Access to Frontline Health Care Act of 2009

Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Roles of federal and state agencies at the International Association of Insurance Supervisors and the Financial Stability Board. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Implementation of S. 2155 Economic Growth, Regulatory Relief, and Consumer Protection Act. Issue: Implementation and regulatory reform of the financial services industry. Implementation of H.R. 748 - the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. Issue: CECL, TDR, Remote Online Notarization, SBA loans. H.R. 20/S.567 - Richard L. Trumka Protecting the Right to Organize Act of 2023. To amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959. Issue: independent contractor status. H.R.1059/S. 1212 - Securing and Enabling Commerce Using Remote and Electronic Notarization Act. To authorize and establish minimum standards for electronic and remote notarizations that occur in or affect interstate commerce, to require any Federal court located in a State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce, and to require any State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce or when the notarization was performed under or relates to a public act, record, or judicial proceeding of the State in which the notary public was commissioned. Issue: remote online notarization. H.R.2891/S. 1323 SAFE Banking Act of 2023 - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation S. 2860 - SAFER Banking Act - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation. H.R. 1807 and S. 3815 - Improving Disclosure for Investors Act - This bill requires the Securities and Exchange Commission (SEC) to propose and finalize rules to allow entities to deliver regulatory documents to investors electronically. The SEC must establish a mechanism for investors to opt out of electronic delivery and receive paper documents instead. If the SEC does not finalize rules within one year after enactment, the bill allows for electronic delivery of these documents. Issue: Electronic delivery. H.R. 3335 - IRS Income Verification Express Service Act - This bill ensures the successful development of the electronic Income Verification Express Service of the Internal Revenue Service by amending the Taxpayer First Act to clarify that taxpayer identity verification is the responsibility of users of the system rather than the taxpayer. Issue: Electronic disclosure. H.R. 2799 - Expanding Access to Capital Act of 2023 - This bill reduces various securities regulations applicable to certain companies, brokers, and advisors. The bill also allows more investors to invest in specified types of ventures. Issue: Capital reform. S. 3735 - Protecting Innovation in Investment Act - To prohibit the Securities and Exchange Commission from finalizing, implementing, or enforcing a proposed rule with respect to conflicts of interest associated with the use of predictive data analytics by broker-dealers and investment advisers. Issue: Predictive data analytics. Issue: FHLBank System Issue: Basel III Issue: Regulation Best Interest Issue: Environmental, Social, and Corporate Governance (ESG). No bill number assigned. Issue: Commercial mortgage-backed security (CMBS) debt. No bill number assigned. Issue: Making Diversity and Inclusion Efforts more Intentional. No bill number assigned. Issue: Unclaimed life insurance products. No bill number assigned. Issue: Covered agreement on prudential measures with respect to the business of insurance and reinsurance. No bill number assigned. Issue: Government Sponsored Enterprises (GSE) reform. No bill number assigned.

Client expense: $1,042,541 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FIN - Quarter 4 2023 Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Insurance Capital Standards and Global Capital Standards. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Endgame Implementation of S. 2155 Economic Growth, Regulatory Relief, and Consumer Protection Act. Issue: Implementation and regulatory reform of the financial services industry. Implementation of H.R. 748 - the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. Issue: Remote Online Notarization. H.R. 20/S.567 - Richard L. Trumka Protecting the Right to Organize Act of 2023. To amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959. Issue: independent contractor status. H.R.1059/S. 1212 - Securing and Enabling Commerce Using Remote and Electronic Notarization Act. To authorize and establish minimum standards for electronic and remote notarizations that occur in or affect interstate commerce, to require any Federal court located in a State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce, and to require any State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce or when the notarization was performed under or relates to a public act, record, or judicial proceeding of the State in which the notary public was commissioned. Issue: remote online notarization. H.R.2891/S. 1323 SAFE Banking Act of 2023 - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation S. 2860 - SAFER Banking Act - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation. Issue: FHLBank System Issue: Basel III Endgame Issue: Regulation Best Interest Issue: Government Sponsored Enterprises (GSE) reform. No bill number assigned.

Client expense: $900,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Roles of federal and state agencies at the International Association of Insurance Supervisors and the Financial Stability Board. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Implementation of S. 2155 Economic Growth, Regulatory Relief, and Consumer Protection Act. Issue: Implementation and regulatory reform of the financial services industry. Implementation of H.R. 748 - the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. Issue: CECL, TDR, Remote Online Notarization, SBA loans. H.R. 20/S.567 - Richard L. Trumka Protecting the Right to Organize Act of 2023. To amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959. Issue: independent contractor status. H.R.1059/S. 1212 - Securing and Enabling Commerce Using Remote and Electronic Notarization Act. To authorize and establish minimum standards for electronic and remote notarizations that occur in or affect interstate commerce, to require any Federal court located in a State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce, and to require any State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce or when the notarization was performed under or relates to a public act, record, or judicial proceeding of the State in which the notary public was commissioned. Issue: remote online notarization. H.R.2891/S. 1323 SAFE Banking Act of 2023 - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation S. 2860 - SAFER Banking Act - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation. H.R. 1807 - Improving Disclosure for Investors Act - This bill requires the Securities and Exchange Commission (SEC) to propose and finalize rules to allow entities to deliver regulatory documents to investors electronically. The SEC must establish a mechanism for investors to opt out of electronic delivery and receive paper documents instead. If the SEC does not finalize rules within one year after enactment, the bill allows for electronic delivery of these documents. Issue: Electronic delivery. Issue: FHLBank System Issue: Basel III Issue: Regulation Best Interest Issue: Environmental, Social, and Corporate Governance (ESG). No bill number assigned. Issue: Commercial mortgage-backed security (CMBS) debt. No bill number assigned. Issue: Making Diversity and Inclusion Efforts more Intentional. No bill number assigned. Issue: Unclaimed life insurance products. No bill number assigned. Issue: Covered agreement on prudential measures with respect to the business of insurance and reinsurance. No bill number assigned. Issue: Government Sponsored Enterprises (GSE) reform. No bill number assigned.

Client expense: $1,035,678 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FIN - Quarter 3 2023 Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Implementation of S. 2155 Economic Growth, Regulatory Relief, and Consumer Protection Act. Issue: Implementation and regulatory reform of the financial services industry. H.R. 20/S.567 - Richard L. Trumka Protecting the Right to Organize Act of 2023. To amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959. Issue: independent contractor status. H.R.1059/S. 1212 - Securing and Enabling Commerce Using Remote and Electronic Notarization Act. To authorize and establish minimum standards for electronic and remote notarizations that occur in or affect interstate commerce, to require any Federal court located in a State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce, and to require any State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce or when the notarization was performed under or relates to a public act, record, or judicial proceeding of the State in which the notary public was commissioned. Issue: remote online notarization. H.R.2891/S. 1323 SAFE Banking Act of 2023 - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation S. 2860 - SAFER Banking Act - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation. Issue: FHLBank System Issue: Regulation Best Interest Issue: Environmental, Social, and Corporate Governance (ESG). No bill number assigned. Issue: Unclaimed life insurance products. No bill number assigned. Issue: Government Sponsored Enterprises (GSE) reform. No bill number assigned.

Client expense: $780,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Roles of federal and state agencies at the International Association of Insurance Supervisors and the Financial Stability Board. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Implementation of S. 2155 Economic Growth, Regulatory Relief, and Consumer Protection Act. Issue: Implementation and regulatory reform of the financial services industry. Implementation of H.R. 748 - the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. Issue: CECL, TDR, Remote Online Notarization, SBA loans. H.R. 20/S.567 - Richard L. Trumka Protecting the Right to Organize Act of 2023. To amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959. Issue: independent contractor status. H.R.1059/S. 1212 - Securing and Enabling Commerce Using Remote and Electronic Notarization Act. To authorize and establish minimum standards for electronic and remote notarizations that occur in or affect interstate commerce, to require any Federal court located in a State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce, and to require any State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce or when the notarization was performed under or relates to a public act, record, or judicial proceeding of the State in which the notary public was commissioned. Issue: remote online notarization. H.R.2891/S. 1323 SAFE Banking Act of 2023 - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation S. 2860 - SAFER Banking Act - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: Cannabis legislation. Issue: FHLBank System Issue: Regulation Best Interest Issue: Environmental, Social, and Corporate Governance (ESG). No bill number assigned. Issue: Commercial mortgage-backed security (CMBS) debt. No bill number assigned. Issue: Making Diversity and Inclusion Efforts more Intentional. No bill number assigned. Issue: Unclaimed life insurance products. No bill number assigned. Issue: Covered agreement on prudential measures with respect to the business of insurance and reinsurance. No bill number assigned. Issue: Government Sponsored Enterprises (GSE) reform. No bill number assigned. H.R. 1807, the Improving Disclosure for Investors Act.

