Health Savings and Affordability Act of 2009

Implementation of healthcare reform legislation; premium tax, high-value health plan tax, tax credits, LTC insurance in cafeteria plans, FSA limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - Executive Branch actions re PL 111-148 and PL 111-152. *Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. *Tax incentives for LTC insurance - HR 897, To amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long-term care needs; S 94, A bill to amend the Internal Revenue Code of 1986 to provide for a nonrefundable tax credit for long-term care insurance premiums; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 1891, To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for half of an individual's long-term care insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 6234, Comprehensive Long-Term Care Support Act of 2010. *HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission. *HSA improvements - HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes; HR 3971, To amend the Internal Revenue Code of 1986 to expand the permissible use of health savings accounts to include health insurance payments and to increase the dollar limitation for contributions to health savings accounts, and for other purposes. *Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. *Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. *Tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits - S 2958, CARE Act of 2010. *Changes to premium tax, high-value health plan tax - HR 4872, Health Care and Education Reconciliation Act of 2010. *Repeal HSA and FSA restrictions - HR 5923, To amend the Patient Protection and Affordable Care Act to repeal certain limitations on tax health care benefits; S 3673, Patients' Freedom to Choose Act. *Treatment of high deductible health plans as qualified health plans, repeal of HSA and FSA restrictions - HR 5936, Restoring Assistance for Families' and Seniors' Health Expenses Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts; Letter to IRS urging the Internal Revenue Service to improve its new Schedule H to better reflect the benefits non-profit hospitals systems provide to their communities; Meetings with IRS re implementation of the provisions of IRC 501(r) enacted as part of the PPACA and Schedule H reporting by hospitals that are part of health care systems.

H.R. 897, Long-Term Care and Retirement Security Act (Putnam) tax incentives for LTC insurance; (cont.) H.R. 1891, Sunset of Life Protection Act (Alexander) tax incentives for LTC insurance; H.R. 2096, Long-Term Care Affordability and Security Act (Pomeroy) tax incentives for LTC insurance; H.R. 2974: HSAs for Veterans (Campbell) HSA contributions by veterans; H.R. 3478, Patient-Controlled Healthcare Protection Act (Gohmert) HSA improvements, transparency; H.R. 3490, Wellness Programs (Johnson) tax incentives for employer-sponsored wellness programs; H.R. 3508, Healthy Savings Act (Paulsen) HSA improvements; H.R. 3590, Patient Protection and Affordable Care Act (Reid) premium tax, high-value health plan tax, tax credits, LTC insurance in cafeteria plans, FSA limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses; H.R. 3610, Health Savings and Affordability Act (Austria) health insurance tax deduction, HSAs; H.R. 3971, Health Savings Account Expansion Act (Flake) HSA improvements; H.R. 4872, Health Care and Education Reconciliation Act (Spratt) changes to premium tax, high-value health plan tax; S. 94, Long-Term Care Family Accessibility Act (Vitter) tax incentives for LTC insurance; S. 702, Long-Term Care Affordability and Security Act (Grassley) tax incentives for LTC insurance; S. 2958 CARE Act (Menendez) tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits TAX (Regulatory) Issues relating to Health Savings Accounts; issues related to COBRA subsidy requirements; issues relating to withholding of government contract payments; and issues relating to health care reform implementation.

Client expense: $2,290,000 · Firm income: Not reported

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts; Letter to IRS urging the Internal Revenue Service to improve its new Schedule H to better reflect the benefits non-profit hospitals systems provide to their communities.

