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.

Implementation of the Medicare Improvements for Patients and Providers Act of 2008, reimbursement for home oxygen therapy. H.R.3220, Medicare Home Oxygen Therapy Act of 2009 - Medicare reimbursement procedures for the home oxygen benefit. CMS regulations concerning the DMEPOS Competitive Bidding program, inhalation drugs and sleep disorder therapies. H.R. 1077 and S. 343, the Medicare Respiratory Therapy Initiative Act of 2009, reimbursement for respiratory therapy. Public Law 111-148, the Patient Protection and Affordable Care Act of 2009 - reimbursement process and payment levels for Medicare home oxygen benefit. H.R. 3790, legislation to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner. Also participated in meetings and discussions on prospective legislative proposal to reform Medicare home oxygen therapy benefit.

Client expense: Not reported · Firm income: $75,000

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

H.R. 1548 - Pathway for Biosimilars Act Oppose Physician-Owned Hospital restrictions in H.R. 3200, H.R. 3962, H.R. 3590, and all health care reform measures H.R. 756/ S.660 - Support National Pain Care Policy Act of 2009 Oppose use of comparative effectiveness research to determine health care coverage or reimbursement decisions Support Health IT funding and standards Support Hagen/Enzi/Hatch Amendment to S. 325 Support HR 1894 and S. 769 Support Eshoo/Barton Amendment on biosimilars (to H.R. 3200) in House Energy and Commerce Committee Support increased Osteoporosis screening funds in health care reform bills Support request for House Oversight Committee hearings on prostate cancer, additional efforts to screen for and treat Oppose the establishment of a "Super MedPAC" Commission empowered to cut Medicare payments and benefits Oppose the Medicare cuts included in H.R. 3200, H.R. 3962, H.R. 3590, and all health care reform measures Oppose Senate Amendment 2793 Support McCain Motion to Recommit H.R. 3590 with instructions to remove all Medicare cuts Support Senate Amendment 2942 Support H.R. 3790 Support H.R. 2115 Support patient-centered comparative effectiveness research language passed by the Senate in H.R. 3590 Support 340B Federal Drug Discount Program purchasing provisions passed by the House and Senate in H.R. 3590 Oppose all efforts to shorten the 12-year exclusivity period provided (in both the House and Senate health care reform bills) for the original biologic drug as it pertains to a safe pathway for biosimilar "follow-on" drugs Support "Specialty Tier" pricing relief in Medicare Part D Drug Plans and in CMS rulemaking regarding those plans. Support increased funding to address the growing national burden of arthritis, including intervention and prevention plans. Support Efforts to Eliminate "Lifetime Caps" on health insurance benefits. Support Part D Medicare Coverage Gap Discount Program "draft guidance" to improve the program for beneficiaries. Oppose Recess Appointment of Dr. Donald Berwick as CMS Administrator. Support expanded screening for Osteoporosis for both women and men under new coverage rules. Support nomination of Peter Pitts for the Patient-Centered Outcomes Research Institute Board of Governors. Support Medicare reimbursement for Provenge to treat prostate cancer. Support the most stringent and rigorous testing of biosimilars that would or could be used as replacements for the original, innovator biologic drugs. Support the Council for American Medical Innovation comments to The National Commission on Fiscal Responsibility and Reform regarding the continuing need for spending to promote medical innovation to save lives and money. Support the Partnership to Fight Chronic Disease response to the Agency for Healthcare Research and Quality request for feedback on the National Quality Strategy and Plan development in regards to the Affordable Care Act.

Client expense: $76,368 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

H.R. 3790: Medicare Competitive Bidding for DMEPOS S. 254/H.R. 574: Medicare Home Infusion Therapy Coverage Act of 2009

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

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

Health care issues affecting individuals with neuromuscular disease, including transitional health care issues; advocating for neurologists' eligibility for Medicare payment incentives under the Patient Protection and Affordable Care Act; research and treatment of spinal muscular atrophy - H.R. 2149/S. 1158; and Competitive Bidding Repeal - H.R. 3790

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care issues affecting individuals with neuromuscular disease, including H.R. 2149/S. 1158, legislation to accelerate research and treatment of spinal muscular atrophy and H.R. 3790, Competitive Bidding Repeal