Client expense: $887,493 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173 - Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions, Insurance Capital Standards and Global Capital Standards. Roles of federal and state agencies at the International Association of Insurance Supervisors and the Financial Stability Board. Implementation of S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Implementation of S. 2155 Economic Growth, Regulatory Relief, and Consumer Protection Act. Issue: Implementation and regulatory reform of the financial services industry. Implementation of H.R. 748 - the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This bill responds to the COVID-19 (i.e., coronavirus disease 2019) outbreak and its impact on the economy, public health, state and local governments, individuals, and businesses. Issue: CECL, TDR, Remote Online Notarization, SBA loans. H.R. 20/S.567 - Richard L. Trumka Protecting the Right to Organize Act of 2023. To amend the National Labor Relations Act, the Labor Management Relations Act, 1947, and the Labor-Management Reporting and Disclosure Act of 1959. Issue: independent contractor status. H.R.1059/S. 1212 - Securing and Enabling Commerce Using Remote and Electronic Notarization Act. To authorize and establish minimum standards for electronic and remote notarizations that occur in or affect interstate commerce, to require any Federal court located in a State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce, and to require any State to recognize notarizations performed by a notary public commissioned by another State when the notarization occurs in or affects interstate commerce or when the notarization was performed under or relates to a public act, record, or judicial proceeding of the State in which the notary public was commissioned. Issue: remote online notarization. H.R.2891/S. 1323 SAFE Banking Act of 2023 - This bill would create protections for financial institutions that provide financial services to State-sanctioned marijuana businesses and service providers for such businesses. Issue: cannabis Issue: Cannabis legislation Issue: FHLBank System Issue: Regulation Best Interest Issue: Environmental, Social, and Corporate Governance (ESG). No bill number assigned. Issue: Commercial mortgage-backed security (CMBS) debt. No bill number assigned. Issue: Making Diversity and Inclusion Efforts more Intentional. No bill number assigned. Issue: Unclaimed life insurance products. No bill number assigned. Issue: Covered agreement on prudential measures with respect to the business of insurance and reinsurance. No bill number assigned. Issue: Government Sponsored Enterprises (GSE) reform. No bill number assigned. H.R. 1807, the Improving Disclosure for Investors Act.

Client expense: $980,852 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 2 Middle Class Opportunity Act, Card Check provisions; 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 241, a 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; 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; 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 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; 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 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; 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; 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 socio-economic, 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.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; 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; 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; 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; 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; 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; Comment letter expressing concerns taht ONC's certification criteria for EHR eliminates flexibility CMS established in rule for achieving meaningful use; 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; HR 6095 to amend title XVIII of the Social Security Act to preserve integrated care for durable medical equipment under the competitive bidding program for qualified hospital-related DME entities; S 3653 Healthcare Bureacrats Elimination Act, A bill to remove unelected, unaccountable bureaucrats from seniors' personal health decisions by repealing the IPAB.

Client expense: $5,390,000 · 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. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094/S 3978 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. Also Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. Advocated for passage of short and long-term solutions to the Medicare Physician Fee Schedule payment cuts spurred by the Sustainable Growth Rate (SGR) formula. No Bill #: Advocate for extension of Medicare Therapy Caps Exceptions process. HR 3790 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner: educated and advocated on impact on occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 1137 - Athletic Trainers Access to Medicare Act - opposed PL 111-152 - Reconciliation Act of 2010 - implentation as it relates to occupational therapy. HR 5712 - Physician Payment and Therapy Relief Act: advocated to reduce impact on occupational therapy for Medicare payment policy changes. HR 1708 - Ending the Medicare Disability Waiting Period Act of 2009: Advocated for passage. HR 4993 - Home Health Care Planning Improvement Act of 2010: Advocated for passage and educated about occupational therapy services. S 3216 - Medicare Rural Health Care Equity Act of 2010: Advocated for passage. HR 4371 - A bill to amend Title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services: Advocated regarding impact to occupational therapy services. No bill: Advocate to Congress and Centers for Medicare/Medicaid Services (CMS) to oppose proposed Multiple Procedure Payment Reductions, cuts to therapy reimbursement in the proposed 2011 Medicare Physician Fee Schedule rule. CMS staff: Marilyn Tavenner, Principal Deputy Administrator and Johnathan Bluhm, Director of Center for Medicare Management HR 1586 - Education and Medicaid Funding for States: Supported passage. HR 4994 - Medicare and Medicaid Extenders Act: advocated for therapy cap exceptions process extension through 2011 and advocated related to RUGS-IV implementation.

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

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

No bill #: Funding of Higher Education Loan Forgiveness for Occupational Therapists working with Children and or veterans. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. S. 3686 and Draft Bills DHAPPS1108 and DSAPPs1108 - Fiscal 2011 Labor, HHS & Education Appropriations: Lobby for report language to make occupational therapy an initiating service for Medicare Home Health beneficiaries. Lobbied for increased funding for all of the following programs: National Institute of Health (NIH); National Center on Medical and Rehabilitation Research, The Centers for Disease Controls Falls Prevention Program and older driver initiative; the Health Resources Services Administration; The Administration on Aging; the Older Americans Act (OAA); The Veterans Administration (VA); The Substance Abuse and Mental Health Services Administration (SAMSHA); The National Institute for Mental Health (NIMH); The Department of Education - for funding; funding for professions of national need under the Hihger Education act; and Title VII of the Public Health Services Act.

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

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

No bill #: Loan forgiveness for occupational therapists working with children and/or veterans under the Higher Education Act. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 4247 - Keeping All Students Safe Act and S2860 - Preventing Harmful Restraint and Seclusion in Schools Act: Support passage. No Bill # - Reauthorization of the Elementary and Secondary Education Act (No Child Left Behind Act): Educate about role and potential for occupational therapy services in schools.

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

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

No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. S 1963 - Caregivers and Veterans Omnibus Health Services Act of 2010: advocated for passage and inclusion of occupational therapy services. HR 1036 - Veterans Physical Therapy Services Improvement Act of 2009: Educated about the role and impact of occupational therapy services. HR 1558 - Preexisting Condition Patient Protection Act of 2009: Advocated for passage. S Res 490 - A resolution recognizing the measurable, positive impact that the National Committee for Quality Assurance has made on the quality of care patients in the United States have received during the 20 years since the formation of the organization: Advocated for passage. HR 5025 -HITECH Extension for Behavioral Health Services Act of 2010: Educated about occuaptional therapy services. HR 4944 - Siding with America's Patients (SWAP) Act - Educated about occupational therapy services and to ensure coverage. HR 4919, HR 4903 - A bill to repeal the Patient Protection and Affordable Care Act: Educated about occupational therapy services. HR 4910 - A bill to repeal the Patient Protection and Affordable Care Act and enact the Empowering Patients First Act in order to provide incentives to encourage health insurance coverage: Educated about occupational therapy services and to ensure coverage. HR 4894 -- A bill to amend the Patient Protection and Affordable Care Act ot ensure appropriate treatment of Department of Veterans' Affairs and Department of Defense heatlh programs: Educated about occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 678 - Huntington's Disease Parity Act: Advocated for passage PL 111-148 - Patient Protection and Affordable Care Act - promoted role and access to occupational therapy.

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

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

HR 1600/S 1169 - To amend title 10, United States Code, to provide for the treatment of autism under TRICARE; lobbied to educate on Occupational Therapy role in Autism services. S 819/HR 2413 - Autism Treatment Acceleration Act of 2009; lobbied to educate on Occupational Therapy role in Autism services. No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 4662 - Lymphedema Diagnosis and Treatment Cost Saving Act of 2010: Oppose provisions requiring additional accreditation for occupational therapy services. H Res 1258 - A resolution expressing support for designation of May 2010 as Mental Health Month: Advocated passage. H Res 1033 - A resolution expressing support for designation of April 2010 as "National Autism Awareness Month":and supporting efforts to devote new resources to research into the causes and treatment of autism and to improve training and support for individuals with autism and those who care for individuals with autism: Advocated for passage and educated about role of occupational therapy in treatment of autism. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 5025 -HITECH Extension for Behavioral Health Services Act of 2010: Educated about occuaptional therapy services. HR 678 - Huntington's Disease Parity Act: Advocated for passage.