Healthcare reform and international health plans in PL 111-148 - Executive Branch actions re these issues. *Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. *Tax incentives for LTC insurance - HR 897, To amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long-term care needs; S 94, A bill to amend the Internal Revenue Code of 1986 to provide for a nonrefundable tax credit for long-term care insurance premiums; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 1891, To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for half of an individual's long-term care insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. *HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission. *HSA improvements - HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes; HR 3971, To amend the Internal Revenue Code of 1986 to expand the permissible use of health savings accounts to include health insurance payments and to increase the dollar limitation for contributions to health savings accounts, and for other purposes. *Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. *Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. *Tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits - S 2958, CARE Act of 2010. *Premium tax, high-value health plan tax, tax credits, LTC insurance in cafeteria plans, FSA limits, tax exclusiong for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - HR 3590, Patient Protection and Affordable Care Act . *Changes to premium tax, high-value health plan tax - HR 4872, Health Care and Education Reconciliation Act of 2010.

H.R. 897, Long-Term Care and Retirement Security Act (Putnam) tax incentives for LTC insurance; H.R. 1891, Sunset of Life Protection Act (Alexander) tax incentives for LTC insurance; (cont.) H.R. 2096, Long-Term Care Affordability and Security Act (Pomeroy) tax incentives for LTC insurance; H.R. 2974: HSAs for Veterans (Campbell) HSA contributions by veterans; H.R. 3478, Patient-Controlled Healthcare Protection Act (Gohmert) HSA improvements, transparency; H.R. 3490, Wellness Programs (Johnson) tax incentives for employer-sponsored wellness programs; H.R. 3508, Healthy Savings Act (Paulsen) HSA improvements; H.R. 3590, Patient Protection and Affordable Care Act (Reid) premium tax, high-value health plan tax, LTC insurance in cafeteria plans, FSA limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses; H.R. 3610, Health Savings and Affordability Act (Austria) health insurance tax deduction, HSAs; H.R. 3962, Americas Affordable Health Choices Act (Dingell) FSA limits, health savings accounts, eligibility of OTC drugs as tax-free expense; H.R. 3971, Health Savings Account Expansion Act (Flake) HSA improvements; H.R. 4872, Health Care and Education Reconciliation Act (Spratt) changes to premium tax, high-value health plan tax; S. 94, Long-Term Care Family Accessibility Act (Vitter) tax incentives for LTC insurance; S. 702, Long-Term Care Affordability and Security Act (Grassley) tax incentives for LTC insurance; S. 1679, Affordable Health Choices Act (Harkin) LTC insurance in cafeteria plans; S. 1796, Americas Healthy Future Act (Baucus) high-cost health plan tax, industry tax, LTC insurance in cafeteria plans, FSA limits, employer tax exclusion, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses; S. 2958 CARE Act (Menendez) tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits TAX (Regulatory) Issues relating to Health Savings Accounts; issues related to COBRA subsidy requirements; and issues relating to withholding of government contract payments.

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts; Letter to IRS urging the Internal Revenue Service to improve its new Schedule H to better reflect the benefits non-profit hospitals provide to their communities.

FSA limits, health savings accounts, eligibility of OTC drugs as tax-free expense - HR 3962, America's Affordable Health Choices Act. Premium tax, high-value health plan tax, LTC insurance in cafeteria plans, FSA limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - HR 3590, Patient Protection and Affordable Care Act. Changes to premium tax, high-value health plan tax - HR 4872, Health Care and Education Reconciliation Act of 2010. *Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. *Tax incentives for LTC insurance - HR 897, To amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long-term care needs; S 94, A bill to amend the Internal Revenue Code of 1986 to provide for a nonrefundable tax credit for long-term care insurance premiums; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 1891, To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for half of an individual's long-term care insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. *HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission. *HSA improvements - HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes; HR 3971, To amend the Internal Revenue Code of 1986 to expand the permissible use of health savings accounts to include health insurance payments and to increase the dollar limitation for contributions to health savings accounts, and for other purposes. *Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. *Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. *LTC insurance in cafeteria plans - S 1679, 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. *High-cost health plan tax, industry tax, LTC insurance in cafeteria plans, FSA limits, employer tax exclusion, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. *Tax incentives for LTC insurance, consumer protections for LTC insurance, caregiver tax credits - S 2958, CARE Act of 2010.

see attached HR 3508 - Healthy Savings Act HR 3610- Health Savings and Affordability Act HR 3776 -Helping Make Health Insurance Affordable for Individuals and Small Businesses Act HR 3889 -Offering Patients True Individualized Options Act HR 3971 -Health Savings Account Expansion Act S 207 -Health Insurance Tax Relief Act

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

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

Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. Tax incentives for LTC insurance - HR 897, To amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long-term care needs; S 94, A bill to amend the Internal Revenue Code of 1986 to provide for a nonrefundable tax credit for long-term care insurance premiums; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 1891, To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for half of an individual's long-term care insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission. HSA improvements - HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes; HR 3971, To amend the Internal Revenue Code of 1986 to expand the permissible use of health savings accounts to include health insurance payments and to increase the dollar limitation for contributions to health savings accounts, and for other purposes. Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. LTC insurance in cafeteria plans - S 1679, 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. Premium tax, high-value health plan tax, LTC insurance in cafeteria plans, FAS limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - HR 3590, An act entitled The Patient Protection and Affordable Care Act. FSA limits, health savings accounts, eligibility of OTC drugs as tax-free expense - HR 3962, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. High-cost health plan tax, industry tax, LTC insurance in cafeteria plans, FSA limits, employer tax exclusion, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

H.R. 897, Long-Term Care and Retirement Security Act (Putnam) tax incentives for LTC insurance; H.R. 1891, Sunset of Life Protection Act (Alexander) tax incentives for LTC insurance (cont.) H.R. 2096, Long-Term Care Affordability and Security Act (Pomeroy) tax incentives for LTC insurance; H.R. 2974: HSAs for Veterans (Campbell) HSA contributions by veterans; H.R. 3478, Patient-Controlled Healthcare Protection Act (Gohmert) HSA improvements, transparency; H.R. 3490, Wellness Programs (Johnson) tax incentives for employer-sponsored wellness programs; H.R. 3508, Healthy Savings Act (Paulsen) HSA improvements; H.R. 3590, Patient Protection and Affordable Care Act (Reid) premium tax, high-value health plan tax, LTC insurance in cafeteria plans, FSA limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses; H.R. 3610, Health Savings and Affordability Act (Austria) health insurance tax deduction, HSAs; H.R. 3962, Americas Affordable Health Choices Act (Dingell) FSA limits, health savings accounts, eligibility of OTC drugs as tax-free expense; H.R. 3971, Health Savings Account Expansion Act (Flake) HSA improvements; S. 94, Long-Term Care Family Accessibility Act (Vitter) tax incentives for LTC insurance; S. 702, Long-Term Care Affordability and Security Act (Grassley) tax incentives for LTC insurance; S. 1679, Affordable Health Choices Act (Harkin) LTC insurance in cafeteria plans; S. 1796, Americas Healthy Future Act (Baucus) high-cost health plan tax, industry tax, LTC insurance in cafeteria plans, FSA limits, employer tax exclusion, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses TAX (Regulatory) Issues relating to Health Savings Accounts; issues related to COBRA subsidy requirements; and issues relating to withholding of government contract payments.

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts.

see attached HR 3508 - Healthy Savings Act HR 3610- Health Savings and Affordability Act HR 3776 -Helping Make Health Insurance Affordable for Individuals and Small Businesses Act HR 3889 -Offering Patients True Individualized Options Act HR 3971 -Health Savings Account Expansion Act S 207 -Health Insurance Tax Relief Act

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

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

Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. Tax incentives for LTC insurance - HR 897, To amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long-term care needs; S 94, A bill to amend the Internal Revenue Code of 1986 to provide for a nonrefundable tax credit for long-term care insurance premiums; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 1891, To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for half of an individual's long-term care insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission. HSA improvements - HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes; HR 3971, To amend the Internal Revenue Code of 1986 to expand the permissible use of health savings accounts to include health insurance payments and to increase the dollar limitation for contributions to health savings accounts, and for other purposes. Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. LTC insurance in cafeteria plans - S 1679, 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. Premium tax, high-value health plan tax, LTC insurance in cafeteria plans, FAS limits, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - HR 3590, An act entitled The Patient Protection and Affordable Care Act. FSA limits, health savings accounts, eligibility of OTC drugs as tax-free expense - HR 3962, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. High-cost health plan tax, industry tax, LTC insurance in cafeteria plans, FSA limits, employer tax exclusion, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses - S 1796, An original bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

S1679 - Affordable Health Choices Act;HR3610 - Tax deduction for insurance costs;Senate Finance America's Healthy Futures Act;HR1884 - Amend Public Health Service Act re NHSC Loans and Scholarships; HR3596/S1681 - Anti-Trust Exemption and Health/Malpractice Insurers;HR914 - Expand eligibility for residency start-up loans;HR3200 - House Draft Tri-Committee Health Reform Bill;HR3962/HR3590 - Health Reform

Client expense: $52,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3610 to reform FDA regulation of federal imported and domestic food safety with emphasis on those titles and sections related to the certification of imports of ingredients for food and drugs, as well as country-of-origin labeling.

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

Government targets: Agriculture, Dept of (USDA), Energy, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

IRS Discussion about the treatment of hospital foundations in terms of 990, Schedule H; HR 3478 Patient-Controlled Healthcare Protection Act of 2009, bill to amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 1087 ADOPT HIT Act of 2009, a bill to amend the Internal Revenue Code of 1986 to increase the deduction under section 179 for the purchase of qualified health care information technology by medical care providers, and for other purposes; HR 1495 Comprehensive Health Care Reform Act of 2009, a bill to amend the Internal Revenue Code of 1986 to make health care coverage more accessible and affordable; HR 1496 Child Health Care Affordability Act, a bill to amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents; HR 1497 Treat Physicians Fairly Act of 2009, a bill to amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care; S 860 Health Professionals State Loan Repayment Tax Relief Act of 2009, a bill to amend the Internal Revenue Code of 1986 to provide a Federal income tax exclusion for assistance provided to participants in State student loan programs for certain health professionals; HR 2292 Healthy Kids for Healthy Futures Act of 2009, a bill to amend the Employee Retirement Income Security Act of 1974, the Public Health Service Act, and the Internal Revenue Code of 1986 to require coverage of preventive care for children; H.R. 3205 Health Insurance Company Advertising Deduction Denial Act of 2009, a bill to amend the Internal Revenue Code of 1986 to deny any deduction for advertising health insurance; HR 3610 Health Savings and Affordability Act of 2009, a bill to amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts.

HR 3354 -Amend the Internal Revenue Code of 1986 - 7.5% deduction; HR 3508 -Healthy Savings Act, HR 3610 - Health Savings and Affordability Act, HR 859 - Small Business CHOICE Act, S 207 - Health Insurance Tax Relief Act, S 29 -Coverage Continuity Act

Client expense: $375,000 · Firm income: Not reported

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

Generic contributions by veterans - HR 2974, To amend the Internal Revenue Code of 1986 to allow individuals eligible for veterans health benefits to contribute to health savings accounts. Tax incentives for LTC insurance - HR 897, To amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long-term care needs; S 94, A bill to amend the Internal Revenue Code of 1986 to provide for a nonrefundable tax credit for long-term care insurance premiums; S 702, A bill to amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance; HR 1891, To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for half of an individual's long-term care insurance premiums; HR 2096, To amend the Internal Revenue Code of 1986 to allow long-term care insurance to be offered under cafeteria plans and flexible spending arrangements and to provide additional consumer protections for long-term care insurance. High-cost health plan tax, industry tax, LTC insurance in cafeteria plans, FSA limits, employer tax exclusion, tax exclusions for FSAs and HRAs, health savings accounts, tax deduction for itemized health expenses - Draft legislation (Finance/Bausuc-Grassley draft policy options). HSA improvements, transparency - HR 3478, To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission; HR 3508, To amend the Internal Revenue Code of 1986 to provide for improved treatment of HSA account provisions, and for other purposes. Tax incentives for employer-sponsored wellness programs - HR 3490, To amend the Internal Revenue Code of 1986 to provide tax incentives for employer-provided wellness programs. Health insurance tax deduction, HSAs - HR 3610, To amend the Internal Revenue Code of 1986 to improve access to health care by allowing a deduction for the health insurance costs of individuals, expanding health savings accounts, and for other purposes. LTC insurance in cafeteria plans - S 1679, 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.