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Healthcare reform; healthcare regulations; Medicare Part D; proposed antitrust exemptions for certain pharmacies; IVIG payments; Medicare demonstration projects for durable medical equipment; importation of prescription drugs; home infusion; disclosure of PBM information; changes to drug benefits offered under the FEHBP and increasing healthcare value; competitive bidding; proposed revisions to the blood glucose local coverage determination H.R. 574 and S. 254 - Medicare Home Infusion Therapy Coverage Act of 2009; all sections H.R. 1204 - Community Pharmacy Fairness Act of 2009; all sections H.R. 1765 - To Amend Title XVIII of the Social Security Act with respect to payment for the furnishing of intravenous immune globulin (IVIG) in a patient's home for the treatment of primary immune deficiency diseases and to cover certain disposable pumps as durable medical equipment in place of non-disposable pumps under the Medicare program; all sections H.R. 5597 - To Establish a Medicare Patient IVIG Access Demonstration Project; all sections H.R. 4199 - Patient Health and Real Medication Access Cost Savings Act of 2009; all sections H.R. 3962 - Affordable Healthcare for All America Act of 2009; all sections S. 1796 - America's Healthy Future Act of 2009; sections 1001 - 2221 H.R. 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); all sections H.R. 4752 - Medicare Prescription Drug Price Negotiations Act of 2010; all sections Public Law 111-152 - Healthcare and Education Reconciliation Act of 2010 (formerly H.R. 4872); all sections

Client expense: $470,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), Postal Rate Commission, Postal Regulatory Commission, SENATE, U.S. Postal Service (USPS)

Issues related to comprehensive health care reform: Health Information Technology; ARRA Privacy and Security Rules; Generic Biologics; Comparative Effectiveness; Importation of Prescription Drugs; Competitive Bidding; Chronic Care Management; Healthcare Reform; and Healthcare Implementation H.R. 1 - American Recovery and Reinvestment Act of 2009; Title VIII Department of Labor, Health and Human Services, and Education, and related agencies; Healthcare Research and Quality and Title XIII - Health Information Technology for Economic and Clinical Health Act or the HITECH Act; all sections H.R. 1321 and S. 391 - Healthy Americans Act; all sections H.R. 1427 and S. 726 - Promoting Innovation and Access to Life-Saving Medicine Act; all sections H.R. 1548- Pathway for Biosimilars Act; all sections H.R. 3200 - America's Affordable Health Choices Act; all sections H.R. 3596 - Health Insurance Industry Antitrust Enforcement Act of 2009; all sections H.R. 3962 - Affordable Healthcare for America Act; all sections Public Law 111-148 - Patient Protection and Affordable Care Act; all sections (formerly H.R. 3590) H.R. 4199 - Patient Health and Real Medication Access Cost Savings Act; all sections Public Law 111-152 - Health Care and Education Reconciliation Act of 2010; all sections (formerly H.R. 4872 and S. Con. Res. 13) H.R. 4489 - The FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act of 2010; all sections H.R. 5235 - The Medicare Access to Diabetes Supplies Act; all sections H.R. 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); all sections Public Law 104-191 - Health Insurance Portability and Accountability Act (HIPAA); Title II H.R. 5440 - Genomics and Personalized Medicine Act of 2010; all sections

Client expense: $470,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), Postal Rate Commission, Postal Regulatory Commission, SENATE, U.S. Postal Service (USPS)

PL-110-275 Implementation of Medicare DMEPOS Competitive Acquisition Program H.R. 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 H.R.1321, S. 2404 Medicare Advanced Laboratory Diagnostics Act of 2007

Client expense: $1,750,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

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

- S. 301, "A bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP", regarding all provisions. - H.R. 3790, "To amend Title XVIII of the Social Security Act to repeal the Medicare competitive acquision program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner. - H.R. 5440, "The Genomics and Personalized Medicine Act of 2010", regarding all provisions. - H. R. 6331, "Generating Antibiotic Incentives Act of 2010", regarding all provisions.

Client expense: $850,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Treasury, Dept of

HR 3790 - Relating to the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS); Issues concerning diabetes mail order supplies as part of the DMEPOS competitive bidding program; Issues concerning the PECOS program. CMS-1503-P - Proposed Rule - Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2011

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

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

HR 3509: Patient Protection and Affordable Care Act of 2010 - various provisions including: Medical Device Excise Tax, various reimbursement cuts and policy proposals for medical imaging; remote monitoring technology in the context of accountable care organizations, medical homes and post acute bundling; transparency HR 3692: The Affordable Health Care for America Act: Imaging cuts, device tax transparency and remote monitoring PL 110-275: "Medicare Improvements for Patient and Providers Act" (sec. 135) - Medical imaging accreditations program; medical imaging clinical appropriateness demonstration program HR 621/ S 1484: "Home Oxygen Patient Protection Act" - Restores treatment of oxygen equipment to standards that existed prior to enactment of the Deficit Reduction Act of 2005 HR 4872 - Health Care and Education Reconciliation Act of 2010 HR 4213 - Sustainable Growth Rate Extension HR 3790 - Repeal of Medicare Competitive Acquisition program for DME in a budget neutral manner