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

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

H.R. 988/ S. 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 H.R. 2891- Access to Frontline Health Care Act H.R. 3590- Patient Protection and Affordable Care Act S. 1652- IDEA Full Funding Act FY 2011 Funding for Loan Forgiveness for Service in Areas of National Need Student Loan Forgiveness for Physical Therapists who Specialize in Geriatric Care H.R. 3578- Everyone Deserves Unconditional Access to Education Act Creation of new office of Specialized Instructional Support Personnel ESEA Re-authorization Recommendations H.R. 6172 Protecting Student Athletes from Concussions Act H.R. 1347 Concussion Treatment & Care Tools Act of 2009 Institute for Education Science Priorities Education Jobs Fund Expanding physical activity & athletic opportunities for individuals with disabilities in our educational institutions Federal Education Program Integrity Affecting Accrediting Agencies Comments on ESEA/IDEA Alignment

Client expense: $240,000 · 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), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

HR 2751 - FDA Food Safety Modernization Act (Sections on dietary supplements, establishment of foreign FDA offices; and the establishment of voluntary food allergy and anaphylaxis management guidelines) Under Line 17: We would like to include the Agency for Healthcare Research and Quality (AHRQ) and the Institute of Medicine of National Academies HR 1259 - Dextromethorphan Distribution Act of 2009 HR 2891 - Access to Frontline Health Care Act of 2009 HR 2345 - Amends the Fair Credit Reporting Act to provide for an exclusion from Red Flag Guidelines for health care practices (Public Law 111-152) Health Care and Education Reconciliation Act of 2010 [Sections on Medicare Part D Changes; CMS/IRS data match to identify fraudulent providers; funding to fight fraud, waste and abuse; 90-day period of enhanced oversight for initial claims of DME suppliers; excise tax on medical device manufacturers; and drugs purchased by covered entities.] (Public Law 111-148) - Patient Protection and Affordable Care Act [Sections on: reinsurance for early retirees; non-discrimination in health care; essential health benefits requirements; financial integrity in Exchanges; MedPAC study on adequacy of Medicare payments for health care providers serving in rural areas; coverage of comprehensive tobacco cessation services for pregnant women in Medicaid; distributions for medicine qualified only if for prescribed drug or insulin; administrative simplification; payment for biosimilar biological products; approval pathway for biosimilar biological products; patient-centered outcomes research; special rules; prohibition against discrimination on assisted suicide; presentation of prescription drug benefit and risk information; provider screening and other enrollment requirements under Medicare, Medicaid, and CHIP; enhanced Medicare and Medicaid program integrity provisions; maximum period for submission of Medicare claims reduced to not more than 12 months; physicians who order items or services required to be Medicare enrolled physicians or eligible professionals; requirement for physicians to provide documentation on referrals to programs at high risk of waste and abuse; face to face encounter with patient required before physicians may certify eligibility for home health services or durable medical equipment under Medicare; enhanced penalties; adjustments to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive acquisition program; termination of provider participation under Medicaid if terminated under Medicare or other State plan; Medicaid exclusion from participation relating to certain ownership, control, and management affiliations; health information technology enrollment standards and protocols; improvements to the physician quality reporting system; hospital readmissions reduction program; community-based care transitions program; Medicare Advantage payment; demonstration project to evaluate integrated care around a hospitalization; state option to provide health homes for enrollees with chronic conditions; pediatric accountable care organization demonstration project; establishment of Center for Medicare and Medicaid Innovation within CMS; Medicare shared savings program (ACOs); national pilot program on payment bundling; independence at home demonstration program; establishing community health teams to support the patient-centered medical home; Medicaid coverage for the lowest income populations; elimination of exclusion of coverage of certain drugs; providing adequate pharmacy reimbursement (AMP); improvements to the Medicare Part D MTM programs; exemption of certain pharmacies from DMEPOS accreditation requirements; payment adjustments for home health care; Medicare coverage gap discount program; immediate reduction in coverage Medicare Part D gap in 2010; improved information for subsidy eligible individuals reassigned to prescription drug plans and MA-PD plans; improving formulary requirements for prescription drug plans and MA-PD plans with respect to certain categories or classes of drugs; elimination of cost sharing for certain dual eligible individuals; uniform exceptions and appeals process for prescription drug plans and MA-PD plans; Office of the Inspector General studies and reports; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under part D; reducing wasteful dispensing of outpatient prescription drugs in long-term care facilities under prescription drug plans and MA-PD plans; medication management (MTM) services in treatment of chronic disease; advancing research and treatment for pain care management; National Prevention, Health Promotion and Public Health Council; clinical and community preventive services; Medicare coverage of annual wellness visit providing a personalized prevention plan; removal of barriers to preventive services in Medicare; incentives for prevention of chronic diseases in Medicaid; community transformation grants; healthy aging, living well - evaluation of community-based prevention and wellness programs for Medicare beneficiaries; CDC and employer-based wellness programs; coverage of preventive health services; immunizations; community health insurance option; level playing field; State flexibility to establish basic health programs for low-income individuals not eligible for Medicaid; ensuring the quality of care; affordable choices of health benefit plans; national strategy to improve health care quality; interagency Working Group on Health Care Quality; quality measure development; quality measurement; data collection; public reporting; health care delivery system research; quality improvement technical assistance; demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals; transparency reports and reporting of physician ownership or investment interests; prescription drug sample transparency; pharmacy benefit managers transparency requirements; national health care workforce commission; health care workforce assessment; public health workforce recruitment and retention programs; allied health workforce recruitment and retention programs; grants for State and local programs; training in family medicine, general internal... medicine, general pediatrics, and physician assistantship; geriatric education and training: career awards, comprehensive geriatric education; United States Public Health Sciences Track; interdisciplinary, community-based linkages (to support the existing health care workforce); Medicare vaccine coverage issues (Medicare Part B vs. Part D); and funding for the grant program established in the section on medication management (MTM) services in treatment of chronic disease).] (26 CFR Part 54/ 29 CFR Part 2590/ 45 CFR Parts 146 and 148) Medical Loss Ratios; Request for Comments Regarding Section 2718 of the Public Health Service Act (RIN 0950-AA06) Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient Protection and Affordable Care Act; Interim Final Rule (Docket Number: 75FR65495) National Institutes for Health; Interagency Pain Research Coordinating Committee; Call for Nominations (Docket Number: 2010-28041) Solicitation for Nominations for Members of the U.S. Preventive Services Task Force (Docket Number: CMS-0009-N) Health Insurance Reform; Announcement of Maintenance Changes to Electronic Data Transaction Standards Adopted Under the Health Insurance Portability and Accountability Act of 1996 (Docket Number: OCIIO-9992-IFC) Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services under the Patient Protection and Affordable Care Act (Docket Number: 75FR65359)AHRQ Common Formats for Patient Safety Data Collection and Event Reporting; Notice of availability NAIC Regulation for Uniform Definitions and Standardized Rebate Calculation Methodology for Plan Years 2011, 2012 and 2013 per Section 2718 (b) of the Health Service Act HHS Request for Comment on the Development of the National Health Care Quality Strategy and Plan IRS Notice (2010-59) on: Section 105 - Amounts Received under Accident and Health Plans, Section 106 Contributions by Employers to Accident and Health Plans, Section 125 - Cafeteria Plans, Section 220 Archer MSAs, Section 223 Health Savings Accounts (P.L. 111-148, Section 9003) IRS Revised Notice (2011-5) on: Section 105 - Amounts Received under Accident and Health Plans, Section 106 Contributions by Employers to Accident and Health Plans, Section 125 Cafeteria Plans (P.L. 111-148, Section 9003) HHS National Health Care Quality Strategy and Plan IOM Study on the Determination of Essential Health Benefits in P.L. 111-148 Concept Opportunities for Pharmacist Clinical Services in Health Care Reform Provisions

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), SENATE, White House Office

No bill #: Funding of Higher Education Loan Forgiveness for Occupational Therapists working with Children and or veterans. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. S. 3686 and Draft Bills DHAPPS1108 and DSAPPs1108 - Fiscal 2011 Labor, HHS & Education Appropriations: Lobby for report language to make occupational therapy an initiating service for Medicare Home Health beneficiaries. Lobbied for increased funding for all of the following programs: National Institute of Health (NIH); National Center on Medical and Rehabilitation Research, The Centers for Disease Controls Falls Prevention Program and older driver initiative; the Health Resources Services Administration; The Administration on Aging; the Older Americans Act (OAA); The Veterans Administration (VA); The Substance Abuse and Mental Health Services Administration (SAMSHA); The National Institute for Mental Health (NIMH); The Department of Education - for funding; funding for professions of national need under the Hihger Education act; and Title VII of the Public Health Services Act.

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

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

HR 1600/S 1169 - To amend title 10, United States Code, to provide for the treatment of autism under TRICARE; lobbied to educate on Occupational Therapy role in Autism services. S 819/HR 2413 - Autism Treatment Acceleration Act of 2009; lobbied to educate on Occupational Therapy role in Autism services. No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 4662 - Lymphedema Diagnosis and Treatment Cost Saving Act of 2010: Oppose provisions requiring additional accreditation for occupational therapy services. H Res 1258 - A resolution expressing support for designation of May 2010 as Mental Health Month: Advocated passage. H Res 1033 - A resolution expressing support for designation of April 2010 as "National Autism Awareness Month":and supporting efforts to devote new resources to research into the causes and treatment of autism and to improve training and support for individuals with autism and those who care for individuals with autism: Advocated for passage and educated about role of occupational therapy in treatment of autism. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 5025 -HITECH Extension for Behavioral Health Services Act of 2010: Educated about occuaptional therapy services. HR 678 - Huntington's Disease Parity Act: Advocated for passage.

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

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

No bill #: Loan forgiveness for occupational therapists working with children and/or veterans under the Higher Education Act. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 4247 - Keeping All Students Safe Act and S2860 - Preventing Harmful Restraint and Seclusion in Schools Act: Support passage. No Bill # - Reauthorization of the Elementary and Secondary Education Act (No Child Left Behind Act): Educate about role and potential for occupational therapy services in schools.

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

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

No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. S 1963 - Caregivers and Veterans Omnibus Health Services Act of 2010: advocated for passage and inclusion of occupational therapy services. HR 1036 - Veterans Physical Therapy Services Improvement Act of 2009: Educated about the role and impact of occupational therapy services. HR 1558 - Preexisting Condition Patient Protection Act of 2009: Advocated for passage. S Res 490 - A resolution recognizing the measurable, positive impact that the National Committee for Quality Assurance has made on the quality of care patients in the United States have received during the 20 years since the formation of the organization: Advocated for passage. HR 5025 -HITECH Extension for Behavioral Health Services Act of 2010: Educated about occuaptional therapy services. HR 4944 - Siding with America's Patients (SWAP) Act - Educated about occupational therapy services and to ensure coverage. HR 4919, HR 4903 - A bill to repeal the Patient Protection and Affordable Care Act: Educated about occupational therapy services. HR 4910 - A bill to repeal the Patient Protection and Affordable Care Act and enact the Empowering Patients First Act in order to provide incentives to encourage health insurance coverage: Educated about occupational therapy services and to ensure coverage. HR 4894 -- A bill to amend the Patient Protection and Affordable Care Act ot ensure appropriate treatment of Department of Veterans' Affairs and Department of Defense heatlh programs: Educated about occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 678 - Huntington's Disease Parity Act: Advocated for passage

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

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

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. Advocated for passage of short and long-term solutions to the Medicare Physician Fee Schedule payment cuts spurred by the Sustainable Growth Rate (SGR) formula. No Bill #: Advocate for extension of Medicare Therapy Caps Exceptions process. HR 3790 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner: educated and advocated on impact on occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 1708 - Ending the Medicare Disability Waiting Period Act of 2009: Advocated for passage. HR 4993 - Home Health Care Planning Improvement Act of 2010: Advocated for passage and educated about occupational therapy services. S 3216 - Medicare Rural Health Care Equity Act of 2010: Advocated for passage. HR 4371 - A bill to amend Title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services: Advocated regarding impact to occupational therapy services. No bill: Advocate to Congress and Centers for Medicare/Medicaid Services (CMS) to oppose proposed Medicare Physician Payment Reductions, cuts to therapy reimbursement in the proposed 2011 Medicare Physician Fee Schedule rule. CMS staff: Marilyn Tavenner, Principal Deputy Administrator and Johnathan Bluhm, Director of Center for Medicare Management HR 1586 - Education and Medicaid Funding for States: Supported passage.

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

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

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

HR 6012 - To direct the Secretary of Health and Human Services to review uptake and utilization of diabetes screening benefits and establish an outreach program with respect to such benefits, and for other purposes. HR 2891 - Access to Frontline Health Care Act of 2009 Under Line 17: We would like to include the Agency for Healthcare Research and Quality (AHRQ) HR 2345 - Amends the Fair Credit Reporting Act to provide for an exclusion from Red Flag Guidelines for health care practices HR 1259 - Dextromethorphan Distribution Act of 2009 Drug Safety Discussion Draft Bill (builds on the Food and Drug Globalization Act - HR 759) - Amends the Federal Food, Drug, and Cosmetic Act to improve the safety of drugs, and for other purposes. (Public Law 111-152) Health Care and Education Reconciliation Act of 2010 [Sections on Medicare Part D Changes; CMS/IRS data match to identify fraudulent providers; funding to fight fraud, waste and abuse; 90-day period of enhanced oversight for initial claims of DME suppliers; excise tax on medical device manufacturers; and drugs purchased by covered entities.] (Public Law 111-148) - Patient Protection and Affordable Care Act [Sections on: reinsurance for early retirees; non-discrimination in health care; essential health benefits requirements; financial integrity in Exchanges; MedPAC study on adequacy of Medicare payments for health care providers serving in rural areas; coverage of comprehensive tobacco cessation services for pregnant women in Medicaid; distributions for medicine qualified only if for prescribed drug or insulin; administrative simplification; payment for biosimilar biological products; approval pathway for biosimilar biological products; patient-centered outcomes research; special rules; prohibition against discrimination on assisted suicide; presentation of prescription drug benefit and risk information; provider screening and other enrollment requirements under Medicare, Medicaid, and CHIP; enhanced Medicare and Medicaid program integrity provisions; maximum period for submission of Medicare claims reduced to not more than 12 months; physicians who order items or services required to be Medicare enrolled physicians or eligible professionals; requirement for physicians to provide documentation on referrals to programs at high risk of waste and abuse; face to face encounter with patient required before physicians may certify eligibility for home health services or durable medical equipment under Medicare; enhanced penalties; adjustments to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive acquisition program; termination of provider participation under Medicaid if terminated under Medicare or other State plan; Medicaid exclusion from participation relating to certain ownership, control, and management affiliations; health information technology enrollment standards and protocols; improvements to the physician quality reporting system; hospital readmissions reduction program; community-based care transitions program; Medicare Advantage payment; demostration project to evaluate integrated care around a hospitalization; state option to provide health homes for enrollees with chronic conditions; pediatric accountable care organization demonstration project; establishment of Center for Medicare and Medicaid Innovation within CMS; Medicare shared savings program; national pilot program on payment bundling; independence at home demonstration program; establishing community health teams to support the patient-centered medical home; Medicaid coverage for the lowest income populations; elimination of exclusion of coverage of certain drugs; providing adequate pharmacy reimbursement (AMP); improvements to the Medicare Part D MTM programs; exemption of certain pharmacies from DMEPOS accreditation requirements; payment adjustments for home health care; Medicare coverage gap discount program; immediate reduction in coverage Medicare Part D gap in 2010; improved information for subsidy eligible individuals reassigned to prescription drug plans and MA-PD plans; improving formulary requirements for prescription drug plans and MA-PD plans with respect to certain categories or classes of drugs; elimination of cost sharing for certain dual eligible individuals; uniform exceptions and appeals process for prescription drug plans and MA-PD plans; Office of the Inspector General studies and reports; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under part D; reducing wasteful dispensing of outpatient prescription drugs in long-term care facilities under prescription drug plans and MA-PD plans; medication management (MTM) services in treatment of chronic disease; advancing research and treatment for pain care management; National Prevention, Health Promotion and Public Health Council; clinical and community preventive services; Medicare coverage of annual wellness visit providing a personalized prevention plan; removal of barriers to preventive services in Medicare; incentives for prevention of chronic diseases in Medicaid; community transformation grants; healthy aging, living well - evaluation of community-based prevention and wellness programs for Medicare beneficiaries; CDC and employer-based wellness programs; coverage of preventive health services; immunizations; community health insurance option; level playing field; State flexibility to establish basic health programs for low-income individuals not eligible for Medicaid; ensuring the quality of care; affordable choices of health benefit plans; national strategy to improve health care quality; interagency Working Group on Health Care Quality; quality measure development; quality measurement; data collection; public reporting; health care delivery system research; quality improvement technical assistance; demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals; transparency reports and reporting of physician ownership or investment interests; prescription drug sample transparency; pharmacy benefit managers transparency requirements; national health care workforce commission; health care workforce assessment; public health workforce recruitment and retention programs; allied health workforce recruitment and retention programs; grants for State and local programs; training in family medicine, general internal medicine, general pediatrics, and physician assistantship; geriatric education and training: career awards, comprehensive geriatric education; United States Public Health Sciences Track; interdisciplinary, community-based linkages (to support the existing health care workforce); Medicare vaccine coverage issues (Medicare Part B vs. Part D); nominations to National Health Care Workforce Commission and Board of Governors of the Patient-Centered Outcomes Research (PCOR) Institute; and funding for the grant program established in the section on medication management (MTM) services in treatment of chronic disease).] (26 CFR Part 54/ 29 CFR Part 2590/ 45 CFR Parts 146 and 148) Medical Loss Ratios; Request for Comments Regarding Section 2718 of the Public Health Service Act (Docket Number: OCIIO-9992-IFC) Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services under the Patient Protection and Affordable Care Act (RIN 0991-AB62) HIPAA Privacy Rule Accounting of Disclosures Under the Health Information Technology for Economic and Clinical Health Act; Request for Information (RIN 0991AB57) Modifications to the HIPAA Privacy, Security, and Enforcement Rules Under the Health Information Technology for Economic and Clinical Health Act (Docket Number: FDA-2010-D-0431) Draft Guidance for Food and Drug Administration Staff and Tobacco Retailers on Civil Money Penalties and No-Tobacco-Sale Orders for Tobacco Retailers; Availability (Docket Number: FDA-2010-N-0449) Risks and Benefits of Long-Term Use of Nicotine Replacement Therapy Products; Public Workshop; Request for Comments FDA Draft Guidance for Industry Tobacco Retailer Training Programs NAIC Regulation for Uniform Definitions and Standardized Rebate Calculation Methodology for Plan Years 2011, 2012 and 2013 per Section 2718 (b) of the Health Service Act HHS National Health Care Quality Strategy and Plan Draft Report of the HHS Secretarys Advisory Committee on Genetics, Health, and Society on Genetics Education and Training of Health Care Professionals, Public Health Providers, and Consumers Concept Opportunities for Pharmacist Clinical Services in Health Care Reform Provisions

Client expense: $212,859 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

H.R. 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 H.R. 2891- Access to Frontline Health Care Act H.R. 3590- Patient Protection and Affordable Care Act S. 1652- IDEA Full Funding Act FY 2011 Funding for Loan Forgiveness for Service in Areas of National Need Student Loan Forgiveness for Physical Therapists who Specialize in Geriatric Care H.R. 3578- Everyone Deserves Unconditional Access to Education Act Creation of new office of Specialized Instructional Support Personnel ESEA Re-authorization Recommendations

Client expense: $280,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 H.R. 2891- Access to Frontline Health Care Act H.R. 3590- Patient Protection and Affordable Care Act S. 1652- IDEA Full Funding Act FY 2011 Funding for Loan Forgiveness for Service in Areas of National Need Student Loan Forgiveness for Physical Therapists who Specialize in Geriatric Care H.R. 3578- Everyone Deserves Unconditional Access to Education Act Creation of new office of Specialized Instructional Support Personnel ESEA Re-authorization Recommendations H.R. 6172 Protecting Student Athletes from Concussions Act H.R. 1347 Concussion Treatment & Care Tools Act of 2009 Institute for Education Science Priorities Education Jobs Fund Expanding physical activity & athletic opportunities for individuals with disabilities in our educational institutions Federal Education Program Integrity Affecting Accrediting Agencies

Client expense: $310,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

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

HR 2345 - Amends the Fair Credit Reporting Act to provide for an exclusion from Red Flag Guidelines for health care practices HR 1259 - Dextromethorphan Distribution Act of 2009 HR 2891 - Access to Frontline Health Care Act of 2009 Under Line 17: We would like to include the Agency for Healthcare Research and Quality (AHRQ) (Public Law 111-152) Health Care and Education Reconciliation Act of 2010 [Sections on Medicare Part D Changes; CMS/IRS data match to identify fraudulent providers; funding to fight fraud, waste and abuse; 90-day period of enhanced oversight for initial claims of DME suppliers; excise tax on medical device manufacturers; and drugs purchased by covered entities.] (Public Law 111-148) - Patient Protection and Affordable Care Act [Sections on: reinsurance for early retirees; non-discrimination in health care; essential health benefits requirements; financial integrity in Exchanges; MedPAC study on adequacy of Medicare payments for health care providers serving in rural areas; coverage of comprehensive tobacco cessation services for pregnant women in Medicaid; distributions for medicine qualified only if for prescribed drug or insulin; administrative simplification; payment for biosimilar biological products; approval pathway for biosimilar biological products; patient-centered outcomes research; special rules; prohibition against discrimination on assisted suicide; presentation of prescription drug benefit and risk information; provider screening and other enrollment requirements under Medicare, Medicaid, and CHIP; enhanced Medicare and Medicaid program integrity provisions; maximum period for submission of Medicare claims reduced to not more than 12 months; physicians who order items or services required to be Medicare enrolled physicians or eligible professionals; requirement for physicians to provide documentation on referrals to programs at high risk of waste and abuse; face to face encounter with patient required before physicians may certify eligibility for home health services or durable medical equipment under Medicare; enhanced penalties; adjustments to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive acquisition program; termination of provider participation under Medicaid if terminated under Medicare or other State plan; Medicaid exclusion from participation relating to certain ownership, control, and management affiliations; health information technology enrollment standards and protocols; improvements to the physician quality reporting system; hospital readmissions reduction program; community-based care transitions program; Medicare Advantage payment; demostration project to evaluate integrated care around a hospitalization; state option to provide health homes for enrollees with chronic conditions; pediatric accountable care organization demonstration project; establishment of Center for Medicare and Medicaid Innovation within CMS; Medicare shared savings program; national pilot program on payment bundling; independence at home demonstration program; establishing community health teams to support the patient-centered medical home; Medicaid coverage for the lowest income populations; elimination of exclusion of coverage of certain drugs; providing adequate pharmacy reimbursement (AMP); improvements to the Medicare Part D MTM programs; exemption of certain pharmacies from DMEPOS accreditation requirements; payment adjustments for home health care; Medicare coverage gap discount program; immediate reduction in coverage Medicare Part D gap in 2010; improved information for subsidy eligible individuals reassigned to prescription drug plans and MA-PD plans; improving formulary requirements for prescription drug plans and MA-PD plans with respect to certain categories or classes of drugs; elimination of cost sharing for certain dual eligible individuals; uniform exceptions and appeals process for prescription drug plans and MA-PD plans; Office of the Inspector General studies and reports; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under part D; reducing wasteful dispensing of outpatient prescription drugs in long-term care facilities under prescription drug plans and MA-PD plans; medication management (MTM) services in treatment of chronic disease; advancing research and treatment for pain care management; National Prevention, Health Promotion and Public Health Council; clinical and community preventive services; Medicare coverage of annual wellness visit providing a personalized prevention plan; removal of barriers to preventive services in Medicare; incentives for prevention of chronic diseases in Medicaid; community transformation grants; healthy aging, living well - evaluation of community-based prevention and wellness programs for Medicare beneficiaries; CDC and employer-based wellness programs; coverage of preventive health services; immunizations; community health insurance option; level playing field; State flexibility to establish basic health programs for low-income individuals not eligible for Medicaid; ensuring the quality of care; affordable choices of health benefit plans; national strategy to improve health care quality; interagency Working Group on Health Care Quality; quality measure development; quality measurement; data collection; public reporting; health care delivery system research; quality improvement technical assistance; demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals; transparency reports and reporting of physician ownership or investment interests; prescription drug sample transparency; pharmacy benefit managers transparency requirements; national health care workforce commission; health care workforce assessment; public health workforce recruitment and retention programs; allied health workforce recruitment and retention programs; grants for State and local programs; training in family medicine, general internal medicine, general pediatrics, and physician assistantship; geriatric education and training: career awards, comprehensive geriatric education; United States Public Health Sciences Track; interdisciplinary, community-based linkages (to support the existing health care workforce); Medicare vaccine coverage issues (Medicare Part B vs. Part D); and nominations to National Health Care Workforce Commission and Board of Governors of the Patient-Centered Outcomes Research (PCOR) Institute).] (26 CFR Part 54/ 29 CFR Part 2590/ 45 CFR Parts 146 and 148) Medical Loss Ratios; Request for Comments Regarding Section 2718 of the Public Health Service Act (RIN 0991-AB62) HIPAA Privacy Rule Accounting of Disclosures Under the Health Information Technology for Economic and Clinical Health Act; Request for Information HHS Draft Healthy People 2020 Objectives HHS Strategic Framework on Multiple Chronic Conditions Draft Report of the HHS Secretarys Advisory Committee on Genetics, Health, and Society on Genetics Education and Training of Health Care Professionals, Public Health Providers, and Consumers Concept Pharmacist Clinical Services Provisions in Health Care Reform

Client expense: $151,510 · Firm income: Not reported

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

H.R. 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 H.R. 2891- Access to Frontline Health Care Act H.R. 3590- Patient Protection and Affordable Care Act S. 1652- IDEA Full Funding Act FY 2011 Funding for Loan Forgiveness for Service in Areas of National Need Student Loan Forgiveness for Physical Therapists who Specialize in Geriatric Care H.R. 3578- Everyone Deserves Unconditional Access to Education Act Creation of new office of Specialized Instructional Support Personnel ESEA Re-authorization Recommendations