Americas Healthy Future Act (Baucus) high-cost health plan tax, industry tax, LTC insurance in cafeteria plans, FSA limits, employer tax exclusion, tax exclusion for FSAs and HRAs, health savings accounts, tax deduction for itemized medical expenses (cont.) H.R. 897, Long-Term Care and Retirement Security Act (Putnam) tax incentives for LTC insurance; H.R. 1891, Sunset of Life Protection Act (Alexander) tax incentives for LTC insurance; H.R. 2096, Long-Term Care Affordability and Security Act (Pomeroy) tax incentives for LTC insurance; H.R. 2974: HSAs for Veterans (Campbell) HSA contributions by veterans; H.R. 3478, Patient-Controlled Healthcare Protection Act (Gohmert) HSA improvements, transparency; H.R. 3490, Wellness Programs (Johnson) tax incentives for employer-sponsored wellness programs; H.R. 3508, Healthy Savings Act (Paulsen) HSA improvements; H.R. 3610, Health Savings and Affordability Act (Austria) health insurance tax deduction, HSAs; S. 94, Long-Term Care Family Accessibility Act (Vitter) tax incentives for LTC insurance; S. 702, Long-Term Care Affordability and Security Act (Grassley) tax incentives for LTC insurance; S. 1679, Affordable Health Choices Act (Harkin) LTC insurance in cafeteria plans TAX (Regulatory) Issues relating to Health Savings Accounts; issues related to COBRA subsidy requirements; and issues relating to withholding of government contract payments.

Client expense: $2,410,000 · Firm income: Not reported

HR1625/S654 - Amend Title XIX of the SSA; HR1884 - Amend Public Health Service Act re NHSC Loans and Scholarships; HR914 - Expand eligibility for residency start-up loans; HR1615/S646 - Restore deferment of loan repayment for medical residents;HR2714/S1110/S1380 - Expand powers of MedPAC;S1174/HR2350 - Education Loan Deferment;HR2891 - Health Provider Loan Repayment;HR3200 - House Draft Tri-Committee Health Reform Bill;HR3014 - HIT Small Business Loan Bill; S1679 - Affordable Health Choices Act; HR3610 - Tax deduction for insurance costs;Senate Finance America's Healthy Futures Act;HR3596/S1681 - Anti-Trust Exemption and Health/Malpractice Insurers;

Client expense: $50,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3610 to reform FDA regulation of federal imported and domestic food safety with emphasis on those titles and sections related to the certification of imports of ingredients for food and drugs, as well as country-of-origin labeling.

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

Government targets: Agriculture, Dept of (USDA), Energy, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 3126, Consumer Financial Protection Act of 2009, all provisions; H.R. 1456, Consumer Overdraft Protection Fair Practices Act, all provisions; H.R. 2897, Bank Accountability and Risk Assesment Act of 2009, all provsions; H.R. 3610 Health Savings and Affordability Act of 2009, all provisions; S. 605/H.R. 302/H.R. 1406, Stock Market Recovery Act of 2009, all provisions; H.R. 3269, Corporate and Financial Institutions Compensation Fairness Act, all provisons; foreign tax repatriation issues (no bill)

Client expense: $51,275 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3126, Consumer Financial Protection Act of 2009, all provisions; H.R. 1456, Consumer Overdraft Protection Fair Practices Act, all provisions; H.R. 2897, Bank Accountability and Risk Assesment Act of 2009, all provsions; H.R. 3610 Health Savings and Affordability Act of 2009, all provisions; S. 605/H.R. 302/H.R. 1406, Stock Market Recovery Act of 2009, all provisions; H.R. 3269, Corporate and Financial Institutions Compensation Fairness Act, all provisons; foreign tax repatriation issues (no bill)

Client expense: $51,275 · Firm income: Not reported

Animal Health Biotech Pet Food issues Animal Wellbeing Legislation to require the federal government to purchase meat, dairy and poultry products only from farmers meeting certain animal welfare requirements, including a restriction on confinement housing. HR 3610, all titles, as it relates to FDA regulation of pet food and pet food ingredients, including imported ingredients and the labeling thereof. Food & Drug Administration pending Advanced Feed Safety System discussions with industry as to ingredient and processing definitions and standards.

Client expense: Not reported · Firm income: $30,000

Government targets: Agriculture, Dept of (USDA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office

HR 3610 to reform FDA regulation of federal imported and domestic food safety with emphasis on those titles and sections related to the certification of imports of ingredients for food and drugs, as well as country-of-origin labeling.

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

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Bills and provisions relating to the dietary supplement industry, including but not limited to: S. 3230, S. 770, S. 771/H.R. 1363, S. 762/H.R. 1249, H.R. 1107, S. 2470, H.R. 3610, S. 1274/H.R. 2108, S. 1776, S. 2245, H.R. 3937, H.R. 3624, S. 654/H.R. 1148, H.R. 5904, S. 3385

Client expense: Not reported · Firm income: Not reported

Bills and provisions relating to the dietary supplement industry, including but not limited to: S. 3230, S. 770, S. 771/H.R. 1363, S. 762/H.R. 1249, H.R. 1107, S. 2470, H.R. 3610, S. 1274/H.R. 2108, S. 1776, S. 2245, H.R. 3937, H.R. 3624, S. 654/H.R. 1148, H.R. 5904, S. 3385

Client expense: Not reported · Firm income: Not reported

Bills and provisions relating to the dietary supplement industry, including but not limited to: S. 3230, S. 770, S. 771/H.R. 1363, S. 762/H.R. 1249, H.R. 1107, S. 2470, H.R. 3610, S. 1274/H.R. 2108, S. 1776, S. 2245, H.R. 3937, H.R. 3624, S. 654/H.R. 1148, H.R. 5904, S. 3385

Client expense: Not reported · Firm income: Not reported

Bills and provisions relating to the dietary supplement industry, including but not limited to: S. 3230, S. 770, S. 771/H.R. 1363, S. 762/H.R. 1249, H.R. 1107, S. 2470, H.R. 3610, S. 1274/H.R. 2108, S. 1776, S. 2245, H.R. 3937, H.R. 3624, S. 654/H.R. 1148, H.R. 5904, S. 3385

Client expense: Not reported · Firm income: Not reported

Bills and provisions relating to the dietary supplement industry, including but not limited to: S. 3230, S. 770, S. 771/H.R. 1363, S. 762/H.R. 1249, H.R. 1107, S. 2470, H.R. 3610, S.1274/H.R. 2108, S. 1776, S. 2245, H. R. 3937, H.R. 3624, S. 654/H.R. 1148, H.R. 5904, S. 3385

Client expense: Not reported · Firm income: Not reported

Bills and provisions relating to the dietary supplement industry, including but not limited to: S. 3230, S. 770, S. 771/H.R. 1363, S. 762/H.R. 1249, H.R. 1107, S. 2470, H.R. 3610, S.1274/H.R. 2108, S. 1776, S. 2245, H. R. 3937, H.R. 3624, S. 654/H.R. 1148, H.R. 5904, S. 3385

Client expense: Not reported · Firm income: Not reported