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Intl Trade Administration (ITA), Office of Management & Budget (OMB), SENATE

Implementation of Medicare Improvements for Patients and Providers Act of 2008 H.Con.Res.85 - Concurrent Resolution on the Budget for Fiscal Year 2010, all titles H.R.3200 - America's Affordable Health Choices Act of 2009, all titles H.R.3220 - Medicare Home Oxygen Therapy Act of 2009, all titles S.Con.Res.13 - Concurrent Resolution on the Budget for Fiscal Year 2010, all titles S.1796 - America's Healty Future Act of 2009 H.R. 3962 - Presentation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 4213 - American Jobs and Closing Tax Loopholes Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3790 - Repeal of Medicare DMEPOS Competitive Acquisition Program H.R. 3081 - Continuing Appropriations Act of 2011 H.R.3082 - Continuing Appropriations & Surface Transportation Extensions Act, 2011 H.R.4853 - Tax Relief, Unemployment Insurance Reauthorization, and Job Creation Act of 2010 H.R.4994 - Medicare and Medicaid Extenders Act of 2010

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Implementation of Medicare Improvements for Patients and Providers Act of 2008 H.Con.Res.85 - Concurrent Resolution on the Budget for Fiscal Year 2010, all titles H.R.3200 - America's Affordable Health Choices Act of 2009, all titles H.R.3220 - Medicare Home Oxygen Therapy Act of 2009, all titles S.Con.Res.13 - Concurrent Resolution on the Budget for Fiscal Year 2010, all titles S.1796 - America's Healty Future Act of 2009 H.R. 3962 - Presentation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 4213 - American Jobs and Closing Tax Loopholes Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3790 - Repeal of Medicare DMEPOS Competitive Acquisition Program H.R. 3081 - Continuing Appropriations Act of 2011 H.R.3082 - Continuing Appropriations & Surface Transportation Extensions Act, 2011 H.R.4853 - Tax Relief, Unemployment Insurance Reauthorization, and Job Creation Act of 2010 H.R.4994 - Medicare and Medicaid Extenders Act of 2010

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Competitive bidding for home medical equipment; Medicare audits; Medicare power wheelchair reimbursement; Medicare oxygen reimbursement; and Medicare durable medical equipment reimbursement. H.R. 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 in a budget neutral manner. (see continuation page) H.R. 4994, Medicare and Medicaid Extenders Act of 2010 (Became PL 111-309 on 12/15/10)

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

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

***see addendum page H.R. 3220, "Medicare Home Oxygen Therapy Act of 2009" H.R 1077, S. 343, "Medicare Respiratory Therapy Initiative Act of 2009" H.R. 2373, "Home Oxygen Patient Protection Act of 2009" PL 111-148, "The Patient Protection and Affordable Care Act", implementation PL 111-152, "The Reconciliation Act of 2010", implementation H.R. 3790, "Bill to repeal the Medicare competitive acquisition program for durable medical equipment" H.R. 5712, "Physician Payment and Therapy Relief Act of 2010, health care provisions" H.R. 4994, "Medicare and Medicaid Extenders Act of 2010, health care provisions" ***, no specific bill(s), Medicare Inhalation Drug Therapies and Oxygen Reimbursement, provider enrollment standards, and DME Competitive Bidding, CPAP coverage & reimbursement, program integrity

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

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

Drug Supply Chain safety S. 301, Physician Payments Sunshine Act of 2009 S. 525, Pharmaceutical Market Access and Drug Safety Act of 2009, Drug Supply Chain Safety and Pedigree H.R. 3200, America's Affordable Health Choices Act of 2009, Medical Device Tax, Drug Supply Chain Safety HR 4872, Health Care and Education Reconciliation Act of 2010 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 budge neutral manner Medical Device Tax Issues

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Treasury, Dept of

Performance Based Pharmacy Reimbursement/Medication Therapy Management proposal; Postal Service - discussions around 5-day mail delivery; Competitive bidding; HR 1204, Community Pharmacy Fairness Act - antitrust exemption for pharmacies; HR 4489, FEHBP Prescription Drug Integrity, Transparency and Cost Savings Act; S. 369, Preserve Access to Affordable Generics Act; S. 1630, Affordable Access to Prescription Medications Act prescription drug copays and formularies; HR 5597, To establish a Medicare patient IVIG access demonstration project; HR 3790, Repeal of DMEPOS competitive bidding program;