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

HR 1600/S 1169 - To amend title 10, United States Code, to provide for the treatment of autism under TRICARE; lobbied to educate on Occupational Therapy role in Autism services. S 819/HR 2413 - Autism Treatment Acceleration Act of 2009; lobbied to educate on Occupational Therapy role in Autism services. No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 4662 - Lymphedema Diagnosis and Treatment Cost Saving Act of 2010: Oppose provisions requiring additional accreditation for occupational therapy services. H Res 1258 - A resolution expressing support for designation of May 2010 as Mental Health Month: Advocated passage. H Res 1033 - A resolution expressing support for designation of April 2010 as "National Autism Awareness Month":and supporting efforts to devote new resources to research into the causes and treatment of autism and to improve training and support for individuals with autism and those who care for individuals with autism: Advocated for passage and educated about role of occupational therapy in treatment of autism. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 5025 -HITECH Extension for Behavioral Health Services Act of 2010: Educated about occuaptional therapy services. HR 678 - Huntington's Disease Parity Act: Advocated for passage.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

No bill #: Loan forgiveness for occupational therapists working with children and/or veterans under the Higher Education Act. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 4247 - Keeping All Students Safe Act and S2860 - Preventing Harmful Restraint and Seclusion in Schools Act: Support passage. No Bill # - Reauthorization of the Elementary and Secondary Education Act (No Child Left Behind Act): Educate about role and potential for occupational therapy services in schools. HR 4872 (PL 111-152) - Health Care and Education Affordability Reconciliation Act: advocated for loan forgiveness for Occupational Therapy.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR4691 (PL 111-144) - Temporary Extensions Act of 2010: Advocate for extension of Medicare Therapy Caps Exceptions process and the Medicare Physicians Payment Update. HR 4851 (PL 111-157) - Continuing Extension Act of 2010: Advocate for extension of Medicare Physicians Payment Update. HR 3692 (PL 111-192) - Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010: Advocated for extension of Medicare Physicians Payment Update. Advocated for passage of short and long-term solutions to the Medicare Physician Fee Schedule payment cuts spurred by the Sustainable Growth Rate (SGR) formula. No Bill #: Advocate for extension of Medicare Therapy Caps Exceptions process. HR 3790 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner: educated and advocated on impact on occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 1708 - Ending the Medicare Disability Waiting Period Act of 2009: Advocated for passage. HR 4993 - Home Health Care Planning Improvement Act of 2010: Advocated for passage and educated about occupational therapy services. S 3216 - Medicare Rural Health Care Equity Act of 2010: Advocated for passage. HR 4371 - A bill to amend Title XVIII of the Social Security Act to continue using 2009 Medicare practice expense relative value units for certain cardiology services: Advocated regarding impact to occupational therapy services.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 5200 - FEHBP Dependent Coverage Extension Act: Educate and advocate for coverage of Occupational Therapy services. S 1963 - Caregivers and Veterans Omnibus Health Services Act of 2010: advocated for passage and inclusion of occupational therapy services. HR 1036 - Veterans Physical Therapy Services Improvement Act of 2009: Educated about the role and impact of occupational therapy services. HR 1558 - Preexisting Condition Patient Protection Act of 2009: Advocated for passage. S Res 490 - A resolution recognizing the measurable, positive impact that the National Committee for Quality Assurance has made on the quality of care patients in the United States have received during the 20 years since the formation of the organization: Advocated for passage. HR 5025 -HITECH Extension for Behavioral Health Services Act of 2010: Educated about occuaptional therapy services. HR 4944 - Siding with America's Patients (SWAP) Act - Educated about occupational therapy services and to ensure coverage. HR 4919, HR 4903 - A bill to repeal the Patient Protection and Affordable Care Act: Educated about occupational therapy services. HR 4910 - A bill to repeal the Patient Protection and Affordable Care Act and enact the Empowering Patients First Act in order to provide incentives to encourage health insurance coverage: Educated about occupational therapy services and to ensure coverage. HR 4894 -- A bill to amend the Patient Protection and Affordable Care Act ot ensure appropriate treatment of Department of Veterans' Affairs and Department of Defense heatlh programs: Educated about occupational therapy services. HR 5040 - Health Information Technology Extension for Behavioral Health Services Act of 2010: advocated for passage and educated about occupational therapy services. HR 678 - Huntington's Disease Parity Act: Advocated for passage

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

No bill #: Funding of Higher Education Loan Forgiveness for Occupational Therapists working with Children and or veterans. No bill#: Lobbied to establish a reserve fund for the Medicare Outpatient Therapy Caps Repeal to provide funding for cap repeal. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. Draft Bills DHAPPS1108 and DSAPPs1108 - Fiscal 2011 Labor, HHS & Education Appropriations: Lobby for report language to make occupational therapy an initiating service for Medicare Home Health beneficiaries. Lobbied for increased funding for all of the following programs: National Institute of Health (NIH); National Center on Medical and Rehabilitation Research, The Centers for Disease Controls Falls Prevention Program and older driver initiative; the Health Resources Services Administration; The Administration on Aging; the Older Americans Act (OAA); The Veterans Administration (VA); The Substance Abuse and Mental Health Services Administration (SAMSHA); The National Institute for Mental Health (NIMH); The Department of Education - for funding; funding for professions of national need under the Hihger Education act; and Title VII of the Public Health Services Act.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 H.R. 2891- Access to Frontline Health Care Act H.R. 3200-Affordable Health Choices Act H.R. 3962- Affordable Health Care Act for America FY 2011 Funding for Loan Forgiveness for Service in Areas of National Need Student Loan Forgiveness for Physical Therapists who Specialize in Geriatric Care H.R. 3590- Patient Protection and Affordable Care Act S. 1652- IDEA Full Funding Act H.R. 3578- Everyone Deserves Unconditional Access to Education Act Creation of new office of Specialized Instructional Support Personnel ESEA Re-authorization Recomendations

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 H.R. 2891- Access to Frontline Health Care Act H.R. 3200-Affordable Health Choices Act H.R. 3962- Affordable Health Care Act for America FY 2011 Funding for Loan Forgiveness for Service in Areas of National Need Student Loan Forgiveness for Physical Therapists who Specialize in Geriatric Care H.R. 3590- Patient Protection and Affordable Care Act S. 1652- IDEA Full Funding Act H.R. 3578- Everyone Deserves Unconditional Access to Education Act Creation of new office of Specialized Instructional Support Personnel ESEA Re-authorization Recomendations

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

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

No bill #: Funding of Higher Education Loan Forgiveness for Occupational Therapists working with Children and or veterans. No bill#: Lobbied to establish a reserve fund for the Medicare Outpatient Therapy Caps Repeal to provide funding for cap repeal. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. No bill # - Labor, HHS & Education Appropriations: Lobby for report language to make occupational therapy an initiating service for Medicare Home Health beneficiaries.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 43 and S. 46 - Medicare Access to Rehabilitative Services Act of 2009: Support and passage of all provisions, lobbying for the repeal of the provisions of the 1997 Balance Budget Act which imposed a $1840 annual cap on occupational therapy services covered by Medicare. HR 1094 - Medicare Home Health Flexibility Act of 2009: All provisions, passage, lobbying for changes to current regulations governing the provision of home health services under Medicare Part B to allow Occupational Therapy to qualify as an initiating service. HR 1137 - Athletic Trainers' Equal Access to Medicare Act of 2009: lobbying against specific provisions in the legislation that would allow athletic trainers to bill Medicare as a therapy service incident to a physicians order. HR 2479 - Medicare Orthotics and Prosthetics Improvement Act of 2009: Oppose. Negatively impacts occupational therapy scope of practice. HR 2068 - Medicare Telehealth Expansion Act of 2009: Advocate for passage and inclusion of occupational therapy. S 1131/HR 2560 - Independence at Home Act of 2009: Support passage and inclusion of occupational therapy. HR 1829/S 950 - Medicare Patient Access to Physical Therapists Act of 2009: advocate for changing the bill to include occupational therapy. HR 3184/S 1186 - Medicare Independent Living Act: Advocate for passage No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. S. 1679 - Affordable Health Choices Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and support of efforts to address shortages in health care workforce, including occupational therapy.. S. 1796 - America's Healthy Future Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR4691 (PL 111-144) - Temporary Extensions Act of 2010: Advocate for extension of Medicare Therapy Caps Exceptions process and the Medicare Physicians Payment Update. HR 4851 (PL 111-157) - Continuing Extension Act of 2010: Advocate for extension of Medicare Physicians Payment Update.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. S. 1679 - Affordable Health Choices Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and support of efforts to address shortages in health care workforce, including occupational therapy.. S. 1796 - America's Healthy Future Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

No bill #: Loan forgiveness for occupational therapists working with children and/or veterans under the Higher Education Act. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

HR 1600/S 1169 - To amend title 10, United States Code, to provide for the treatment of autism under TRICARE; lobbied to educate on Occupational Therapy role in Autism services. S 819/HR 2413 - Autism Treatment Acceleration Act of 2009; lobbied to educate on Occupational Therapy role in Autism services. No bill #: Health Care Reform; Educate about recommendations and position of the American Occupational Therapy Association regarding occupational therapy. HR 3200 - America's Affordable Health Choices Act of 2009: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy. S. 1679 - Affordable Health Choices Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and support of efforts to address shortages in health care workforce, including occupational therapy.. S. 1796 - America's Healthy Future Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 2891 - Access to Frontline Health Care Act of 2009: Support passage. HR 3590 (PL 111-148) - Patient Protection and Affordable Care Act: lobby regarding inclusion of occupational therapy, mental health coverage, and rehabilitation services; and in support of efforts to address shortages in health care workforce, including occupational therapy; and oppose Wyden Amendment D-9 offset related to orthotics and prosthetics; advocated to change Lincoln D-10 amendment to reduce the scope of the amendment and to include occupational therapy. HR 4662 - Lymphedema Diagnosis and Treatment Cost Saving Act of 2010: Oppose provisions requiring additional accreditation for occupational therapy services.

Client expense: $110,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

H Res 1003 - Expressing support for the designation of January 10, 2010, through January 16, 2010, as National Influenza Vaccination Week HR 2891 - Access to Frontline Health Care Act of 2009 Under Line 17: We would like to include the Agency for Healthcare Research and Quality (AHRQ) S 750 - Caring for an Aging America Act HR 1259 - Dextromethorphan Distribution Act of 2009 S 1213 - A bill to amend title XI of the Social Security Act to provide for the conduct of comparative effectiveness research. HR 2345 - Amends the Fair Credit Reporting Act to provide for an exclusion from Red Flag Guidelines for health care practices S 1213 - Patient-Centered Outcomes Research Act of 2009 HR 756/S 660 - National Pain Care Policy Act of 2009 HR 4872/ Public Law 111-152 - Health Care and Education Reconciliation Act of 2010 [Sections on Medicare Part D Changes; CMS/IRS data match to identify fraudulent providers; funding to fight fraud, waste and abuse; 90-day period of enhanced oversight for initial claims of DME suppliers; excise tax on medical device manufacturers; and drugs purchased by covered entities.] HR 3962 - Affordable Health Care for America Act [Sections on: wellness program grants; administrative simplification; ensuring adequacy of provider networks; essential benefits package defined; requiring information transparency and plan disclosure; state prohibitions on discrimination against health care providers; protection of physician prescriber information; nondiscrimination on abortion and respect for rights of conscience; study and report on methods to increase electronic health record (EHR) use by small health care providers; contracts for the offering of exchange-participating health benefits plans; payment rates for items and services; modernized payment initiatives and delivery system reforms; provider participation under the public health insurance option; limitations on health care related expenditures including distributions for medicine qualified only if for prescribed drugs or insulin; excise tax on medical devices; permitting physician assistants to order post-hospital extended care services and to provide for recognition of attending physician assistants as attending physicians to serve hospice patients; resource-based feedback program for physicians in Medicare; modifications to the physician quality reporting initiative; home infusion therapy report to Congress; durable medical equipment (DME) program improvements; MedPAC study and report on bone mass measurement; payment for biosimilar biological products; study and report on DME competitive bidding process; reducing potentially preventable hospital readmissions; post-acute care services payment reform plan and bundling pilot program; Institute of Medicine study on geographic variation in health care spending and promoting high-value health care; implementation, and Congressional review, of proposal to revise Medicare payments to promote high-value health care; phase-in of payment based on fee-for-service costs; quality bonus payments for Medicare Advantage plans; improvements to Medicare Part D including elimination of coverage gap; discounts for certain Part D drugs in original coverage gap; repeal of provision relating to submission of claims by pharmacies located in or contracting with long-term care facilities; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under Part D; no mid-year formulary changes permitted; negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries; accurate dispensing in long-term care facilities and free generic fill; elimination of part D cost-sharing for certain non-institutionalized full-benefit dual-eligible individuals; intelligent assignment in enrollment; demonstration to promote access for Medicare beneficiaries with limited English proficiency by providing reimbursement for culturally and linguistically appropriate services; accountable care organization pilot program; medical home pilot program; coverage and waiver of cost-sharing for preventive services; expanding access to vaccines; expansion of Medicare-covered preventive services at Federally Qualified Health Centers; independence at home demonstration program; recognition of certified Diabetes Educators as certified providers for purposes of Medicare Diabetes outpatients self-management training services; comparative effectiveness research; establishment of national priorities for quality improvement; development of new quality measures; GAO evaluation of data collection process for quality measurements; multi-stakeholder pre-rulemaking input into selection of quality measures; application of quality measures; reports on financial relationships between manufacturers and distributors of covered drugs, devices, biologicals, or medical supplies under Medicare, Medicaid, or CHIP and physicians and other health care entities and between physicians and other health care entities; requirement for public reporting by hospitals and ambulatory surgical centers on health care-associated infections; pharmacy benefit managers transparency requirements; increased funding and flexibility to fight fraud and abuse; enhanced penalties for false statements on provider or supplier enrollment applications; enhanced penalties for submission of false statements material to a false claim; enhanced penalties for delaying inspections; enhanced hospice program safeguards; enhanced penalties for individuals excluded from program participation; enhanced penalties for obstruction of program audits; exclusion of certain individuals and entities from participation in Medicare and State health care programs; enhanced CMS program protection authority; enhanced Medicare, Medicaid and CHIP program disclosure requirements relating to previous affiliations; require providers and suppliers to adopt programs to reduce waste, fraud and abuse; maximum period for submission of Medicare claims reduced to not more than 12 months; telehealth expansion and enhancements; physicians who order DME or home health services required to be Medicare enrolled physicians or eligible professionals; face-to-face encounter with patient required before eligibility certifications for home health services or DME; required repayments of Medicare and Medicaid overpayments; expanded application of hardship waivers for OIG exclusions to beneficiaries of any federal health care program; requiring provider and supplier payments under Medicare to be made through direct deposit or electronic funds transfer at insured depository institutions; under Medicaid and CHIP, required coverage of preventive services, tobacco cessation, medical home pilot program, inclusion of public health clinics under the vaccines for children program, accountable care organization pilot program, state option to disregard certain income in providing continued Medicaid coverage for certain individuals with extremely high prescription, payments to pharmacists (AMP), assuring adequate payment levels for services; report on Medicaid payments, health care acquired conditions, require providers and suppliers to adopt programs to reduce waste, fraud and abuse, overpayments, termination of provider participation under Medicaid and CHIP if terminated under Medicare or other State plan or Child health plan, Medicaid and CHIP exclusion from participation relating to certain ownership, control and management affiliations; requirement to report expanded set of data elements under Medicaid Management Information System to detect fraud and abuse, and extension of QI program; improved coordination and protection for dual-eligibles; assessment of Medicare cost-intensive diseases and conditions; establishment of Center for Medicare and Medicaid Innovation within CMS; frontline health providers loan repayment program; health workforce evaluation and assessment; improving accountability for approved medical residency training; other health care workforce issues; prevention and wellness; implementation of best practices in the delivery of health care; assistant Secretary for health information; expanded participation in 340B Program; improvements to 340B Program integrity; No Child Left Unimmunized Against Influenza: demonstration program using elementary and secondary schools as influenza vaccination centers; implementation of medication management services in treatment of chronic diseases; community-based collaborative care networks; Institute of Medicine conference on pain; pain research at NIH; public awareness campaign on pain management; licensure pathway for biosimilar biological products; Indian Health Care Improvement; and Medicare vaccine coverage issues (Medicare Part B vs. Part D).] HR 3590/ Public Law 111-148 - Patient Protection and Affordable Care Act [Sections on: reinsurance for early retirees; non-discrimination in health care; essential health benefits requirements; financial integrity in Exchanges; MedPAC study on adequacy of Medicare payments for health care providers serving in rural areas; coverage of comprehensive tobacco cessation services for pregnant women in Medicaid; distributions for medicine qualified only if for prescribed drug or insulin; administrative simplification; payment for biosimilar biological products; approval pathway for biosimilar biological products; patient-centered outcomes research; special rules; prohibition against discrimination on assisted suicide; presentation of prescription drug benefit and risk information; provider screening and other enrollment requirements under Medicare, Medicaid, and CHIP; enhanced Medicare and Medicaid program integrity provisions; maximum period for submission of Medicare claims reduced to not more than 12 months; physicians who order items or services required to be Medicare enrolled physicians or eligible professionals; requirement for physicians to provide documentation on referrals to programs at high risk of waste and abuse; face to face encounter with patient required before physicians may certify eligibility for home health services or durable medical equipment under Medicare; enhanced penalties; adjustments to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive acquisition program; termination of provider participation under Medicaid if terminated under Medicare or other State plan; Medicaid exclusion from participation relating to certain ownership, control, and management affiliations; health information technology enrollment standards and protocols; improvements to the physician quality reporting system; hospital readmissions reduction program; community-based care transitions program; Medicare Advantage payment; demostration project to evaluate integrated care around a hospitalization; state option to provide health homes for enrollees with chronic conditions; pediatric accountable care organization demonstration project; establishment of Center for Medicare and Medicaid Innovation within CMS; Medicare shared savings program; national pilot program on payment bundling; independence at home demonstration program; establishing community health teams to support the patient-centered medical home; Medicaid coverage for the lowest income populations; elimination of exclusion of coverage of certain drugs; providing adequate pharmacy reimbursement (AMP); exemption of certain pharmacies from DMEPOS accreditation requirements; payment adjustments for home health care; Medicare coverage gap discount program; immediate reduction in coverage Medicare Part D gap in 2010; improved information for subsidy eligible individuals reassigned to prescription drug plans and MAPD plans; improving formulary requirements for prescription drug plans and MAPD plans with respect to certain categories or classes of drugs; elimination of cost sharing for certain dual eligible individuals; uniform exceptions and appeals process for prescription drug plans and MAPD plans; Office of the Inspector General studies and reports; including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out-of-pocket threshold under part D; reducing wasteful dispensing of outpatient prescription drugs in long-term care facilities under prescription drug plans and MAPD plans; medication management (MTM) services in treatment of chronic disease; advancing research and treatment for pain care management; National Prevention, Health Promotion and Public Health Council; clinical and community preventive services; Medicare coverage of annual wellness visit providing a personalized prevention plan; removal of barriers to preventive services in Medicare; incentives for prevention of chronic diseases in Medicaid; community transformation grants; healthy aging, living well - evaluation of community-based prevention and wellness programs for Medicare beneficiaries; CDC and employer-based wellness programs; coverage of preventive health services; immunizations; community health insurance option; level playing field; State flexibility to establish basic health programs for low-income individuals not eligible for Medicaid; ensuring the quality of care; affordable choices of health benefit plans; national strategy to improve health care quality; interagency Working Group on Health Care Quality; quality measure development; quality measurement; data collection; public reporting; health care delivery system research; quality improvement technical assistance; demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals; transparency reports and reporting of physician ownership or investment interests; prescription drug sample transparency; pharmacy benefit managers transparency requirements; national health care workforce commission; health care workforce assessment; public health workforce recruitment and retention programs; allied health workforce recruitment and retention programs; grants for State and local programs; training in family medicine, general internal medicine, general pediatrics, and physician assistantship; geriatric education and training: career awards, comprehensive geriatric education; United States Public Health Sciences Track; interdisciplinary, community-based linkages (to support the existing health care workforce); and Medicare vaccine coverage issues (Medicare Part B vs. Part D).] Public Law 111-31 - Family Smoking Prevention and Tobacco Control Act on smoking cessation, advertising and marketing of tobacco products; and sale and distribution of tobacco. [Regulation Identifier Number (RIN) 0991-AB54] HIPAA Administrative Simplification: Standards for Privacy of Individually Identifiable Health Information [Genetic Information Nondiscrimination Act of 2008 (GINA)] [Regulation Identifier Number (RIN) 0991AB55] HIPAA Administrative Simplification: Enforcement HHS Draft Healthy People 2020 Objectives Concept - Role of Pharmacist-Provided Patient Care Services in Health Care Reform Concept - Include Pharmacists and Pharmacies in H1N1 and seasonal flu immunization activities Concept - National Health Service Corp

Client expense: $149,615 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

H.R. 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 H.R. 2891- Access to Frontline Health Care Act H.R. 3200-Affordable Health Choices Act H.R. 3962- Affordable Health Care Act for America FY 2011 Funding for Loan Forgiveness for Service in Areas of National Need Student Loan Forgiveness for Physical Therapists who Specialize in Geriatric Care H.R. 3590- Patient Protection and Affordable Care Act S. 1652- IDEA Full Funding Act H.R. 3578- Everyone Deserves Unconditional Access to Education Act Creation of new office of Specialized Instructional Support Personnel ESEA Re-authorization Recomendations

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 1204, the "Community Pharmacy Fairness Act of 2009", and S. 2161 Community Pharmacy Fairness Act from the 110th Congress; H.R. 616 and S. 511, the "Access to Durable Medical Equipment Act of 2009"; H.R. 1970 and S. 956, the "Preserve Patient Access to Reputable DMEPOS Providers Act of 2009"; H.R. 6331 (110th Congress), the "Medicare Improvements for Patients and Providers Act of 2008." Sec. 154 related to Medicare DMEPOS competitive acquisition program; and Sec. 172, related to submission of claims by pharmacies located in or contracting with long-term care facilities; Sec. 203, related to pharmacy payment under Medicaid; H.R. 1, "American Recovery and Reinvestment Act - P.L. 111-5 -- provisions related to Health Information Technology and HIPPA requirements; H.R. 5839 of the 110th Congress, the "Safeguarding America's Pharmaceuticals Act of 2008", provision relating to pedigree and track and trace requirements; H.R. 1427, the "Promoting Innovation and Life Savings Medicines Act of 2009"; H.R. 2647 and S. 1390, National Defense Authorization Act for 2010-Provides for the funding for the Department of Defense for fiscal year 2010-including the Tricare pharmacy program; H.R. 3108, the "Medication Therapy Benefits Act of 2009"; S. 1649, the "Weapons of Mass Destruction (WMD) Prevention and Preparednesss Act of 2009, pharmacy provider provisions; S. 1383, the "Dextromethorphan Abuse Reduction Act; H.R.3663: To amend title XVIII of the Social Security Act to delay the date on which the accreditation requirement under the Medicare Program applies to suppliers of durable medical equipment that are pharmacies; H.R. 2891, the "Access to Frontline Health Care Act of 2009"; H.R. 3200, the "America's Affordable Health Choices Act of 2009"; the draft Senate HELP Committee's "Affordable Health Choices Act of 2009"; Senate Finance Committee draft health care reform bill, all provisions related to Medicaid AMP pharmacy reimbursement, Medicare Part B DMEPOS accreditation and surety bond requirements, medication therapy management, public plan option and pharmacy benefit manager transparency requirements; H.R.3590: An act entitled The Patient Protection and Affordable Care ActDME Accreditation, AMP Fix, PBM Transparency, MTM Expansion, OPM PBA v. PBM; Senator Akaka Amendment to Senate version of H.R. 3590 to establish automatic enrollment into a Medicare Part D "chronic care management" program for targeted individuals; Senator Brown amendment to H.R. 3590 eliminating DMEPOS surety bond requirement for retail pharmacies; Senator Dorgan Drug Reimportation amendment to H.R. 3590; FSA Debit Card Programseeking Congressional support to amend IRS guidance (no legislation). P.L. 110-275, the Medicare Improvements for Patients and Providers Act of 2008, implementation of Part D prompt payment and Part B DMEPOS provisions; H.R. 4213, American Workers, State, and Business Relief Act of 2010, section 213, Medicare Part B DMEPOS accreditation requirements; H.R. 4872 and substitute amendment to H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010, section 1101, the Medicare Part D "donut hole", section 1305, oversight of DMEPOS suppliers.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE, Small Business Administration (SBA), Treasury, Dept of

HR 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 HR 2891- Access to Frontline Health Care Act HR 3200-Affordable Health Choices Act Senate Legislation- Affordable Health Choices Act Comments on proposed priorities for NIDRRs RRTC's and RERCs. FY 2010 Funding for Loan Forgiveness for Service in Areas of National Need

Client expense: $207,222 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA)

HR 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 HR 2891- Access to Frontline Health Care Act HR 3200-Affordable Health Choices Act Senate Legislation- Affordable Health Choices Act Comments on proposed priorities for NIDRRs RRTC's and RERCs. FY 2010 Funding for Loan Forgiveness for Service in Areas of National Need

Client expense: $207,222 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA)

HR 988/ S 1057 - Physical Therapist Student Loan Repayment Eligibility Act of 2009 HR 2891- Access to Frontline Health Care Act HR 3200-Affordable Health Choices Act Senate Legislation- Affordable Health Choices Act Comments on proposed priorities for NIDRRs RRTC's and RERCs. FY 2010 Funding for Loan Forgiveness for Service in Areas of National Need

Client expense: $207,222 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA)