Life Sustaining Treatment Preferences Act of 2009

S. 465, Advance Directive Improvement and Education Act [Sen. Nelson (FL)] to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. Advocating for introduction of Comprehensive LGBT Aging legislation [Rep. Baldwin]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 465, Advance Directive Improvement and Education Act [Sen. Nelson (FL)] to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. Advocating for introduction of Comprehensive LGBT Aging legislation [Rep. Baldwin]

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

S. 465, Advance Directive Improvement and Education Act [Sen. Nelson (FL)] to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care.

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

Increasing Medicare's Resident Limits: "Resident Physician Shortage Reduction Act of 2009" ( S 973/HR 2251); Provider Reimbursement for End of Life Care Counseling: Life Care Sustaining Treatment Preferences Act of 2009 (HR 1898), "Affordable Health Care for America Act, Div. B, Title II; Subtitle C, Section 1233 (HR 3962); Medicare Reimbursement for use of Shared Decision-Making Tools": (HR 2580/S 1133), "Affordable Health Care for America Act", Div. B, Title II, Subtitle C, Section 1236 (HR 3962); Medicare Physician Payments: Averting a 21% Reduction in CY 2010: "Patient Protection and Affordable Care Act" (HR 3590), "Medicare Physician Fairness Act of 2009" (S 1776), "Medicare Physician Payment Reform Act of 2009" (HR 3961) "Continuing Extension Act of 2010" (HR 4851); Maintaining Operating Indirect Medical Education Payments: "Patient Protection and Affordable Care Act" Title V (HR 3590), "Affordable Health Care for America Act" Division B, Title V; Preventing Cuts to Medicare and Medicaid Disproportionate Share Hospital Payments: "Patient Protection and Affordable Care Act," Title II, Subtitle G and Title III, Subtitle B, Part III (HR 3590), Affordable Health Care for America Act, Division B, Title I, Subtitle A, Part II and Division B, Title VII, Subtitle A (HR 3962) "Health Care and Education Affordability Reconciliation Act of 2010 (HR 4872); Preventing Reductions to Medicare Inpatient and Outpatient Payment Rate Updates: "Patient Protection and Affordable Care Act," Title III, Subtitle B, Part III (HR 3590), Affordable Health Care for America Act Division B, Title I (HR 3962), "Health Care and Education Affordability Reconciliation Act of 2010" (HR 4872); Medicare support for Nurse Training: Medicare Graduate Nursing Education Act (HR 3185/S1569), Affordable Health Care for America Act" Title V, Subtitle F (HR 3590); Geographic Variations in Medicare Payments: Affordable Health Care for America Act Division B, Title I, Subtitles B and C (HR 3962), "Patient Protection and Affordable Care Act" Title III (HR 3950), "Health Care and Education Affordability Reconciliation Act of 2010 (HR 4872); Establishment of Independent Medicare advisory Commission:"Patient Protection and Affordable Care Act" Title III, Subtitle E (HR 3590), "Health Care and Education Affordability Reconciliation Act of 2010 (HR 4872); Medicare and Medicaid Health IT Incentive Payments Proposed Rule:"Continuing Extension Act of 2010" (HR 4851); Extension of ARRA Medicaid Federal Matching Assistance Program: "American workers, State and Business Relief Act of 2010" (HR 4213); Medicare payments for clinical laboratories: "Affordable Health Care for America Act" (HR 3590).

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. H.R.3590 The Patient Protection and Affordable Care Act. (House/Senate vehicle for health care reform legislation). .

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

S. 795, the Elder Justice Act, to establish a multi-pronged, coordinated strategy to address elder abuse, neglect, and exploitation at the federal, state, and local levels and H.R. 448 and S. 1821, legislation to authorize the Department of Justice to provide grants to state and local law enforcement agencies, prosecutors and courts for improving the investigation and prosecution of elder abuse and to improve services to victims of such crimes. S. 1150, Advance Planning and Compassionate Care Act of 2009 - supporting components of legislation regarding advance planning and quality treatment of advanced chronic progressive conditions H.R. 1898, the Life Sustaining Treatment Preferences Act of 2009. H.R. 1255, legislation that would pertains to class actions and individuals who reside in intermediate care facilitiesinformation gathering only. General communications regarding issues related to adult guardianship data

Client expense: $290,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Library of Congress (LOC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL)), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R.1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders.

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

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL)), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R.1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders.

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

Extending the Moratoria on the FY2008 Medicaid Intergovernmental Transfer/Cost Limit Regulations and the FY 2008 Medicaid Graduate Education Proposed Rules; Increasing Medicare's Resident Limits: "Resident Physician Shortage Reduction Act of 2009" ( S 973/HR 2251), "America's Healthy Future Act," Title II, Subtitle A (S 1796), "America's Affordable Health Choices Act of 2009" Division B, Title V (HR 3200); Increases in Outlier Payment Threshold: FY 2010 Inpatient PPS Proposed Rule; Provider Reimbursement for End of Life Care Counseling: Life Care Sustaining Treatment Preferences Act of 2009 (HR 1898), "Affordable Health Care for America Act, Div. B, Title II; Subtitle C, Section 1233 (HR 3962), Americas Affordable Health Choices Act of 2009 Div. B, Title II, Subtitle C, Section 1233 (HR 3200); Medicare Reimbursement for use of Shared Decision-Making Tools": (HR 2580/S 1133), "Affordable Health Care for America Act", Div. B, Title II, Subtitle C, Section 1236 (HR 3962), Americas Affordable Health Choices Act of 2009, Div. B, Title II, Subtitle C, Section 1236 (HR 3200); Medicare Physician Payments: Averting a 21% Reduction in CY 2010: "America's Healthy Future Act of 2009" Title III, Subtitles A and B (S 1796), "America's Affordable Health Choices Act of 2009" Division B, Title I, Subtitle B (HR 3200), "Patient Protection and Affordable Care Act" (HR 3950), "Medicare Physican Fairness Act of 2009" (S 1776), "Medicare Physican Payment Reform Act of 2009" (HR 3961); Maintaining Capital Indirect Medical Education Payments: FY 2010 Inpatient Prospective Payment System Proposed Rule; Maintaining Operating Indirect Medical Education Payments: " America's Healthy Future Act of 2009" Title III, Subtitle A (S 1796), "America's Affordable Health Choices Act of 2009" Division B, Title V (HR 3200), "Patient Protection and Affordable Care Act" Title V (HR 3950), "Affordable Health Care for America Act" Division B, Title V; Preventing Cuts to Medicare and Medicaid Disproportionate Share Hospital Payments: Americas Healthy Future Act Title I, Subtitle G, Part VI, Subtitle D (S 1796), Americas Affordable Health Choices Act of 2009 Division B, Title I, Subtitle A and Division B, Title VIII (HR 3200), "Patient Protection and Affordable Care Act," Title II, Subtitle G and Title III, Subtitle B, Part III (HR 3950), Affordable Health Care for America Act, Division B, Title I, Subtitle A, Part II and Division B, Title VII, Subtitle A (HR 3962); Preventing Reductions to Medicare Inpatient and Outpatient Payment Rate Updates: Americas Healthy Future Act Title III, Subtitle B, Part III, Subtitle E (S 1796),Americas Affordable Health Choices Act of 2009 Division B, Title I (HR 3200), "Patient Protection and Affordable Care Act," Title III, Subtitle B, Part III (HR 3950), Affordable Health Care for America Act Division B, Title I (HR 3962); Medicare support for Nurse Training: Medicare Graduate Nursing Education Act (HR 3185/S1569), Affordable Health Care for America Act" Title V, Subtitle F (HR 3590), "America's Healthy Future Act" Title III, Part II, Subpart IV (S 1796); Geographic Variations in Medicare Payments: Americas Healthy Future Act Title III (S 1796), Americas Affordable Health Choices Act of 2009 Division B, Title I, Subtitle C, Sections 1157, 1158, 1159 (HR 3200), Affordable Health Care for America Act Division B, Title I, Subititles B and C (HR 3962), "Patient Protection and Affordable Care Act" Title III (HR 3950); Establishment of Independent Medicare advisory Commission:Americas Healthy Future Act Title III, Subtitle E (S 1796), Americas Affordable Health Choices Act of 2009 (HR 3200), "Patient Protection and Affordable Care Act" Title III, Subtitle E (HR 3590).

H.R. 1898, S. 1150, the Life Sustaining Treatment Preferences Act of 2009 H.R. 1255, To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits on behalf of such resident. S. 795, the Elder Justice Act, to establish a multi-pronged, coordinated strategy to address elder abuse, neglect, and exploitation at the federal, state, and local levels and H.R. 448 and S. 1821, legislation to authorize the Department of Justice to provide grants to state and local law enforcement agencies, prosecutors and courts for improving the investigation and prosecution of elder abuse and to improve services to victims of such crimes---ABA supports S. 1150, Advance Planning and Compassionate Care Act of 2009- supporting components legislation regarding advance planning and quality treatment of advanced chronic progressive conditions,

Client expense: $270,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Library of Congress (LOC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Patent & Trademark Office (PTO), SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R. 1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. H.R.3590 The Patient Protection and Affordable Care Act. (House/Senate vehicle for health care reform legislation). .

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

Improving Health Insurance Coverage: "Healthy Americans Act" (S 391), "America's Affordable Health Choices Act of 2009" (HR 3200), "Affordable Health Choices Act" (S 1679); Hospital Transparency; Health Professions Shortages Including Capitation Grants for Nursing Schools, "Nurse Education, Expansion and Development Act" (S 497/HR 2043), End of Life Care: "Life Sustaining Treatment Preferences Act of 2009" (HR 1898); Expanding Comparative Effectiveness Research: "Comparative Effectiveness Research Act of 2009" (HR 2502), "Patient-Centered Outcomes Research Act of 2009" (S 1213); Follow-on Biologics: "Pathway for Biosimilars Act of 2009" (HR 1548); Inclusion of Academic Health Centers in Health Care Reform Through the Creation of Healthcare Innovation Zones (HR 3134); Provider Reimbursements Associated With Expansion of Health Insurance Coverage, "America's Affordable Health Choices Act of 2009" (HR 3100), "Affordables Health Choices Act" (S 1679).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S.

Extending the Moratoria on the FY2008 Medicaid Intergovernmental Transfer/Cost Limit Regulations and the FY 2008 Medicaid Graduate Education Proposed Rules; Increasing Medicare's Resident Limits: Resident Physician Shortage Reduction Act of 2009 (S 973/HR 2251); Increases in Outlier Payment Threshold: FY2010 Inpatient PPS Proposed Rule; Provider Reimbursement for End of Life Care Counseling: Life Care Sustaining Treatment Preferences Act of 2009 (HR 1898); Provider Reimbursement for use of "Shared Decision-Making Tools" (HR 2580/S 1133); Medicare Value Based Purchasing; Medicare Physician Payments - Preventing a 21% Reduction in CY2010; Maintaining Medicare Operating and Capital Indirect Medical Education Payments: FY 2010 Inpatient Prospective Payment System Proposed Rule; Preventing Cuts to Medicare and Medicaid Disproportionate Share Hospital Payments; Medicare and Medicaid Health Information Technology Incentive Payments; Preventing Reductions to Medicare Inpatient and Outpatient Payment Rate Updates; Medicare Support for Nurse Training, "Medicare Graduate Nursing Education Act (HR 3185/S 1569); Geographic Variation in Medicare Payments, "America's Affordable Health Choices Act of 2009 (HR 3200); Medicare Reimbursement for Health Homes.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S.

H.R. 448, Elder Abuse Victims Act of 2009, would authorize the Department of Justice to provide grants to state and local law enforcement agencies, prosecutors and courts for improving the investigation and prosecution of elder abuse and to improve services to victims of such crimes H.R. 1898, the Life Sustaining Treatment Preferences Act of 2009

Client expense: $290,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Library of Congress (LOC), Office of Management & Budget (OMB), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL)), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R.1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care. House Tri-Committee health care reform legislation.

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

PL 111-5, American Recovery and Reinvestment Act of 2009 - Issues related to health care reform and comparative effectiveness implementation. HR 1050, Human Cloning Prohibition Act of 2009 - Issues related to consumer protection in health care. HR 1174, FEMA Independence Act of 2009 - Issues related to infection and readmissions bundling. HR 1188, Access to Emergency Medical Services Act of 2009 - Issues related to emergency medical systems reform. HR 1427, Promoting Innovation and Access to Life-Saving Medicine Act - Issues related to biogenics. HR 1898, Life Sustaining Treatment Preferences Act of 2009 - Issues related to end of life care. HR 2427, Informed Consumer Choices in Health Care Act of 2009 - Issues related to insurance structure. HR 2525, Safeguarding Our Hospitals' Futures Act of 2009. HR 2937, MRSA Infection Prevention and Patient Protection Act. S 468, Access to Emergency Medical Services Act of 2009 - Issues related to emergency medical systems reform. S 726, Promoting Innovation and Access to Life-Saving Medicine Act - Issues related to generic biologics. S 1213, Patient-Centered Outcomes Research Act of 2009 - Issues related to comparative effectiveness and health disparities. Issues related to health care reform. Health care issues related to small business owners. Issues related to health information technology. Issues related to health care delivery system and payment reforms. Issues related to insurance coverage options. Issues related to health care financing options. Issues related to hospital infections and medical errors. Issues related to medical disparities and comparative effectiveness. Issues related to insurance connectors. Issues related to the elimination of childhood pre-existing conditions. Issues related to health safety and consumer choice proposals. Issues related to lower prescription drug costs. Issues related to drug import and medical safety device. Issues related to patient safety call.

Extending the Moratoria on the FY2008 Medicaid Intergovernmental Transfer/Cost Limit Regulations and the FY 2008 Medicaid Graduate Education Proposed Rules; Increasing Medicare's Resident Limits: Resident Physician Shortage Reduction Act of 2009 (S. 973/HR 2251); Increases in Outlier Payment Threshold: FY2010 Inpatient PPS Proposed Rule; Provider Reimbursement for End of Life Care Counseling: Life Care Sustaining Treatment Preferences Act of 2009 (HR 1898); Provider Reimbursement for use of "Shared Decision-Making Tools" (HR 2580/S. 1133); Medicare Value Based Purchasing; Medicare Physician Payments - Preventing a 21% Reduction in CY2010; Maintaining Medicare Operating and Capital Indirect Medical Education Payments: FY 2010 Inpatient Prospective Payment System Proposed Rule; Preventing Cuts to Medicare and Medicaid Disproportionate Share Hospital Payments; Medicare and Medicaid Health Information Technology Incentive Payments; Preventing Reductions to Medicare Inpatient and Outpatient Payment Rate Updates.

Client expense: $210,000 · Firm income: Not reported

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

Improving Health Insurance Coverage: Healthy Americans Act (S 391); Hospital Transparency, Health Professions Shortages, End of Life Care: Life Sustaining Treatment Preferences Act of 2009 (HR 1898); Expanding Comparative Effectiveness Research: Comparative Effectiveness Research Act of 2009 (HR 2502); Patient-Centered Outcomes Research Act of 2009 (S 1213); Follow-on Biologics: Pathway for Biosimilars Act of 2009 (HR 1548).

Client expense: $210,000 · Firm income: Not reported

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

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL)), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R.1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. S. 1150/H.R. 2911Advance Planning and Compassionate Care Act of 2009, A bill to improve end-of-life care.

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

Improving Health Insurance Coverage: Healthy Americans Act (S 391); Hospital Transparency, Health Professions Shortages, End of Life Care: Life Sustaining Treatment Preferences Act of 2009 (HR 1898); Expanding Comparative Effectiveness Research The American Recovery and Reinvestment Act of 2009 (HR 1): Health Information Privacy: The American Recovery and Reinvestment Act of 2009 (HR 1).

Client expense: $65,226 · Firm income: Not reported

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

S. 465, Advance Directive Improvement and Education Act (Sen. Nelson (FL)), to improve access to information about individuals' health care options and legal rights for care near the end of life, to promote advance care planning and decision making so that individuals' wishes are known should they become unable to speak for themselves, continued on next page... Continued: S. 465, to engage health care providers in disseminating information about and assisting in the preparation of advance directives, which include living wills and durable powers of attorney for health care, and for other purposes. H.R. 2994, National Pain Care Policy Act (Rep. Capps), to amend the Public Health Service Act with respect to pain care. H.R. 7181, Life Sustaining Treatment Preferences Act of 2008 (Rep. Blumenauer). To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders. H.R.1898, Life Sustaining Treatment Preferences Act of 2009, to amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program for consultations regarding orders for life sustaining treatment and to provide grants for the development and expansion of programs for such orders.

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