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

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

HR 1077 & S 343 (Medical Respiratory Therapy Initiative Act of 2009) HR 3790 - Repeal of Competitive Bid

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3015 (111th Congress)/H.R. 3865 (110th Congress): The Home Health Care Access Protection Act -- all sections S. 457/H.R. 3030: Fostering Independence Through Technology Act of 2009 -- all sections S. 1157: Craig Thomas Rural Hospital and Provider Equity Act -- sections 11, 14, and 18 S. 2814/H.R. 4993: Home Health Care Planning Improvement Act -- all sections H.R. 2068, Medicare Telehealth Enhancement Act -- sections 104, 105, and 106 S. 1131/H.R. 2560: The Independence at Home Act -- All sections H.R.3790: (Bill to repeal competitive acquisition program for DME) All sections H.R. 1: American Recovery and Reinvestment Act of 2009 Sections relating to technology

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

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

H.R. 1548 - Pathway for Biosimilars Act Oppose Physician-Owned Hospital restrictions in H.R. 3200, H.R. 3962, H.R. 3590, and all health care reform measures H.R. 756/ S.660 - Support National Pain Care Policy Act of 2009 Oppose use of comparative effectiveness research to determine health care coverage or reimbursement decisions Support Health IT funding and standards Support Hagen/Enzi/Hatch Amendment to S. 325 Support HR 1894 and S. 769 Support Eshoo/Barton Amendment on biosimilars (to H.R. 3200) in House Energy and Commerce Committee Support increased Osteoporosis screening funds in health care reform bills Support request for House Oversight Committee hearings on prostate cancer, additional efforts to screen for and treat Oppose the establishment of a "Super MedPAC" Commission empowered to cut Medicare payments and benefits Oppose the Medicare cuts included in H.R. 3200, H.R. 3962, H.R. 3590, and all health care reform measures Oppose Senate Amendment 2793 Support McCain Motion to Recommit H.R. 3590 with instructions to remove all Medicare cuts Support Senate Amendment 2942 Support H.R. 3790 Support H.R. 2115 Support patient-centered comparative effectiveness research language passed by the Senate in H.R. 3590 Support 340B Federal Drug Discount Program purchasing provisions passed by the House and Senate in H.R. 3590 Oppose all efforts to shorten the 12-year exclusivity period provided (in both the House and Senate health care reform bills) for the original biologic drug as it pertains to a safe pathway for biosimilar "follow-on" drugs Support "Specialty Tier" pricing relief in Medicare Part D Drug Plans and in CMS rulemaking regarding those plans. Support increased funding to address the growing national burden of arthritis, including intervention and prevention plans. Support Efforts to Eliminate "Lifetime Caps" on health insurance benefits. Support Part D Medicare Coverage Gap Discount Program "draft guidance" to improve the program for beneficiaries. Oppose Recess Appointment of Dr. Donald Berwick as CMS Administrator. Support expanded screening for Osteoporosis for both women and men under new coverage rules. Support nomination of Peter Pitts for the Patient-Centered Outcomes Research Institute Board of Governors. Support Medicare reimbursement for Provenge to treat prostate cancer. Support the most stringent and rigorous testing of biosimilars that would or could be used as replacements for the original, innovator biologic drugs. Support the Council for American Medical Innovation comments to The National Commission on Fiscal Responsibility and Reform regarding the continuing need for spending to promote medical innovation to save lives and money. Support the Partnership to Fight Chronic Disease response to the Agency for Healthcare Research and Quality request for feedback on the National Quality Strategy and Plan development in regards to the Affordable Care Act.

Client expense: Not reported · Firm income: $13,310

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Ostomy and Wound Care Issues; Health Care Reform Priorities; H. Con. Res. 245 - Ostomy Care Resolution; H.R. 3790 - Repeal Competitive Bidding of Medical Devices; H.R. 5095 - Repeal Medical Device Tax; Implementation of Device Tax in Health Care and Education Reconciliation Act (P.L. 111-152).

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Treasury, Dept of

Changes to Medicare regarding durable medical equipment benefits. (H.R. 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.

Client expense: $215,000 · Firm income: Not reported

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

Average Manufacturer Price Pharmacy Reimbursement H.R. 3590 agency implementation DEA Physician/Agent Definition in Skilled Nursing Facilities H.R. 3790 Repeals DMEPOS Competitive Bidding Medicare Actual Average Acquisition Cost (AAAC) State Medicaid Pharmacy Reimbursement Repeal of 1099 Reporting Requirement for Businesses PPACA of 2010 Section 9006

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

H.R. 3220- Medicare Home Oxygen Therapy Act; all provisions, H.R. 3200 - America's Affordable Health Choices Act, provisions related to Durable Medical Equipment; S. 975 - Seniors and Taxpayers Obligation Protection Act; all provisions; General issues related to durable medical equipment, Fraud & Abuse; America's Healthy Future Act of 2009 (Senate Finance Committee version of H.R. 3200: America's Affordable Health Choices Act of 2009), provisions related to Durable Medical Equipment; H.R. 3790 - DMEPOS Competitive Bidding Repeal Bill, all provisions; H.R. 3962 - Affordable Health Care for America Act; all provisions; H.R. 3590 - Patient Protection and Affordable Care Act; all provisions; S.2128 & H.R. 4222 - Prevent Health Care Fraud Act of 2009; all provisions; H.R. 5546 - Fighting Fraud with Innovative Technology Act; all provisions; H.R. 3082 - Continuing Appropriations and Surface Transportation Exensions Act of 2011, all provisions.

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

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

See next page and see also HCR - Health Care Issues. Medicare/Medicaid Community Choice Act (HR 1670 and S 683) (changed to Community First Choice Option in health reform) Advocated to end the institutional bias in Medicaid. The bill would 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 for other purposes. HR 3790 to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner. Medicare In the Home restriction (HR 3184 and S 1186) - reintroduction of legislation to reverse the CMS rule that Medicare will pay for wheelchairs only as needed in the home rather than as needed for the individual to go to medical appointments, go to the pharmacy and grocery store, attend worship services, accompany children to school and other activities, vote and otherwise be independent and participate in the community. HR 2390, the Guidance, Understanding and Information for Dual Eligibles (GUIDE) Act to provide one-on-one counseling to people with cognitive impairments navigate and protect their rights with regard to the confusing Part D Prescription Drug Benefit Program authorized under the Medicare Modernization Act (MMA) of 2003. S 700/HR 1708 to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. DME Competitive Bidding - Met with CMS officials to discuss implementation of the DMEPOS competitive bidding program to make the transition as easy as possible for members who are Medicare beneficiaries. S 1630 a bill to amend Medicare to improve prescription drug coverage under Medicare part D and to amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to improve prescription drug coverage under private health insurance Supported HR 3799 that would cap out of pocket prescription costs at a max of $200 per prescription and at $500 total for any group of prescriptions in Medicare Part D. For people with chronic conditions who participate in Medicare Part D the increasing costs of specialty medicines can cause hardships and make access to prescription drugs unattainable. Supported HR 3621, the Medicare Premium Fairness Act, to protect millions of seniors and people with disabilities who receive Social Security benefits from unfair increases in their 2010 Medicare Part B premiums. -- Advocated that Center for Medicare and Medicaid Services (CMS) make Medicare Part D improvements including reassignmentof Low Income Subsity (LIS) recipients who have previously chosen Part D plans based on premium lability, curb waste of unused drugs, address the established price threshold for prescription medications to be included on the Specialty Tier i Part D plans' formularies, address the problems of co-payments and co-insurance and pricing of both specialty tier medications and all medications, create an appeals process for medications placed on specialty tiers, and study the impact of excessive cost-sharing. -- Supported extending the moratoriumon Medicare therapy caps. -- Worked with numerous consumer, manufacturer, and supplier groups on crafting legislation that would create a separate benefit category for complex rehab equipment under Medicare. Opposed HR 1255, a bill that would make it more difficult for the Protection and Advocacy System to file suits on behalf of people who are confined to institutions. See also Health.

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

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

Implementation of the Medicare Improvements for Patients and Providers Act of 2008, reimbursement for home oxygen therapy. H.R.3220, Medicare Home Oxygen Therapy Act of 2009 - Medicare reimbursement procedures for the home oxygen benefit. CMS regulations concerning the DMEPOS Competitive Bidding program, inhalation drugs and sleep disorder therapies. H.R. 1077 and S. 343, the Medicare Respiratory Therapy Initiative Act of 2009, reimbursement for respiratory therapy. Public Law 111-148, the Patient Protection and Affordable Care Act of 2009 - reimbursement process and payment levels for Medicare home oxygen benefit. H.R. 3790, legislation to repeal the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner. Also participated in meetings and discussions on prospective legislative proposal to reform Medicare home oxygen therapy benefit.

Client expense: Not reported · Firm income: $75,000

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

H.R. 3790: Medicare Competitive Bidding for DMEPOS S. 254/H.R. 574: Medicare Home Infusion Therapy Coverage Act of 2009

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

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

Performance Based Pharmacy Reimbursement/Medication Therapy Management proposal; Postal Service - discussions around 5-day mail delivery; Competitive bidding; HR 1204, Community Pharmacy Fairness Act - antitrust exemption for pharmacies; HR 4489, FEHBP Prescription Drug Integrity, Transparency and Cost Savings Act; S. 369, Preserve Access to Affordable Generics Act; S. 1630, Affordable Access to Prescription Medications Act prescription drug copays and formularies; HR 5597, To establish a Medicare patient IVIG access demonstration project; HR 3790, Repeal of DMEPOS competitive bidding program;

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

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

Issues related to comprehensive health care reform: Health Information Technology; ARRA Privacy and Security Rules; Generic Biologics; Comparative Effectiveness; Chronic Care Management; Healthcare Reform; and Healthcare Implementation H.R. 1- American Recovery and Reinvestment Act of 2009; Title VIII Department of Labor, Health and Human Services, and Education, and related agencies; Healthcare Research and Quality and Title XIII - Health Information Technology for Economic and Clinical Health Act or the HITECH Act; all sections H.R. 1321 and S. 391 - Healthy Americans Act; all sections H.R. 1427 and S. 726 - Promoting Innovation and Access to Life-Saving Medicine Act; all sections H.R. 1548 - Pathway for Biosimilars Act; all sections H.R. 3200 - America's Affordable Health Choices Act; all sections H.R. 3596 - Health Insurance Industry Antitrust Enforcement Act of 2009; all sections H.R. 3962 - Affordable Healthcare for America Act; all sections Public Law 111-148 - Patient Protection and Affordable Care Act; all sections (formerly H.R. 3590) H.R. 4199 - Patient Health and Real Medication Access Cost Savings Act; all sections Public Law 111-152 - Health Care and Education Reconciliation Act of 2010; all sections (formerly H.R. 4872 and S. Con. Res. 13) H.R. 4489 - The FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act of 2010; all sections H.R. 5235 - The Medicare Access to Diabetes Supplies Act; all sections H.R. 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); all sections Public Law 104-191 - Health Insurance Portability and Accountability Act (HIPAA); Title II H.R. 5440 - Genomics and Personalized Medicine Act of 2010; all sections

Client expense: $960,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), Postal Regulatory Commission, SENATE

Health care issues affecting individuals with neuromuscular disease, including H.R. 2149/S. 1158, legislation to accelerate research and treatment of spinal muscular atrophy and H.R. 3790, Competitive Bidding Repeal

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care issues affecting individuals with neuromuscular disease, including transitional health care issues; advocating for neurologists' eligibility for Medicare payment incentives under the Patient Protection and Affordable Care Act; research and treatment of spinal muscular atrophy - H.R. 2149/S. 1158; and Competitive Bidding Repeal - H.R. 3790

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Drug Supply Chain safety S. 301, Physician Payments Sunshine Act of 2009 S. 525, Pharmaceutical Market Access and Drug Safety Act of 2009, Drug Supply Chain Safety and Pedigree H.R. 3200, America's Affordable Health Choices Act of 2009, Medical Device Tax, Drug Supply Chain Safety America's Healthy Future Act of 2009 HR 4872, Health Care and Education Reconciliation Act of 2010 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 budge neutral manner

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues related to the prevention and treatment of lung disease including the following legislation:HR 1619 Children's Health Protection Act of 2009; HR 716 Access to Cancer Clinical Trials Act; S. 488 Access to Cancer Clinical Trials Act; HR 1850 Quit Smoking for Life Act; S. 770 Medicare, Medicaid, and MCH Tobacco Cessation Promotion Act of 2009; S. 717 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act; HR 332 Lung Cancer Mortality Reduction Act of 2009; HR 2112 Lung Cancer Mortality Reduction Act of 2009; S. 670 Smoke Free Mothers and Babies Act of 2009; HR 3200: America's Affordable Health Choices Act of 2009; S. 1679 Affordable Health Choices Act; S.1796 Americas Healthy Future Act of 2009; HR 3590 The Patient Protection and Affordable Care Act; H.R. 3220 Medicare Home Oxygen Therapy Act of 2009; 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; H.R.4872 Health Care and Education Reconciliation Act of 2010; Issues related to asthma; Issues related to chronic obstructive pulmonary disease; Issues related to lung cancer; Issues related to tuberculosis; Issues related to durable medical equipment; Issues related to pulmonary rehabilitation services; Issues related to influenza; Issues related to tobacco cessation services; Issues related to the implementation of the Patient Protection and Affordable Care Act;

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, U.S. Postal Service (USPS), U.S. Trade Representative (USTR), White House Office

Issues related to the prevention and treatment of lung disease, including the following legislation: HR 1619 Children's Health Protection Act of 2009; S 643 Children's Health Protection Act of 2009; HR 716 Access to Cancer Clinical Trials Act; S. 488 Access to Cancer Clinical Trials Act; HR 1850 Quit Smoking for Life Act; S. 770 Medicare, Medicaid, and MCH Tobacco Cessation Promotion Act of 2009; S. 717 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act S. 332 Lung Cancer Mortality Reduction Act of 2009; HR 2112 Lung Cancer Mortality Reduction Act of 2009; S 670 Smoke Free Mothers and Babies Act of 2009; S.914 Cures Acceleration Network and National Institutes of Health Reauthorization Act of 2009; HR 1079 Pulmonary Fibrosis Research Enhancement Act; HR 2730 Student-to-School Nurse Ratio Improvement Act of 2009; HR 3293 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2010; HR 3200: America's Affordable Health Choices Act of 2009; S. 1679 Affordable Health Choices Act; S.1796 Americas Healthy Future Act of 2009; HR 3590 The Patient Protection and Affordable Care Act; S. 1577 The Asthma Act; H.R. 3220 Medicare Home Oxygen Therapy Act of 2009; HR 2293 The Public Health Trade Advisory Committee Act; S. 1760 Family Asthma Act; HR 3754 Family Asthma Act; H.Res 919 Supporting the goals and ideals of Chronic Obstructive Pulmonary Disease Awareness Month; S. 2817 A bill to amend part D of title V of the Elementary and Secondary Education Act of 1965 to provide grants to schools for the development of asthma management plans and the purchase of asthma inhalers and spacers for emergency use, as necessary; P.L. 110-233, Genetic Information Nondescrimination Act; 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; H.R.4872 Health Care and Education Reconciliation Act of 2010; Issues related to asthma; Issues related to chronic obstructive pulmonary disease; Issues related to lung cancer; Issues related to tuberculosis; Issues related to nicotine drug delivery devices; Issues related to drug safety; Issues related to durable medical equipment; Issues related to pulmonary rehabilitation services; Issues related to influenza; Issues related to genetic non-discrimination; Issues related to tobacco strategic plan; Issues related to prevention and wellness. Issues related to the implementation of the Patient Protection and Affordable Care Act; H.R.5297 Small Business Jobs and Credit Act of 2010

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Postal Regulatory Commission, SENATE, U.S. Postal Service (USPS), U.S. Trade Representative (USTR), White House Office

Implementation of Medicare Improvements for Patients and Providers Act of 2008 H.Con.Res.85 - Concurrent Resolution on the Budget for Fiscal Year 2010, all titles H.R.3200 - America's Affordable Health Choices Act of 2009, all titles H.R.3220 - Medicare Home Oxygen Therapy Act of 2009, all titles S.Con.Res.13 - Concurrent Resolution on the Budget for Fiscal Year 2010, all titles S.1796 - America's Healty Future Act of 2009 H.R. 3962 - Presentation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 4213 - American Jobs and Closing Tax Loopholes Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3790 - Repeal of Medicare DMEPOS Competitive Acquisition Program H.R. 3081 - Continuing Appropriations Act of 2011

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Implementation of Medicare Improvements for Patients and Providers Act of 2008 H.Con.Res.85 - Concurrent Resolution on the Budget for Fiscal Year 2010, all titles H.R.3200 - America's Affordable Health Choices Act of 2009, all titles H.R.3220 - Medicare Home Oxygen Therapy Act of 2009, all titles S.Con.Res.13 - Concurrent Resolution on the Budget for Fiscal Year 2010, all titles S.1796 - America's Healty Future Act of 2009 H.R. 3962 - Presentation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 H.R. 3590 - Patient Protection and Affordable Care Act H.R. 4213 - American Jobs and Closing Tax Loopholes Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 3790 - Repeal of Medicare DMEPOS Competitive Acquisition Program H.R. 3081 - Continuing Appropriations Act of 2011

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

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. 301, "A bill to amend title XI of the Social Security Act to provide for transparency in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP", regarding all provisions. - H.R. 3790, "To amend Title XVIII of the Social Security Act to repeal the Medicare competitive acquision program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS) in a budget neutral manner. - H.R. 5440, "The Genomics and Personalized Medicine Act of 2010", regarding all provisions. - H. R. 6331, "Generating Antibiotic Incentives Act of 2010", regarding all provisions.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Treasury, Dept of

H.R. 1548 - Pathway for Biosimilars Act Oppose Physician-Owned Hospital restrictions in H.R. 3200, H.R. 3962, H.R. 3590, and all health care reform measures H.R. 756/ S.660 - Support National Pain Care Policy Act of 2009 Oppose use of comparative effectiveness research to determine health care coverage or reimbursement decisions Support Health IT funding and standards Support Hagen/Enzi/Hatch Amendment to S. 325 Support HR 1894 and S. 769 Support Eshoo/Barton Amendment on biosimilars (to H.R. 3200) in House Energy and Commerce Committee Support increased Osteoporosis screening funds in health care reform bills Support request for House Oversight Committee hearings on prostate cancer, additional efforts to screen for and treat Oppose the establishment of a "Super MedPAC" Commission empowered to cut Medicare payments and benefits Oppose the Medicare cuts included in H.R. 3200, H.R. 3962, H.R. 3590, and all health care reform measures Oppose Senate Amendment 2793 Support McCain Motion to Recommit H.R. 3590 with instructions to remove all Medicare cuts Support Senate Amendment 2942 Support H.R. 3790 Support H.R. 2115 Support patient-centered comparative effectiveness research language passed by the Senate in H.R. 3590 Support 340B Federal Drug Discount Program purchasing provisions passed by the House and Senate in H.R. 3590 Oppose all efforts to shorten the 12-year exclusivity period provided (in both the House and Senate health care reform bills) for the original biologic drug as it pertains to a safe pathway for biosimilar "follow-on" drugs Support "Specialty Tier" pricing relief in Medicare Part D Drug Plans and in CMS rulemaking regarding those plans. Support increased funding to address the growing national burden of arthritis, including intervention and prevention plans. Support Efforts to Eliminate "Lifetime Caps" on health insurance benefits. Support Part D Medicare Coverage Gap Discount Program "draft guidance" to improve the program for beneficiaries. Oppose Recess Appointment of Dr. Donald Berwick as CMS Administrator. Support expanded screening for Osteoporosis for both women and men under new coverage rules. Support nomination of Peter Pitts for the Patient-Centered Outcomes Research Institute Board of Governors.

Client expense: $176,190 · Firm income: Not reported

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

***see addendum page H.R. 3220, "Medicare Home Oxygen Therapy Act of 2009" H.R 1077, S. 343, "Medicare Respiratory Therapy Initiative Act of 2009" H.R. 2373, "Home Oxygen Patient Protection Act of 2009" PL 111-148, "The Patient Protection and Affordable Care Act", implementation PL 111-152, "The Reconciliation Act of 2010", implementation H.R. 3790, "Bill to repeal the Medicare competitive acquisition program for durable medical equipment" H.R. 4213, "American Jobs and Closing Tax Loopholes Act of 2010", oxygen reimbursement ***, no specific bill(s), Medicare Inhalation Drug Therapies and Oxygen Reimbursement, provider enrollment standards, and DME Competitive Bidding, CPAP coverage & reimbursement, program integrity

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

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

Ostomy and Wound Care Issues; Health Care Reform Priorities; H. Con. Res. 245 - Ostomy Care Resolution; H.R. 3790 - Repeal Competitive Bidding of Medical Devices; H.R. 5095 - Repeal Medical Device Tax; Implementation of Device Tax in Health Care and Education Reconciliation Act (P.L. 111-152).

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

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

HR 3790, relating to the Medicare competitive acquisition program for durable medical equipment and prosthetics, orthotics, and supplies (DMEPOS); Issues concerning diabetes mail order supplies as part of the DMEPOS competitive bidding program; Issues concerning the PECOS program.

Client expense: Not reported · Firm income: $75,000

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

H.R.574 & S.254, The Medicare Home Infusion Therapy Coverage Act of 2009, establishing reimbursement for home infusion therapy services. H.R. 3790, repeal the Medicare competitive acquisition program for durable medical equipment (DMEPOS).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Competitive bidding for home medical equipment; Medicare audits; Medicare power wheelchair reimbursement; Medicare oxygen reimbursement; and Medicare durable medical equipment reimbursement. H.R. 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 in a budget neutral manner.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE