fees to pay for increased inspection of products HR 1213 - To amend title XVIII of the Social Security Act to provide that the Medicare initial preventive physical examination not be required for a referral with respect to ultrasound screening for abdominal aortic aneurysms and to provide for such screening with respect to at-risk Medicare beneficiaries between the ages of 65 and 75 - provisions related to unlinking the AAA screening with the Welcome to Medicare Physicial Exam and extension of the one-time benefit to at-risk 65-75 year old Medicare beneficiaries. Call to Action Health Reform 2009, as presented by Senate Finance Committee Chairman Baucus.

Client expense: $1,238,000 · Firm income: Not reported

H.R. 1213 / draft Senate legislation (Screening Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act of 2009) -- Legislation to unlink the abdominal aortic aneurysm screening from the Welcome to Medicare Physical Exam and extend the one-time screening benefit to 65-75 year-old Medicare beneficiaries who are at risk for a rupture.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Prevention - Screening Abdominal Aortic Aneurysms Very Efficiently Act of 2009, H.R. 1213 2. Health care and Medicare physician payment reform 3. Physician Payments Sunshine Act, S. 301 4. Quality - Physician Quality Reporting Initiative and use of registries for reporting quality measures

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Medicare/Prescription Drug Plan. S.330/H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices and to use the savings to reduce the coverage gap. Medicare/Part D Means Testing. S. Amdt. 805 (to S. Con. Res. 13), S. 677: requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Part D. Medicare/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Combating Waste, Fraud, Abuse. H.R. 27: relating to additional provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare/Therapy Caps. H.R. 43, S. 46: repealing outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authorizing coverage under Part B for medically necessary dental procedures. Medicare/Rural Improvements. H.R. 902, S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125: requiring the reporting of expenditures for nursing services at skilled nursing facilities. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894/S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. H.R. 1407, S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700, H.R. 1708: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for Kidney Transplants. H.R. 1458, S. 565: provision related to continued coverage for immunosuppressive drugs furnished beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765, S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equip- ment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574, S. 254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Physician-Manufacturer Transparency. S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Comparative Effectiveness. S. Amdt. 793 (to S. Con. Res. 13): prohibiting research information comparing the effectiveness of different treatments to deny coverage of products or services under federal health care programs including Medicare. Medicare/Medicaid Reimbursement. S. Amdt. 799 (to S. Con. Res. 13): addressing the systemic inequities of Medicare and Medicaid reimbursement in rural areas. Medicaid/Home and Community-based Long Term Care. S. 434: provision to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid. Medicaid/Community-based Attendant Services and Supports. S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid.