Resident Physician Shortage Reduction Act of 2009

H.R.1409/S.560, Employee Free Choice Act, Labor related issues. H.R.2273, Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, Nurse staffing requirement issues. S.1031, National Nusring Shortage Reform and Patient Advocacy Act, Nurse staffing requirement issues. S.3135/H.R.2536, Emergency Nursing Supply Relief Act, Nurse workforce related issues. S.829/H.R.989, Patriot Employers Act, Tax credit related issues. S.914, Physician Workforce Enhancement Act of 2009, Physician Residency program issues. S.973/H.R.2251, Resident Physician Shortage Reduction Act of 2009, Physician residency training positions. S.1788/H.R.2381, Nurse and Health Care Worker Protection Act, Worker safety issues. S.3491/H.R.5527, Registered Nuse Staffing Act of 2010, Nurse staffing issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3590 The Patient Protection and Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4851 The Continuing Extension Act of 2010 - All provisions related to Medicare physician payments, and physician and hospital eligibility for health care information technology/electronic health records incentive payments. H.R. 2251 and S.973 Resident Shortage Reduction Act of 2009. All provisions related to graduate medical education. S. 1776 Medicare Physician Fairness Act of 2009. All provisions concerning the Medicare Physician Fee Schedule. H.R. 4691 Temporary Extension Act of 2010 - All provisions related to Medicare physician payments. H.R. 4213 The American Workers, State, and Business Relief Act of 2010. All provisions related to Medicare physician payments and Medicaid Federal Medical Assistance Payments (FMAP) to states associated with the American Recovery and Reinvestment Act of 2009. H.R. 3962 Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 Medical and health care policy matters concerning post-Katrina disaster assistance for New Orleans area hospitals, and health care/Medicaid reform initiatives in Louisiana including adjustments and extensions related to Medicaid Federal Medical Assistance Payments (FMAP) for states associated with the American Recovery and Reinvestment Act of 2009. Medicare and Medicaid incentive payments for physicians and hospitals associated with the use of electronic health records. H.R. 6072 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010. All provisions concerning Medicare and Medicaid incentive payments for physicians and hospitals associated with the use of electronic health records. S. 3708 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010. All provisions concerning Medicare and Medicaid incentive payments for physicians and hospitals associated with the use of electronic health records. H.R. 5712 Veterans', Seniors', and Children's Health Technical Corrections Act of 2010 H.R. 1586 Education, Jobs and Medicaid Funding Bill/FAA Air Transportation Modernization and Safety Improvement Act. All provisions related to Medicaid. H.R. 5712 The Physician Payment and Therapy Relief Act of 2010. All provisions concerning the Medicare Phyusician Fee Schedule. H.R. 4994 Medicare and Medicaid Extenders Act of 2010. All provisions concerning the Medicare Phyusician Fee Schedule and graduate medical education. H.R. 6427 Medicare Phyhsician Payment Update Extension Act. All provisions concerning the Medicare Phyusician Fee Schedule.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

H.R. 3590 The Patient Protection and Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4851 The Continuing Extension Act of 2010 - All provisions related to Medicare physician payments, and physician and hospital eligibility for health care information technology/electronic health records incentive payments. H.R. 2251 and S.973 Resident Shortage Reduction Act of 2009. All provisions related to graduate medical education. S. 1776 Medicare Physician Fairness Act of 2009. All provisions concerning the Medicare Physician Fee Schedule. H.R. 4691 Temporary Extension Act of 2010 - All provisions related to Medicare physician payments. H.R. 4213 The American Workers, State, and Business Relief Act of 2010. All provisions related to Medicare physician payments and Medicaid Federal Medical Assistance Payments (FMAP) to states associated with the American Recovery and Reinvestment Act of 2009. H.R. 3962 Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 Medical and health care policy matters concerning post-Katrina disaster assistance for New Orleans area hospitals, and health care/Medicaid reform initiatives in Louisiana including adjustments and extensions related to Medicaid Federal Medical Assistance Payments (FMAP) for states associated with the American Recovery and Reinvestment Act of 2009. H.R. 6072 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010. All provisions concerning Medicare and Medicaid incentive payments for physicians and hospitals associated with the use of electronic health records. S. 3708 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010. All provisions concerning Medicare and Medicaid incentive payments for physicians and hospitals associated with the use of electronic health records. H.R. 5712 Veterans', Seniors', and Children's Health Technical Corrections Act of 2010 H.R. 1586 Education, Jobs and Medicaid Funding Bill/FAA Air Transportation Modernization and Safety Improvement Act. All provisions related to Medicaid. H.R. 4994 Medicare and Medicaid Extenders Act of 2010. All provisions related to Medicare physician payments and graduate medical education. H.R. 6427 Medicare Phyhsician Payment Update Extension Act. All provisions related to Medicare physician payments. S. 3686 Departments of Labor, Health and Human Services and Education, and Related Agencies Appropriations Act, 2011. All provisions related to biomedical education and research. H.R. 3081 Continuing Appropriations Act, 2011. All provisions related to biomedical education and research. H.R. 5712 The Physician Payment and Therapy Relief Act of 2010. All provisions related to Medicare physician payments.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

FY2011 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act (provisions related to funding levels for NIH, the National Children's Study, Title VII, open access, and racial disparities medical research) H.R. 2251/S. 973, Resident Physician Shortage Reduction Act of 2009 H.R. 598, Elimination of the indirect medical education adjustment to teaching hospitals Healthcare reform and graduate medical education policies, generally

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

Budget Negotiations FY2011 Graduate Medical Education (increasing slots) Medicaid Intergovernmental transfer and FMAP funding (public hospital definition) American Recovery and Reinvestment Act Medicaid 340(b) Program Medicaid Graduate Medical Education (GME) funding Medicare Recovery Audit Committee HR 3962- America's Affordable Health Choices Act of 2009 Senate Bill- (H.R.3590) Patient Protection and Affordable Care Act Health Care and Education Reconciliation Act of 2010 (H.R.4872) Resident Physician Shortage Reduction Act (S973) (HR 2251) FY 2011 Medicare Inpatient PPS Proposed Rule and Supplemental Proposed Rule

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

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

Monitor legislation and advise client as to how it affects them. Labor, HHS, & Education Appropriations FY 2011 C.R, Medical Assistance Percentages (FMAP) program, CAP IME, Patient Protection and Affordable Care Act (H.R.3590), Affordable Health Choices Act (S.1679), America's Healthy Future Act of 2009 (S.1796), Reconciliation Act of 2010 (H.R.4872). Electronic Health Record Incentives for Multi Campus Hospitals Act of 2010 (S. 3078, H.R. 6072), Medicare hospital reimbursement issues and Medicare graduate medical education reimbursement issues (American Recovery and Reinvestment Act of 2009, H.R. ; 42 CFR 413.79; Resident Physician Shortage Reduction Act (H.R. 2251/S. 973); Medicare physician payment adjustment (HR. 3961, S.1776, H.R.3326, H.R. 3590, H.R. 4851, S. 3153, H.R. 4213); Section 508 wage index extension and gain sharing extension (H.R. 4213); HIT incentive payment legislation affecting hospitals and physicians in response to proposed rule CMS-0033-P (H.R. 4851, S. 3153, H.R. 4213); Medicare 72-hour payment window limitation (H.R.4213); HIT incentive payments and meaningful use requirements in final rule CMS-0033-F (H.R. 6072, S. 3708)

Client expense: Not reported · Firm income: Not reported

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

Medicare hospital reimbursement issues and Medicare graduate medical education reimbursement issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L. 111-5) provisions related to moratorium on Medicare capital IME regulation (CMS 1390-F, CMS-1406-P), Medicare HIT investments and requirements; 42 CFR 413.79; President Obama proposals on Medicare bundled payments, reimbursement for readmissions, value-based purchasing (Budget Resolutions, H Con Res 312, S Con Res 70); Resident Physician Shortage Reduction Act (H.R. 2251/S. 973); Medicare provisions in various health care reform proposals (including disproportionate share hospital, GME, bundling, readmissions, value-based purchasing, wage index, market basket, gainsharing, and other provisions in the Affordable Health Care for America Act (H.R.3962); Patient Protection and Affordable Care Act (H.R.3590, P.L. 111-148)); and Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872), P.L. 111-152); Medicare Commission legislation (S.1110, S. 1380, H.R.2718), provisions that would empower a Commission to implement Medicare policy changes; geographic variation legislation (H.R. 2844, H.R. 2919, H.R. 2921, H.R. 2201, S.Amdt. 887) affecting hospitals and/or physician payment policy; value-based purchasing legislation (H.R. 1776); other workforce legislation (H.R. 1946, S.1569)); Puerto Rico Medicare Parity (H.R. 2680, H.R. 1501, H.R.1502); Medicare physician payment adjustment (HR. 3961, S.1776, H.R.3326, H.R. 3590, H.R. 4851, S. 3153, H.R. 4213); Section 508 wage index extension and gainsharing extension (H.R. 4213); HIT incentive payment legislation affecting hospitals and physicians in response to proposed rule CMS-0033-P (H.R. 4851, S. 3153, H.R. 4213); Medicare 72-hour payment window limitation (H.R.4213); HIT incentive payments and meaningful use requirements in final rule CMS-0033-F (H.R. 6072, S. 3708); the "coding offset" in the proposed and final Medicare inpatient prospective payment system rule for 2011 (CMS-1498); the Medicare and Medicaid Extenders Act (H.R. 4994, later P.L. 111-309); and cancer hospital Medicare payment issues. Medicaid issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L.111-5) and ARRA FMAP Extension (H.R. 4263, H.R. 2847, H.R.4213) provisions related to the Federal Medical Assistance Percentage, provisions related to disproportionate share hospitals, moratoria on Medicaid regulations (CMS-2258-FC,CMS-2279-P, CMS-2213-P, CMS-2275-F, CMS-2287-P), and HIT investments; Medicaid provisions in various health care reform proposals (including the American Health Care Choices Act (Senate HELP Committee bill (S.1679), Affordable Healthcare for America Act (H.R. 3962), Patient Protection and Affordable Care Act (H.R. 3590, P.L. 111-148), and the Health and Education Affordability Reconciliation Act of 2010 (H.R. 4872, P.L. 111-152)), including disproportionate share hospital and FMAP provisions; New York State 1115 Medicaid waiver Partnership Plan extension (11-W-00114/2) provisions related to hospitals; the Medicaid Emergency Psychiatric Care Demonstration Project Act of 2009 (S.1130/H.R.1415); Medicaid incentives for HIV screening (H.R. 3091/S.1446)); HIT incentive payment legislation affecting hospitals and physicians in response to proposed rule CMS-0033-P (H.R. 4851, S. 3153, H.R. 4213); HIT incentive payments and meaningful use requirements in final rule CMS-0033-F (H.R. 6072, S.3708); and the Medicare and Medicaid Extenders Act (H.R. 4994, later P.L. 111-309).

Client expense: $380,000 · Firm income: Not reported

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

H.R.2251, S 973, Resident Physician Shortage Reduction Act of 2009. Medicare and Medicaid reimbursement issues, Graduate Medical Education.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 444 - The 340B Program Improvement and Integrity Act of 2009 S. 1239 - The 340B Program Improvement and Integrity Act of 2009 S. 973, H.R. 2251 - Resident Physician Shortage Reduction Act S. 1776 - The Medicare Physician Fairness Act of 2009 H.R. 3961 - Medicare Physician Payment Reform Act of 2009

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.973/H.R. 2251 - Residency slots Graduate Medcial Education funding

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

American Health Security Act (H.R. 1200); Access for All America Act (H.R. 1296/S.486); Primary Care Volunteer Incentive Act (H.R. 1185); Health Access and Health Professions Supply Act (S.790); Title VII Reauthorization (S.1720); Conrad State 30 Improvement Act (S.628); Recognizing the value of community health centers (HCon.Res.144/S.Con.Res.25). Tri-Caucus Health Equity and Accountant Act; Health Information Technology Public Utility Act of 2009 (S.890); Womens Medical House Demonstration Act (S.1303); Family Healthcare Accessibility Act (H.R.1745); Community Coalitions for Access and Quality Improvement Act (H.R.1614/S.652); Health Access and Health Professions Supply Act (S.790); GAO Study request on VA/CHCs Act (no bill#); Affordable Health Choices Act (H.R.3200); Resident Physician Shortage Act (S.973/H.R.2251); Seniors Mental Health Access Improvement Act (H.R.1693/S.671); Public Health Workforce Development Act (H.R.2620/S.1143); Helping Fill the Medicine Rx Gap Act (H.R.2777/S.1201); Primary Care Training Enhancement Act (H.R.2930); Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act (S.1404); Community & Rural Medical Residency Preservation Act (S.1300) Americas Healthy Future Act of 2009, Chairmans Mark Senate Finance Committee; MedPAC Reform Act of 2009 (S.1110); Consumers Health Care Act of 2009 (S.1278); Preserving Patient Access to Primary Care Act of 2009 (H.R.2350); Senate HELP Affordable Health Choices Act (S.1679); Medicare Telehealth Enhancement Act of 2009 (H.R.2068); Medicare Transition Care Act of 2009 (S.1295); School Based Health Clinic Establishment Act of 2009 (H.R.3003); DSH Collaborative Care Network Pilot Program Act of 2009 (H.R.3430); Affordable Health Care for America Act (H.R.3962); The Patient Protection and Affordable Care Act (H.R.3590); Community-Based Residency Training Act (H.R.4409); Reconciliation Act of 2010 (H.R.4872); EHR Clarification for health centers (H.R.6348); Senate EHR/HIT Clarification; Vision Preservation Act (draft).

Client expense: $170,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

FY2011 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act (provisions related to funding levels for NIH, the National Children's Study, Title VII, open access, and racial disparities medical research) H.R. 2251/S. 973, Resident Physician Shortage Reduction Act of 2009 H.R. 598, Elimination of the indirect medical education adjustment to teaching hospitals Healthcare reform and graduate medical education policies, generally

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comments to CMS proposed rule defining meaningful use of electronic Health Records concern that the rules will severely limit hospitals' ability to access federal financing for health information technology and put many hospitals at risk for Medicare payment penalties beginning in 2015; FDA Grants Hospitals 18 Months to Replace Steris System 1 Processor; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake; HR 4700 The Transparency in All Health Care Pricing Act of 2010, to provide for transparency in health care pricing; HR 4803 The Patients Right to Know Act, to ensure health care consumer and provider access to certain health benefits plan information and to amend title XIX of the Social Security Act to provide transparency in hospital price and quality information; HR 6072 and S 3708 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010, to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 6376 to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services

Client expense: $4,270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

H.R.1409/S.560, Employee Free Choice Act, Labor related issues. H.R.2273, Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, Nurse staffing requirement issues. S.1031, National Nusring Shortage Reform and Patient Advocacy Act, Nurse staffing requirement issues. S.3135/H.R.2536, Emergency Nursing Supply Relief Act, Nurse workforce related issues. S.829/H.R.989, Patriot Employers Act, Tax credit related issues. S.914, Physician Workforce Enhancement Act of 2009, Physician Residency program issues. S.973/H.R.2251, Resident Physician Shortage Reduction Act of 2009, Physician residency training positions. S.1788/H.R.2381, Nurse and Health Care Worker Protection Act, Worker safety issues. S.3491/H.R.5527, Registered Nuse Staffing Act of 2010, Nurse staffing issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.914, Physician Workforce Enhancement Act of 2009, Physician workforce related issues. H.R.1468, Medical Justice Act of 2009, Medical liability related issues. H.R.936/S.733, National Trauma Center Stabilization Act of 2009, Emergency readiness and trauma related issues. General monitoring on Not-for-profit hospitals charity care and community benefits. S.391, Healthy Americans Act, Health care reform. H.R.193, AmeriCare Health Insurance Act of 2009, Health care reform. H.R.2251/S.973, Resident Physician Shortage Reduction Act of 2009, Physician workforce related issues. Health care reform, Hospital related issues and initiatives. S.1640, Take Back Your Health Act of 2009, Hospital related issues and initiatives. Public Law 110-343, Patient Protection and Affordable Care Act, Hospital related issues and initiatives. Public Law 111-148, The Patient Protection and Affordable Care Act, Hospital related issues and initiatives. Public Law 111-152, Health Care and Education Reconciliation Act of 2010, Hospital related issues and initiatives. H.R.4213, American Jobs and Closing Tax Loopholes Act of 2010, Medicare payment related issues; and Build America Bonds program issues. H.R.6005, Ensuring Equality fo rearly EHR Adoption Act, Hospital Information Technology issues. S.3708/H.R.6072, Electronic Health Record Incentives for Multi Campus Hospitals Act, Hospital Information Technology issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3590 The Patient Protection and Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4851 The Continuing Extension Act of 2010 - All provisions related to Medicare physician payments, and physician and hospital eligibility for health care information technology/electronic health records incentive payments. H.R. 2251 and S.973 Resident Shortage Reduction Act of 2009. All provisions related to graduate medical education. S. 1776 Medicare Physician Fairness Act of 2009. All provisions concerning the Medicare Physician Fee Schedule. H.R. 4691 Temporary Extension Act of 2010 - All provisions related to Medicare physician payments. H.R. 4213 The American Workers, State, and Business Relief Act of 2010. All provisions related to Medicare physician payments and Medicaid Federal Medical Assistance Payments (FMAP) to states associated with the American Recovery and Reinvestment Act of 2009. H.R. 3962 Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 Medical and health care policy matters concerning post-Katrina disaster assistance for New Orleans area hospitals, and health care/Medicaid reform initiatives in Louisiana including adjustments and extensions related to Medicaid Federal Medical Assistance Payments (FMAP) for states associated with the American Recovery and Reinvestment Act of 2009. Medicare and Medicaid incentive payments for physicians and hospitals associated with the use of electronic health records. H.R. 6072 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010 S. 3708 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010 H.R. 5712 Veterans', Seniors', and Children's Health Technical Corrections Act of 2010 H.R. 1586 Education, Jobs and Medicaid Funding Bill/FAA Air Transportation Modernization and Safety Improvement Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

H.R. 3590 The Patient Protection and Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4851 The Continuing Extension Act of 2010 - All provisions related to Medicare physician payments, and physician and hospital eligibility for health care information technology/electronic health records incentive payments. H.R. 2251 and S.973 Resident Shortage Reduction Act of 2009. All provisions related to graduate medical education. S. 1776 Medicare Physician Fairness Act of 2009. All provisions concerning the Medicare Physician Fee Schedule. H.R. 4691 Temporary Extension Act of 2010 - All provisions related to Medicare physician payments. H.R. 4213 The American Workers, State, and Business Relief Act of 2010. All provisions related to Medicare physician payments and Medicaid Federal Medical Assistance Payments (FMAP) to states associated with the American Recovery and Reinvestment Act of 2009. H.R. 3962 Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 Medical and health care policy matters concerning post-Katrina disaster assistance for New Orleans area hospitals, and health care/Medicaid reform initiatives in Louisiana including adjustments and extensions related to Medicaid Federal Medical Assistance Payments (FMAP) for states associated with the American Recovery and Reinvestment Act of 2009. Medicare and Medicaid incentive payments for physicians and hospitals associated with the use of electronic health records. H.R. 6072 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010 S. 3708 Electronic Health Record Incentives for Multi-Campus Hospitals Act of 2010 H.R. 5712 Veterans', Seniors', and Children's Health Technical Corrections Act of 2010 H.R. 1586 Education, Jobs and Medicaid Funding Bill/FAA Air Transportation Modernization and Safety Improvement Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

HR 1704/S. 682, The Mental Health on Campus Improvement Act, entire bill. HR 872, Stem Cell Research Improvement Act of 2009, entire bill. HR 873/S. 487, Stem Cell Research Enhancement Act of 2009, entire bill. S. 973/HR 2251, Resident Physician Shortage Reduction Act, entire bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare hospital reimbursement issues and Medicare graduate medical education reimbursement issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L. 111-5) provisions related to moratorium on Medicare capital IME regulation (CMS 1390-F, CMS-1406-P), Medicare HIT investments and requirements; 42 CFR 413.79; President Obama proposals on Medicare bundled payments, reimbursement for readmissions, value-based purchasing (Budget Resolutions, H Con Res 312, S Con Res 70); Resident Physician Shortage Reduction Act (H.R. 2251/S. 973); Medicare provisions in various health care reform proposals (including disproportionate share hospital, GME, bundling, readmissions, value-based purchasing, wage index, market basket, gainsharing, and other provisions in the Affordable Health Care for America Act (H.R.3962); Patient Protection and Affordable Care Act (H.R.3590, P.L. 111-148)); and Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872), P.L. 111-152); Medicare Commission legislation (S.1110, S. 1380, H.R.2718), provisions that would empower a Commission to implement Medicare policy changes; geographic variation legislation (H.R. 2844, H.R. 2919, H.R. 2921, H.R. 2201, S.Amdt. 887) affecting hospitals and/or physician payment policy; value-based purchasing legislation (H.R. 1776); other workforce legislation (H.R. 1946, S.1569)); Puerto Rico Medicare Parity (H.R. 2680, H.R. 1501, H.R.1502); Medicare physician payment adjustment (HR. 3961, S.1776, H.R.3326, H.R. 3590, H.R. 4851, S. 3153, H.R. 4213); Section 508 wage index extension and gainsharing extension (H.R. 4213); HIT incentive payment legislation affecting hospitals and physicians in response to proposed rule CMS-0033-P (H.R. 4851, S. 3153, H.R. 4213); Medicare 72-hour payment window limitation (H.R.4213); HIT incentive payments and meaningful use requirements in final rule CMS-0033-F (H.R. 6072, S. 3708); and the "coding offset" in the proposed and final Medicare inpatient prospective payment system rule for 2011 (CMS-1498). Medicaid issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L.111-5) and ARRA FMAP Extension (H.R. 4263, H.R. 2847, H.R.4213) provisions related to the Federal Medical Assistance Percentage, provisions related to disproportionate share hospitals, moratoria on Medicaid regulations (CMS-2258-FC,CMS-2279-P, CMS-2213-P, CMS-2275-F, CMS-2287-P), and HIT investments; Medicaid provisions in various health care reform proposals (including the American Health Care Choices Act (Senate HELP Committee bill (S.1679), Affordable Healthcare for America Act (H.R. 3962), Patient Protection and Affordable Care Act (H.R. 3590, P.L. 111-148), and the Health and Education Affordability Reconciliation Act of 2010 (H.R. 4872, P.L. 111-152)), including disproportionate share hospital and FMAP provisions; New York State 1115 Medicaid waiver Partnership Plan extension (11-W-00114/2) provisions related to hospitals; the Medicaid Emergency Psychiatric Care Demonstration Project Act of 2009 (S.1130/H.R.1415); Medicaid incentives for HIV screening (H.R. 3091/S.1446)); HIT incentive payment legislation affecting hospitals and physicians in response to proposed rule CMS-0033-P (H.R. 4851, S. 3153, H.R. 4213); and HIT incentive payments and meaningful use requirements in final rule CMS-0033-F (H.R. 6072, S.3708).

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

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

Budget Negotiations FY2011 Graduate Medical Education (increasing slots) Medicaid Intergovernmental transfer and FMAP funding (public hospital definition) American Recovery and Reinvestment Act Medicaid 340(b) Program Medicaid Graduate Medical Education (GME) funding Medicare Recovery Audit Committee HR 3962- America's Affordable Health Choices Act of 2009 Senate Bill- (H.R.3590) Patient Protection and Affordable Care Act Health Care and Education Reconciliation Act of 2010 (H.R.4872) Resident Physician Shortage Reduction Act (S973) (HR 2251) FY 2011 Medicare Inpatient PPS Proposed Rule and Supplemental Proposed Rule

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

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

H.R.2251, S 973, Resident Physician Shortage Reduction Act of 2009. Medicare and Medicaid reimbursement issues, Graduate Medical Education.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 973/HR 2251, Resident Physician shortage Reductions Act of 2009, To amend title XVIII of the Social Security Act (SSA) to provide the distributions of additional residency positions, and for other purposes, S 1355, Rural Health Clinic Patient Access and Improvement Act of undeserved rural area and for other purposes HR 2350, Preserving Patient Access of Primary Care Act of 2009, to amend the Public Health Service Act and the SSA to increase the number of primary care physicians and primary care provider and to improve patient access to primary care services and physicians and primary care provider and to improve patient access to primary care services and for other purposes. HR 2176, Nursing and Allied Health Education Preservations Act of 2009, to amend title XVIII of SSA to continue the ability of hospitals to supply a needed workforce of nurses and allied health professional by preserving funding for hospitals operating nursing and allied health educations programs. S 935/HR 2124 Medicare Long-Term Care Hospital Improvement Act of 2009, to extend subsections (c) and (d) of sections 114 of the Medicare,Medicaid and SCHIP Extension Act of 2007 to provide for regulatory stability during the development of facility and patients criteria for long-term care hospitals under the Medicare Program and for other purposes. S 254/HR 254 Medicare Home Infusion Therapy coverage Act of 2009., to amend title XVIII of the Social Security Act to provide for the coverage of home infusion therapy under the Medicare Program HR 1776, Quality FIRST, to amend title XVIII of the SSA to implement a performance-based payment methodology for the provisions of such service under the Medicare Program, and for other purposes. S 1796/ HR 3200 Americans Healthy Future Act. Senate bill, all Medicare provisions, to provide affordable, quality hearth care for all Americans and reduce the growth in health care spending, and for other purposes HR 2753, Inpatient Psychiatric Service for Individuals Under Aged 21 in Psychiatric Facilities or Programs, 42 CFR 441.151. (a)(2), centers for Medicare and Medicaid Services. To delay the implementations of new Medicare hospital geographic wage reclassifications criteria until the Secretary of Heath and Human Services issues a proposal to revise the hospital wage index classifications system that addresses certain considerations. S 1679/ HR 3962 Affordable Health Choices Act, entire bill, an original bill to make quality, affordable health care available to all Americans, reduce the cost, improve health care quality all Americans and reduce the growth in health care spending and for other purposes. HR 3961, Medicare Physician Payments Reforms Act of 2009. entire bill, to amend title XVIII of the Social Security Act to reform the Medicare SGR payment system for physicians and to reinstitution and update the Pay-As-you- Go requirements of budget neutrally on new tax and mandatory spending legislation, enforces by the of annual automatic sequestrations. HR 3590 - the Patient Protections and Affordable Care Act, entire bill, An act entitled The Patient Protection and Affordable Care Act. HR 4851 - The Continuing Extension of Act 2010 HR 4691- Temporary Extension Act 2010 HR 4872, Health Care and Education Reconciliation Act of 2010 HR 2847 - Hiring Incentive to Restore Employment HR 4213, American Workers, State and Business Relief Incentive Program CMS Proposed Rule: Electronic Health Record Incentive Program CME Interim Final Rule: Health Information's Technology, Initial Set of Standards, Implementations Specification and Certification Criteria for Electronic Health Record Technology

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

American Health Security Act (H.R. 1200); Access for All America Act (H.R. 1296/S.486); Primary Care Volunteer Incentive Act (H.R. 1185); Health Access and Health Professions Supply Act (S.790); Title VII Reauthorization (S.1720); Conrad State 30 Improvement Act (S.628); Recognizing the value of community health centers (HCon.Res.144/S.Con.Res.25). Tri-Caucus Health Equity and Accountant Act; Health Information Technology Public Utility Act of 2009 (S.890); Womens Medical House Demonstration Act (S.1303); Family Healthcare Accessibility Act (H.R.1745); Community Coalitions for Access and Quality Improvement Act (H.R.1614/S.652); Health Access and Health Professions Supply Act (S.790); GAO Study request on VA/CHCs Act (no bill#); Affordable Health Choices Act (H.R.3200); Resident Physician Shortage Act (S.973/H.R.2251); Seniors Mental Health Access Improvement Act (H.R.1693/S.671); Public Health Workforce Development Act (H.R.2620/S.1143); Helping Fill the Medicine Rx Gap Act (H.R.2777/S.1201); Primary Care Training Enhancement Act (H.R.2930); Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act (S.1404); Community & Rural Medical Residency Preservation Act (S.1300) Americas Healthy Future Act of 2009, Chairmans Mark Senate Finance Committee; MedPAC Reform Act of 2009 (S.1110); Consumers Health Care Act of 2009 (S.1278); Preserving Patient Access to Primary Care Act of 2009 (H.R.2350); Senate HELP Affordable Health Choices Act (S.1679); Medicare Telehealth Enhancement Act of 2009 (H.R.2068); Medicare Transition Care Act of 2009 (S.1295); School Based Health Clinic Establishment Act of 2009 (H.R.3003); DSH Collaborative Care Network Pilot Program Act of 2009 (H.R.3430); Affordable Health Care for America Act (H.R.3962); The Patient Protection and Affordable Care Act (H.R.3590); Community-Based Residency Training Act (H.R.4409); Reconciliation Act of 2010 (H.R.4872).

Client expense: $180,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 3590 The Patient Protection and Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4851 The Continuing Extension Act of 2010 - All provisions related to Medicare physician payments, and physician and hospital eligibility for health care information technology/electronic health records incentive payments. H.R. 2251 and S.973 Resident Shortage Reduction Act of 2009. All provisions related to graduate medical education. S. 1776 Medicare Physician Fairness Act of 2009. All provisions concerning the Medicare Physician Fee Schedule. H.R. 4691 Temporary Extension Act of 2010 - All provisions related to Medicare physician payments. H.R. 4213 The American Workers, State, and Business Relief Act of 2010. All provisions related to Medicare physician payments and Medicaid Federal Medical Assistance Payments (FMAP) to states associated with the American Recovery and Reinvestment Act of 2009. H.R. 3962 Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 Medical and health care policy matters concerning post-Katrina disaster assistance for New Orleans area hospitals, and health care/Medicaid reform initiatives in Louisiana including adjustments and extensions related to Medicaid Federal Medical Assistance Payments (FMAP) for states associated with the American Recovery and Reinvestment Act of 2009.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

H.R. 3590 The Patient Protection and Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4851 The Continuing Extension Act of 2010 - All provisions related to Medicare physician payments, and physician and hospital eligibility for health care information technology/electronic health records incentive payments. H.R. 2251 and S.973 Resident Shortage Reduction Act of 2009. All provisions related to graduate medical education. S. 1776 Medicare Physician Fairness Act of 2009. All provisions concerning the Medicare Physician Fee Schedule. H.R. 4691 Temporary Extension Act of 2010 - All provisions related to Medicare physician payments. H.R. 4213 The American Workers, State, and Business Relief Act of 2010. All provisions related to Medicare physician payments and Medicaid Federal Medical Assistance Payments (FMAP) to states associated with the American Recovery and Reinvestment Act of 2009. H.R. 3962 Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 Medical and health care policy matters concerning post-Katrina disaster assistance for New Orleans area hospitals, and health care/Medicaid reform initiatives in Louisiana including adjustments and extensions related to Medicaid Federal Medical Assistance Payments (FMAP) for states associated with the American Recovery and Reinvestment Act of 2009. Medicare and Medicaid incentive payments for physicians and hospitals associated with the use of electronic health records.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

FY2011 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act (provisions related to funding levels for NIH, the National Children's Study, Title VII, open access, and racial disparities medical research) H.R. 2251/S. 973, Resident Physician Shortage Reduction Act of 2009 H.R. 598, Elimination of the indirect medical education adjustment to teaching hospitals Healthcare reform generally

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comments to CMS proposed rule defining meaningful use of electronic Health Records concern that the rules will severely limit hospitals' ability to access federal financing for health information technology and put many hospitals at risk for Medicare payment penalties beginning in 2015; FDA Grants Hospitals 18 Months to Replace Steris System 1 Processor; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake; HR 4700 The Transparency in All Health Care Pricing Act of 2010, to provide for transparency in health care pricing; HR 4803 The Patients Right to Know Act, to ensure health care consumer and provider access to certain health benefits plan information and to amend title XIX of the Social Security Act to provide transparency in hospital price and quality information.

Client expense: $4,230,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

H.R.914, Physician Workforce Enhancement Act of 2009, Physician workforce related issues. H.R.1468, Medical Justice Act of 2009, Medical liability related issues. H.R.936/S.733, National Trauma Center Stabilization Act of 2009, Emergency readiness and trauma related issues. General monitoring on Not-for-profit hospitals charity care and community benefits. S.391, Healthy Americans Act, Health care reform. H.R.193, AmeriCare Health Insurance Act of 2009, Health care reform. H.R.2251/S.973, Resident Physician Shortage Reduction Act of 2009, Physician workforce related issues. Health care reform, Hospital related issues and initiatives. S.1640, Take Back Your Health Act of 2009, Hospital related issues and initiatives. Public Law 110-343, Patient Protection and Affordable Care Act, Hospital related issues and initiatives. Public Law 111-148, The Patient Protection and Affordable Care Act, Hospital related issues and initiatives. Public Law 111-152, Health Care and Education Reconciliation Act of 2010, Hospital related issues and initiatives. H.R.4213, American Jobs and Closing Tax Loopholes Act of 2010, Medicare payment related issues; and Build America Bonds program issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 444 - The 340B Program Improvement and Integrity Act of 2009 S. 1239 - The 340B Program Improvement and Integrity Act of 2009 S. 973, H.R. 2251 - Resident Physician Shortage Reduction Act S. 1776 - The Medicare Physician Fairness Act of 2009 H.R. 3961 - Medicare Physician Payment Reform Act of 2009

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Budget Negotiations FY2011 Graduate Medical Education (increasing slots) Medicaid Intergovernmental transfer and FMAP funding (public hospital definition) American Recovery and Reinvestment Act Medicaid 340(b) Program Medicaid Graduate Medical Education (GME) funding Medicare Recovery Audit Committee HR 3962- America's Affordable Health Choices Act of 2009 Senate Bill- (H.R.3590) Patient Protection and Affordable Care Act Health Care and Education Reconciliation Act of 2010 (H.R.4872) Resident Physician Shortage Reduction Act (S973) (HR 2251) FY 2011 Medicare Inpatient PPS Proposed Rule and Supplemental Proposed Rule CMS 3 Day Rule

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

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

H.R. 1704/S. 682, The Mental Health on Campus Improvement Act, entire bill H.R. 872, Stem Cell Research Improvement Act of 2009, entire bill H.R. 873/S. 487, Stem Cell Research Enhancement Act of 2009, entire bill S. 973/H.R. 2251, Resident Physician Shortage Reduction Act, entire bill H.R. 3200, America's Affordable Health Choices Act, Title III, Subtitle B, Title IV, Title III, Promoting Primary Care; Title IV - Quality, Subtitle A, Subtitle D, Title V - Medicare Graduate Medical Education S. 1679, Affordable Health Choices Act, Title XXXI, Part VIII, Subtitle G - Health IT; Title II - Improving the Quality and Efficiency of Health Care; Title XXXIII, Part T - Employer-Based Wellness Program, Title IV - Health Care Workforce, Sec. 423; Title IV, Subtitle D; Title VI - Improving access to innovative medical therapies H.R. 3590, Patient Protection and Affordable Health Care Act, entire bill H.R. 3692, Affordable Health Care for America Act, entire bill H. Res. 1004/S. Res. 394 - Congratulating the Northwestern University Feinberg School of Medicine for its 150 years of commitment to advancing science and improving health H.R. 4851, Continuing Extension Act of 2010, provision addressing Medicare physician payment cuts H.R. 3962, to provide affordable, quality health care for all Americans and reduce the growth in health care spending, Medicare physician payment cuts provision

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare hospital reimbursement issues and Medicare graduate medical education reimbursement issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L. 111-5) provisions related to moratorium on Medicare capital IME regulation (CMS 1390-F, CMS-1406-P), Medicare HIT investments and requirements; 42 CFR 413.79; President Obama proposals on Medicare bundled payments, reimbursement for readmissions, value-based purchasing (Budget Resolutions, H Con Res 312, S Con Res 70); Resident Physician Shortage Reduction Act (H.R. 2251/S. 973); Medicare provisions in various health care reform proposals (including disproportionate share hospital, GME, bundling, readmissions, value-based purchasing, wage index, market basket, gainsharing, and other provisions in the Affordable Health Care for America Act (H.R.3962); Patient Protection and Affordable Care Act (H.R.3590, P.L. 111-148)); and Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872), P.L. 111-152); Medicare Commission legislation (S.1110, S. 1380, H.R.2718), provisions that would empower a Commission to implement Medicare policy changes; geographic variation legislation (H.R. 2844, H.R. 2919, H.R. 2921, H.R. 2201, S.Amdt. 887) affecting hospitals and/or physician payment policy; value-based purchasing legislation (H.R. 1776); other workforce legislation (H.R. 1946, S.1569)); Puerto Rico Medicare Parity (H.R. 2680, H.R. 1501, H.R.1502); Medicare physician payment adjustment (HR. 3961, S.1776, H.R.3326, H.R. 3590, H.R. 4851, S. 3153, H.R. 4213); Section 508 wage index extension and gainsharing extension (H.R. 4213); HIT incentive payment legislation affecting hospitals and physicians in response to proposed rule CMS-0033-P (H.R. 4851, S. 3153, H.R. 4213); Medicare 72-hour payment window limitation (H.R.4213); and HIT incentive payments and meaningful use requirements in proposed rule CMS-0033-P. Medicaid issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L.111-5) and ARRA FMAP Extension (H.R. 4263, H.R. 2847, H.R.4213) provisions related to the Federal Medical Assistance Percentage, provisions related to disproportionate share hospitals, moratoria on Medicaid regulations (CMS-2258-FC,CMS-2279-P, CMS-2213-P, CMS-2275-F, CMS-2287-P), and HIT investments; Medicaid provisions in various health care reform proposals (including the American Health Care Choices Act (Senate HELP Committee bill (S.1679), Affordable Helahtcare for America Act (H.R. 3962), Patient Protection and Affordable Care Act (H.R. 3590, P.L. 111-148), and the Health and Education Affordability Reconciliation Act of 2010 (H.R. 4872, P.L. 111-152)), including disproportionate share hospital and FMAP provisions; New York State 1115 Medicaid waiver Partnership Plan extension (11-W-00114/2) provisions related to hospitals; the Medicaid Emergency Psychiatric Care Demonstration Project Act of 2009 (S.1130/H.R.1415); Medicaid incentives for HIV screening (H.R. 3091/S.1446)); HIT incentive payment legislation affecting hospitals and physicians in response to proposed rule CMS-0033-P (H.R. 4851, S. 3153, H.R. 4213); and HIT incentive payments and meaningful use requirements in proposed rule CMS-0033-P.

Client expense: $420,000 · Firm income: Not reported

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

H.R.2251, S 973, Resident Physician Shortage Reduction Act of 2009. Medicare and Medicaid reimbursement issues, Graduate Medical Education.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY2011 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Act (provisions concerning funding levels for NIH, the National Children's Study, Title VII, open access, and racial disparities medical research) H.R. 2251/S. 973, Resident Physician Shortage Reduction Act of 2009 H.R. 598, Elimination of the indirect medical education adjustment to teaching hospitals Healthcare reform generally

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

H.R. 3590 The Patient Protection and Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4872 Health Care and Education Reconciliation Act -All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4851 The Continuing Extension Act of 2010 - All provisions related to Medicare physician payments, and physician and hospital eligibility for health care information technology/electronic health records incentive payments. S. 1679 Affordable Health Choices Act. All provisions related to healthcare reform and the Medicare and Medicaid programs. S. 1796 America's Healthy Future Act. All provisions related to healthcare reform and the Medicare and Medicaid programs. H.R. 3200 American Affordable Health Choices Act of 2009. All provisions related to healthcare reform and the Medicare and Medicaid programs. H.R. 2251 and S.973 Resident Shortage Reduction Act of 2009. All provisions related to graduate medical education. H.R. 3962 Affordable Health Care for America Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. S. 1776 Medicare Physician Fairness Act of 2009. All provisions concerning the Medicare Physician Fee Schedule. H.R. 4691 Temporary Extension Act of 2010 - All provisions related to Medicare physician payments. H.R. 4213 The American Workers, State, and Business Relief Act of 2010. All provisions related to Medicare physician payments and Medicaid Federal Medical Assistance Payments (FMAP) to states associated with the American Recovery and Reinvestment Act of 2009. Medical and health care policy matters concerning post-Katrina disaster assistance for New Orleans area hospitals, and health care/Medicaid reform initiatives in Louisiana including adjustments and extensions related to Medicaid Federal Medical Assistance Payments (FMAP) for states associated with the American Recovery and Reinvestment Act of 2009.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

H.R. 3590 The Patient Protection and Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4872 Health Care and Education Reconciliation Act -All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. H.R. 4851 The Continuing Extension Act of 2010 - All provisions related to Medicare physician payments, and physician and hospital eligibility for health care information technology/electronic health records incentive payments. S. 1679 Affordable Health Choices Act. All provisions related to healthcare reform and the Medicare and Medicaid programs. S. 1796 America's Healthy Future Act. All provisions related to healthcare reform and the Medicare and Medicaid programs. H.R. 3200 American Affordable Health Choices Act of 2009. All provisions related to healthcare reform and the Medicare and Medicaid programs. H.R. 2251 and S.973 Resident Shortage Reduction Act of 2009. All provisions related to graduate medical education. H.R. 3962 Affordable Health Care for America Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. S. 1776 Medicare Physician Fairness Act of 2009. All provisions concerning the Medicare Physician Fee Schedule. H.R. 4691 Temporary Extension Act of 2010 - All provisions related to Medicare physician payments. H.R. 4213 The American Workers, State, and Business Relief Act of 2010. All provisions related to Medicare physician payments and Medicaid Federal Medical Assistance Payments (FMAP) to states associated with the American Recovery and Reinvestment Act of 2009. Medical and health care policy matters concerning post-Katrina disaster assistance for New Orleans area hospitals, and health care/Medicaid reform initiatives in Louisiana including adjustments and extensions related to Medicaid Federal Medical Assistance Payments (FMAP) for states associated with the American Recovery and Reinvestment Act of 2009.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE

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).

Client expense: $100,000 · 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.

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. --TRICARE Outpatient Prospective Payment System final rule ? to adopt Medicare payment policies for outpatient services --Children's Health Insurance Program Reauthorization Act (HR 2) ? expand and extend SCHIP, gives states option of covering legal immigrant children and pregnant women --Fiscal Year (FY) 2009 inpatient prospective payment system (IPPS) regulation ? IME Capital provisions --House and Senate Budget Resolutions (S Con Res 13/H Con Res 85) ? healthcare reform --American Recovery and Reinvestment Act of 200 (HR 1) -- Temporary FMAP increase, maintenance of efforts, health information technology, access to capital, moratoria on Medicaid regulations -- Developing healthcare reform proposals including provisions regarding graduate medical education, a public health insurance option, value-based purchasing, readmissions, federal medical assistance percentage, disproportionate share hospital payments, Medicare and Medicaid reimbursement. -- Potential provisions of Fiscal Year (FY) 2010 inpatient prospective payment system (IPPS) regulation: IME capital payment reductions -- Resident Physician Shortage Reduction Act (S973/HR2251) -- to provide for the distribution of additional residency positions --The Emergency Nurse Supply Relief Act" (HR 2536) -- address the "retrogression" backlog of visas for internationally-educated nurses -- "America's Affordable Health Choices Act" (HR 3200) ? payment under public option, graduate medical education, disproportionate share hospital payments, changes in federal medical assistance percentage, Independent Medicare Advisory Council, geographic variation of Medicare payments -- "America's Affordable Health Choices Act" (HR 3200/HR 3962) ? public option, employer mandate, graduate medical education, a public health insurance option, value-based purchasing, readmissions, federal medical assistance percentage, disproportionate share hospital payments, Medicare and Medicaid reimbursement. -- ?Service Members Home Ownership Tax Act? (HR 3590) as amended by the ?Patient Protection and Affordable Care Act? proposals including provisions regarding graduate medical education, a public health insurance option, value-based purchasing, readmissions, federal medical assistance percentage, disproportionate share hospital payments, Medicare and Medicaid reimbursement. ----?Health Care and Education Reconciliation Act? (HR 4872) -- ?Hiring Incentives to Restore Employment Act? (HR 2847) ?enhanced Federal Medical Assistance Percentage -- ?Jobs for Main Street Act 2010? (HR 2847) ? to include hospital bond provision, enhanced Federal Medical Assistance Percentage, extend COBRA subsidies ----?Health Care and Education Reconciliation Act? (HR 4872) -- Temporary Extension Act? (HR 4691) -- COBRA continuation coverage, delays the 21 percent reduction in Medicare physician payments as well. Additionally, the law extends the Medicare physical therapy services caps exceptions process. --American Workers, State, and Business Relief Act? (HR 4213), Federal Medical Assistance Percentage, COBRA benefit subsidy, expiring Medicare payment provisions related to rural hospitals, long-term care hospitals, Section 508 hospital reclassifications, the technical component of certain physician pathology services, mental health services, and add-on payments for ambulance, critical access hospitals, that hospital-based physicians and ARRA IT funding. -- Continuing Extension Act (HR 4851) that would delay the physicians cut, Medicare outpatient therapy services, COBRA benefit subsidy, extend ARRA HIT provisions to outpatient physicians.

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

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

Advocated a proposal for a Stratford Campus Inter-Professional Education facility for Member sponsorship within the FY 2011 Health and Education Appropriations Bill. Supported HR 2251/S 973 "Resident Physician Shortage Reduction Act", that would expand the number of Medicare-supported physician training positions and provide preferences for programs that train primary care physicians and general surgeons. Advocated that various workforce development issues affecting the supply of health professions, including the funding of Graduate Medical Education and HRSA health professions programs (all critical issues to UMDNJ's education mission) be addressed within the Health Reform legislation before the House and Senate.

Client expense: $133,328 · Firm income: Not reported

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

S 2 Middle Class Opportunity Act, Card Check provisions; S 4 Comprehensive Health Reform Act of 2009, a bill to guarantee affordable, quality health coverage for all Americans, and for other purposes; S 45 MCAP Act, a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; S 77 Children's Mental Health Parity Act, a bill to amend title XXI of the Social Security Act to provide for equal coverage of mental health services under the State Children's Health Insurance Program; HR 241a bill to amend title 10, United States Code, to require the amounts reimbursed to institutional providers of health care services under the TRICARE program to be the same as amounts reimbursed under Medicare, and to require the Secretary of Defense to contract for health care services with at least one teaching hospital in urban areas; HR 298 Improving Children's Doctor Access Act of 2009, a bill to amend title XXI of the Social Security Act to require SCHIP annual reports to include information on the HEDIS measure relating to access to primary care practitioners by individuals eligible for child health assistance under such plans and on State efforts to avoid certain displacement of private health coverage, and to express the sense of Congress that such States should utilize Consumer Assessment of Healthcare Providers and Systems consumer satisfaction surveys to measure access by such individuals to physicians; S 179 Health Information Technology Act of 2009, a bill to improve quality in health care by providing incentives for adoption of modern information technology; HR 468 and S 245 Retooling the Health Care Workforce for an Aging America Act of 2009, a bill to expand, train, and support all sectors of the health care workforce to care for the growing population of older individuals in the United States; HR 676 United States National Health Care Act or the Expanded and Improved Medicare for All Act, a bill to provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes; HR 688 and S 326 Kids First Act, a bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program through fiscal year 2013, and for other purposes; Tricare letter sent to DOD from Sen. Ben Nelson urging DoD to revise the rule, expand the transition to the new payment system, offer other adjustments to cushion the financial blow on certain hospitals, and conduct a detailed analysis of its impact on the field; S 391 Healthy Americans Act, a bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away; HR 914 Physician Workforce Enhancement Act of 2009, a bill to amend title VII of the Public Health Service Act to establish a loan program for eligible hospitals to establish residency training programs; HR 936 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of lifesaving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, emergency needs, and information technology; HR 956 HealthCARE Act of 2009, a bill to expand the number of individuals and families with health insurance coverage, and for other purposes; S 408 Wakefield Act, a bill to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children; HR 1085 Health Insurance Coverage Protection Act, a bill to impose a limitation on lifetime aggregate limits imposed by health plans; HR 1086 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009; a bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; HR 1101 Midwifery Care Access and Reimbursement Equity Act of 2009, a bill to amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services; S 441 Quality Reform Expansion and Savings Act of 2009, a bill to encourage the development of coordinated quality reforms to improve health care delivery and reduce the cost of care in the health care system; S 444 National Health Information Technology and Privacy Advancement Act of 2009, a bill to provide for the establishment of a health information technology and privacy system; S 486 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1253 Health Insurance Restrictions and Limitations Clarification Act of 2009, a bill to require that limitations and restrictions on coverage under group health plans be timely disclosed to group health plan sponsors and timely communicated to participants and beneficiaries under such plans in a form that is easily understandable; HR 1296 Access for All America Act, a bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs; HR 1411 United States Primary and Preventive Health Care Corps Act of 2009, a bill to amend the Public Health Service Act to establish a Primary and Public Health Scholarship Program; HR 1460 Nurses Higher Education and Loan Repayment Act, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 1494 Nursing Home Emergency Assistance Act, a bill to ensure that a private for-profit nursing home affected by a major disaster receives the same reimbursement as a public nursing home affected by a major disaster; HR 1558 and S 623 Preexisting Condition Patient Protection Act of 2009, to prohibit health insurers from denying coverage to people with pre-existing conditions; S 616 Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies to Improve Outcomes Now Act of 2009, a bill to amend the Public Health Service Act to authorize medical simulation enhancement programs, and for other purposes; HR 1581 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 628 Conrad State 30 Improvement Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; HR 1614 and S 652 Community Coalitions for Access and Quality Improvement Act of 2009, a bill to authorize the Secretary of Health and Human Services to make grants to community health coalitions to assist in the development of integrated health care delivery; HR 1691 and S 688 Breast Cancer Patient Protection Act of 2009, a bill to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations; HR 1699 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; S 698 State-Based Health Care Reform Act, a bill to ensure the provision of high-quality health care coverage for uninsured individuals through State health care coverage pilot projects that expand coverage and access and improve quality and efficiency in the health care system; S 703 American Health Security Act of 2009, a bill to provide for health care for every American and to control the cost and enhance the quality of the health care system; HR 1745 Family Health Care Accessibility Act of 2009, a bill to amend the Public Health Service Act to provide liability protections for volunteer practitioners at health centers under section 330 of such Act; S 733 National Trauma Center Stabilization Act of 2009, a bill to ensure the continued and future availability of life saving trauma health care in the United States and to prevent further trauma center closures and downgrades by assisting trauma centers with uncompensated care costs, core mission services, and emergency needs; Letter to HHS about the action plan to prevent Healthcare associated infections; Provided information to members of Congress about the Quality and Patient Safety Transparency initiatives by state; Working with Rep. Nathan Deal to get legislation introduced on provider price transparency; HR 1670 and S 683 Community Choice Act of 2009, to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports and which would allow disabled Medicaid recipients to receive care in their homes rather than in nursing homes; HR 2003 and S 830 Children's Hospitals Education Equity Act, a bill to modify the definition of children's hospital for purposes of making payments to children's hospitals that operate graduate medical education programs; HR 1998 Health Care Safety Net Enhancement Act of 2009, a bill to improve access to emergency medical services; HR 2043 Nurse Education, Expansion, and Development Act of 2009, a bill to amend the Public Health Service Act to authorize capitation grants to increase the number of nursing faculty and students; HR 2066 Graduate Psychology Education Act of 2009, a bill to amend the Public Health Service Act to promote mental and behavioral health services for underserved populations; S 890 Health Information Technology (IT) Public Utility Act of 2009, a bill to provide for the use of improved health information technology with respect to certain safety net health care providers; HR 2176 Nursing and Allied Health Education Preservation Act of 2009, to amend title XVIII of the Social Security Act to continue the ability of hospitals to supply a needed workforce of nurses and allied health professionals by preserving funding for hospital operated nursing and allied health education programs; HR 2218 Parental Consent Act of 2009, a bill to prohibit the use of Federal funds for any universal or mandatory mental health screening program; S 957 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; S 958 MediKids Health Insurance Act of 2009, a bill to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2009; HR 2231 Public Health Emergency Response Act of 2009, a bill to amend the Public Health Service Act to ensure that victims of public health emergencies have meaningful and immediate access to medically necessary health care services; HR 2233 Health Empowerment Zone Act of 2009, a bill to authorize the Secretary of Health and Human Services to designate health empowerment zones; S 966 and HR 2252 National Health Care Quality Act, a bill to improve the Federal infrastructure for health care quality improvement in the United States; HR 2249 Health Care Price Transparency Promotion Act of 2009, a bill to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; HR 2251 and S 973 Resident Physician Shortage Reduction Act of 2009, to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; S 979 and HR 2360 SHOP Act, a bill to amend the Public Health Service Act to establish a nationwide health insurance purchasing pool for small businesses and the self-employed that would offer a choice of private health plans and make health coverage more affordable, predictable, and accessible; HR 2273 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; S 999 Child Health Care Crisis Relief Act of 2009, a bill to increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents; S 1001 Health Promotion FIRST Act, a bill to provide for increased research, coordination and expansion of health promotion programs through the Department of Health and Human Services; HR 2350 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; HR 2369 Improving the Quality of Mental and Substance Use Health Care Act of 2009, a bill to improve mental and substance use health care; S 1020 Patient-Focused Critical Care Enhancement Act, a bill to optimize the delivery of critical care medicine and expand the critical care workforce; S 1022 Nurses' Higher Education and Loan Repayment Act of 2009, a bill to amend the Public Health Service Act to establish a graduate degree loan repayment program for nurses who become nursing school faculty members; HR 2381 Nurse and Health Care Worker Protection Act of 2009, a bill to direct the Secretary of Labor to issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other health care workers by establishing a safe patient handling and injury prevention standard, and for other purposes; HR 2388 Physician Availability Act of 2009, a bill to assure that the services of a nonemergency department physician are available to hospital patients 24 hours a day, seven days a week in all non-Federal hospitals with at least 100 licensed beds; S 1028 Strengthening America's Public Health System Act, a bill to amend the Public Health Service Act to improve the Nation's surveillance and reporting for diseases and conditions; S 1031 National Nursing Shortage Reform and Patient Advocacy Act, a bill to amend the Public Health Service Act to establish direct care registered nurse-to-patient staffing ratio requirements in hospitals; HR 2427 and S 1050 Informed Consumer Choices in Health Care Act of 2009, a bill to amend title XXVII of the Public Health Service Act to establish Federal standards for health insurance forms, quality, fair marketing, and honesty in out-of-network coverage in the group and individual health insurance markets, to improve transparency and accountability in those markets, and to establish a Federal Office of Health Insurance Oversight to monitor performance in those markets; HR 2520 Patients' Choice Act, a bill to provide comprehensive solutions for the health care system of the United States; HR 2535 Blueprint for Health Act of 2009, a bill to establish a Blueprint for Health in order to create a comprehensive system of care incorporating medical homes to improve the delivery and affordability of health care through disease prevention, health promotion, and education about and better management of chronic conditions; S 1104 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2536 Emergency Nursing Supply Relief Act, to provide relief for the shortage of nurses in the United States; HR 2691 a bill to provide assistance to adolescents and young adults with serious mental health disorders as they transition to adulthood ; S 1173 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; S 1174 Preserving Patient Access to Primary Care Act of 2009, a bill to amend the Public Health Service Act and the Social Security Act to increase the number of primary care physicians and primary care providers and to improve patient access to primary care services; S 1176 Allied Health Reinvestment Act, a bill to amend the Public Health Service Act to promote and improve the allied health professionals; HR 2744 Equal Rights for Health Care Act Title 42, a bill to prohibit discrimination in Federal assisted health care services and research programs on the basis of sex, race, color, national origin, sexual orientation, gender identity, or disability status; HR 2754 Nurse-Managed Health Clinic Investment Act of 2009, a bill to amend the Public Health Service Act to establish the Nurse-Managed Health Clinic Investment program; HR 2778 Health Equity and Accountability through Research Act of 2009, a bill to amend the Public Health Service Act to redesignate the National Center on Minority Health and Health Disparities as the National Institute for Minority Health and Health Disparities; S 1220 Patient Access to Critical Lab Tests Act, a bill to require that certain complex diagnostic laboratory tests performed by an independent laboratory after a hospital outpatient encounter or inpatient stay during which the specimen involved was collected shall be treated as services for which payment may be made directly to the laboratory under part B of title XVIII of the Social Security Act; HR 2785 Health Care Paperwork Reduction and Fraud Prevention Act of 2009, a bill to reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education; HR 2804Ensuring Continuous Coverage under SCHIP Act of 2009, a bill to amend title XXI of the Social Security Act to require 12-month continuous coverage under the State Children's Health Insurance Program; HR 2810 Public Health Workforce Investment Act of 2009, a bill to amend the Public Health Service Act to establish various programs for the recruitment and retention of public health workers and to eliminate critical public health workforce shortages in Federal, State, local, and tribal public health agencies and health centers; HR 2816 States' Right To Innovate in Health Care Act of 2009, a bill to amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration; HR 2824 Doctor-Patient Relationship and Research Protection Act, to enhance the conduct and support of federally funded comparative effectiveness research relating to health care; HR 2891 Access to Frontline Health Care Act of 2009, a bill to amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish a Frontline Providers Loan Repayment Program; HR 2925 Communities Building Access Act, a bill to amend the Public Health Service Act to provide for community projects that will reduce the number of individuals who are uninsured with respect to health care; HR 2930 Primary Care Training Enhancement Act, a bill to enhance the primary care workforce through modifications to the medical residency training programs and use of qualified teaching health centers and through State primary care scholarship and loan repayment programs; S 1278 Consumers Health Care Act of 2009, a bill to establish the Consumers Choice Health Plan, a public health insurance plan that provides an affordable and accountable health insurance option for consumers; HR 2937 and S 1305 MRSA Infection Prevention and Patient Protection Act, a bill to prevent health care facility-acquired infections; HR 2948 Healthcare Improvements for Generating High Performance (HIGH Performance) Act of 2009, a bill to amend title IX of the Public Health Service Act to provide for the implementation of best practices in the delivery of health care in the United States; HR 2957 Rural Health Access Act of 2009, a bill to amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs; S 1299 Worker Infection Protection Act, a bill to protect health care workers and first responders, including police, firefighters, emergency medical personnel, and other workers at risk of workplace exposure to infectious agents and drug resistant infections; Hatch amendment # 21 requiring the IOM to make recommendations to Congress on how to reduce unnecessary hospital readmissions; HR 2975 Medical Practice Protection Act of 2009, a bill to improve the medical care by reducing the excessive burden imposed by the civil liability system on the health care delivery system; HR 3000 Josephine Butler United States Health Service Act, a bill to establish a United States Health Service to provide high quality comprehensive health care for all Americans and to overcome the deficiencies in the present system of health care delivery; HR 3002 and S 1259 PATIENTS Act of 2009, a bill to protect all patients by prohibiting the use of data obtained from comparative effictiveness research accounts to deny coverage of items or services under Federal health care programs and to ensure that comparative effectiveness research accounts for advancements in personalized medicine and differences in patient treatment response; S 1355 Rural Health Clinic Patient Access and Improvement Act of 2009, a bill to amend title XVIII of the Social Security Act to improve access to health care for individuals residing in underserved rural areas; S. 1403 Strengthen Social Work Training Act of 2009, a bill to amend title VII of the Public Health Service Act to ensure that social work students or social work schools are eligible for support under certain programs that would assist individuals in pursuing health careers or for grants for training projects in geriatrics, and to establish a social work training program; S. 1404 Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act of 2009, a bill to implement demonstration projects at federally qualified community health centers to promote universal access to family-centered, evidence-based behavioral health interventions that prevent child maltreatment and promote family well-being by addressing parenting practices and skills for families from diverse socioeconomic, cultural, racial, ethnic, and other backgrounds; HR3134 Healthcare Innovation Zone Program Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; H.R.3148, a bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R.3151 and S 1585 Rural Access to Nurse Anesthesia Services Act of 2009, a bill to permit pass-through payment for reasonable costs of certified registered nurse anesthetist services in critical access hospitals notwithstanding the reclassification of such hospitals as urban hospitals, including hospitals located in ``Lugar counties'', and for on-call and standby costs for such services; H.R.3158 Place Based Health Care Act of 2009, a bill to reform health care delivery by providing incentives for place-based health care, which seeks to bring health services to the patient by locating community health centers, federally qualified health centers, and community integrated health centers in or near settings that already serve a particular target population, such as schools, workplaces, and senior services facilities; H.R.3185 and S1569, a bill to amend title XVIII of the Social Security Act to provide payment to hospitals for costs of expanded advanced practice nurse training programs; H.R. 3191 Positive Aging Act of 2009, a bill to amend the Public Health Service Act to provide for integration of mental health services and mental health treatment outreach teams, and for other purposes; H.R. 3199 Emergency Medic Transition (EMT) Act of 2009 , a bill to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior medical training; H.R. 3200 America's Affordable Health Choices Act of 2009, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending; H.R. 3217 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; H.R. 3218 Improving Health Care for All Americans Act, a bill to provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools; H.R.3234 Community-Based Health Care Retraining Act, a bill to establish a demonstration project to train unemployed workers for employment as health care professionals; H.R. 3242 Women's Health Office Act of 2009, a bill to improve the health of women through the establishment of Offices of Women's Health within the Department of Health and Human Services; S.1459 Health Care Choice Act of 2009, a bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce; S. 1479 NO TITLE, a bill to provide for the treatment of certain hospitals; H.R. 3391 NO TITLE, a bill to allow for the continuation of critical access hospital designation for certain hospitals in geographic areas experiencing population growth; H.R. 3400 Empowering Patients First Act, a bill to provide for incentives to encourage health insurance coverage; H.R.3421 Medical Debt Relief Act of 2009, a bill to exclude from consumer credit reports medical debt that has been in collection and has been fully paid or settled; HR 3472 a bill to provide for health insurance coverage premium discounts for healthy behavior and improvements toward healthy behavior; HR 3483 Steps Toward Access and Reform (STAR) Act of 2009, a bill to reform the medical liability system, improve access to health care for rural and indigent patients, enhance access to affordable prescription drugs, and for other purposes S 1572, a bill to provide for a point of order against any legislation that eliminates or reduces the ability of Americans to keep their health plan or their choice of doctor or that decreases the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed health care; S 1679 Affordable Health Choices Act, an original bill to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention, and strengthen the health care workforce; HR 3652 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2009, a bill to amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly; S 1720 Health Professions and Primary Care Reinvestment Act, a bill to amend title VII of the Public Health Service Act to provide improved training and primary care; HR 3664 Healthcare Innovation Zone Pilot Act of 2009, a bill to direct the Secretary of Health and Human Services to establish a Healthcare Innovation Zone pilot program; S 1730 Fairness in Health Insurance Act, a bill to provide for minimum loss ratios for health insurance coverage; S 1734 Medical Liability Reform Act of 2009, a bill to reduce the cost of health care and ensure patient access to doctors by ending excessive malpractice verdicts through common-sense lawsuit reform; Senate Finance Committee Americas Healthy Future Act of 2009, Senate Finance Committee health reform bill with provisions on coverage, disease prevention and wellness, delivery system reform, health care quality and efficiency, transparency and program integrity, and financing; Meeting with FTC, senate congressional staff re barriers to clinical integration; HR 3590 Patient Protection and Affordable Care Act, the merged product of the health reform bills from the Senate Finance and Health, Education, Labor and Pensions (HELP) committees; HR 3962 Affordable Health Care for America Act, a bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; HR 3700 Health Care Bill of Rights Act, a bill to establish requirements for any health reform legislation enacted by the Congress or the President during the 111th Congress; HR 3713 American Health Care Solutions Act of 2009, a bill to provide bipartisan solutions to lower health costs, increase access to affordable coverage, and give patients more choices and control; S 1742 Women's Hospitals Education Equity Act, a bill to amend the Public Health Service Act to provide assistance for graduate medical education funding for women's hospitals; Comments to CMS proposed rule defining meaningful use of electronic Health Records concern that the rules will severely limit hospitals' ability to access federal financing for health information technology and put many hospitals at risk for Medicare payment penalties beginning in 2015; FDA Grants Hospitals 18 Months to Replace Steris System 1 Processor; HR 4626 Health Insurance Industry Fair Competition Act, to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; HR 4851 Continuing Extension Act of 2010, to provide a temporary extension of certain programs; Meetings with CMS and HHS to encourage reimbursement under the National Disaster Medical System for hospitals that provided services to victims of the Haitian earthquake.

Client expense: $3,730,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

S.973--Resident Physician Shortage Reduction Act of 2009; S.1679--Affordable Health Choices Act/CLASS Act/Community Living Assistance Services and Supports Act OR Affordable Health Choices Act/Biologics Price Competition and Innovation Act of 2009/CLASS Act/Community Living Assistance Services and Supports Act; S.1776--Medicare Physicians Fairness Act of 2009; S.1796--America's Healthy Future Act of 2009/Elder Justice Act of 2009; H.R.2251--Resident Physician Shortage Act of 2009; H.R.3590--The Patient Protection and Affordable Care Actall provisions therein related to hospitals, skilled nursing facilities, home health agencies and hospices; H.R.3200--America's Affordable Health Choices Act of 2009; H.R.3961--Medicare Physician Payment Reform Act of 2009; H.R.3962--Affordable Health Care for America Act; H.R.4872--Health Care and Education Reconciliation bill; H.R.4213--Extension for Medicare Physician Payment decrease deadline; H.R.4851--Extension for Medicare Physician Payment decrease deadline; FFY 2010 Presidents Budget; Presidents health reform proposals offered in the Administrations FFY 2010 budget and in its June 13 memorandum on health care reform; Senate Finance Committee Health Care Reform Policy Option Papers; FFY 2010 Labor, Health and Human Services, Education, and Pension Appropriations bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; FFY 2010 Medicare Inpatient Hospital PPS Rules; CY 2010 Medicare Outpatient PPS Rules; RY 2010 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2010 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules; FFY 2010 Medicare Skilled Nursing Facility PPS Rules; CY 2010 Medicare Home Health Agency PPS Rules; FFY 2010 Hospice Rules; CY 2010 Medicare Physician Fee Schedule Update; Enhanced federal medical assistance percentage (FMAP); Extension of state Medicaid DSH cap increase established by the American Recovery and Reinvestment Act; Electronic Health Record (EHR) Incentive Payment / Meaningful Use Rule; Medicare Capital Indirect Medical Education payments to teaching hospitals; Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; National Health Service Corp funding; Public Health Service Act nursing and allied health professions program funding; Hospice reimbursement; Comparative effectiveness funding; Preventative health and wellness programs funding; Community health center funding; Coverage for the uninsured; Card check process for hospital employee unionization; Hospital Pay-for-Performance/Value-based purchasing; Hospital pay-for-reporting quality measure reporting; Hospital readmissions; Bundling of hospital and physician and/or post-acute care provider payments; Healthcare-associated infections reporting; Medical error reporting; Medicare Graduate Medical Education (GME) payments to hospitals; Medicare Disproportionate Share Hospital (DSH) payments; Tax deductibility of charitable contributions; False Claims Act expansion addressing fraud related to federal assistance and relief programs that could expose hospitals to liability for receiving and retaining overpayments; Medicare wage index; Recovery Audit Contractor program; Not-for-profit hospital tax-exempt status; Community benefit reporting; Stark and physician self-referral regulations; Hospital pricing transparency; Coverage for undocumented immigrants; Hospital charity care/financial aid; Associated health plans; Emergency preparedness; Mental health parity; Limited service hospitals; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340B drug pricing program; Geographic variation in Medicare payments to hospitals and physicians; Accountable Care Organizations; Medicare payment bundling; Independent Payment Advisory Board (IPAB); Healthcare Acquired Conditions.

Client expense: $190,000 · Firm income: Not reported

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

See page 5 for complete list of lobbying activities H.R. 855, Enhancing Safety in Medicine Utilizing Leading Advanced Simulation Technologies H.R. 2112, Lung Cancer Mortality Reduction Act of 2009 H.R. 2251, Resident Physician Shortage Reduction Act of 2009 H.R. 3590, Patient Protection and Affordable Care Act H.R. 3693; Ensuring the Future Physician Workforce Act of 2009 H.R. 3961, Medicare Physician Payment Reform Act of 2009 H.R. 3962, Affordable Health Care for America Act H.R. 4213, American Workers, State, and Business Relief Act of 2010 (Physician Payment Reform provisions only) H.R. 4691, Temporary Extension Act of 2010 (Physician Payment Reform provisions only) H.R. 4851, Continuing Extension Act of 2010 (Physician Payment Reform provisions only) H.R. 4872, Health Care and Education Affordability Reconciliation Act H. Con. Res. 202, Celebrating the Goals and Ideals of the 20th Anniversary of The Society of Thoracic Surgeons National Database H.J. Res. 45, Increasing the statutory limit on the public debt (Physician Payment Reform provisions only) Health care reform; health care quality improvement; physician workforce; comparative effectiveness research; health information technology

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, White House Office

S. 975/H.R. 2251, Resident Physician Shortage Reduction Act of 2009 H.R. 3200, America's Affordable Health Choices Act of 2009, Division B, Title V H.R. 3590 [P.L. 111-148], Patient Protection and Affordable Care Act, Title V H.R. 3962, Affordable Health Care for America Act, Division B, Title V Issue: Medicare Resident Limits-Removing the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA), White House Office

American Health Security Act (H.R. 1200); Access for All America Act (H.R. 1296/S.486); Primary Care Volunteer Incentive Act (H.R. 1185); Health Access and Health Professions Supply Act (S.790); Title VII Reauthorization (S.1720); Conrad State 30 Improvement Act (S.628); Recognizing the value of community health centers (HCon.Res.144/S.Con.Res.25). Tri-Caucus Health Equity and Accountant Act; Health Information Technology Public Utility Act of 2009 (S.890); Womens Medical House Demonstration Act (S.1303); Family Healthcare Accessibility Act (H.R.1745); Community Coalitions for Access and Quality Improvement Act (H.R.1614/S.652); Health Access and Health Professions Supply Act (S.790); GAO Study request on VA/CHCs Act (no bill#); Affordable Health Choices Act (H.R.3200); Resident Physician Shortage Act (S.973/H.R.2251); Seniors Mental Health Access Improvement Act (H.R.1693/S.671); Public Health Workforce Development Act (H.R.2620/S.1143); Helping Fill the Medicine Rx Gap Act (H.R.2777/S.1201); Primary Care Training Enhancement Act (H.R.2930); Supporting Child Maltreatment Prevention Efforts in Community Health Centers Act (S.1404); Community & Rural Medical Residency Preservation Act (S.1300) Americas Healthy Future Act of 2009, Chairmans Mark Senate Finance Committee; MedPAC Reform Act of 2009 (S.1110); Consumers Health Care Act of 2009 (S.1278); Preserving Patient Access to Primary Care Act of 2009 (H.R.2350); Senate HELP Affordable Health Choices Act (S.1679); Medicare Telehealth Enhancement Act of 2009 (H.R.2068); Medicare Transition Care Act of 2009 (S.1295); School Based Health Clinic Establishment Act of 2009 (H.R.3003); DSH Collaborative Care Network Pilot Program Act of 2009 (H.R.3430); Affordable Health Care for America Act (H.R.3962); The Patient Protection and Affordable Care Act (H.R.3590); Community-Based Residency Training Act (H.R.4409); Reconciliation Act of 2010 (H.R.4872).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 444 - The 340B Program Improvement and Integrity Act of 2009 S. 1239 - The 340B Program Improvement and Integrity Act of 2009 S. 973, H.R. 2251 - Resident Physician Shortage Reduction Act S. 1776 - The Medicare Physician Fairness Act of 2009 H.R. 3961 - Medicare Physician Payment Reform Act of 2009

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

Government targets: Energy, Dept of, HOUSE OF REPRESENTATIVES, SENATE