Medicare Prescription Drug Price Negotiation Act of 2010

Implementation of healthcare reform laws - Executive Branch actions re PL 111-148 and PL 111-152. Repeal Patient Protection and Affordable Health Care Acts (PL 111-148/PL 111-152) - HR 4901, To repeal the Patient Protection and Affordable Care Act; HR 4903, To repeal the Patient Protection and Affordable Care Act; HR 4910, To repeal the Patient Protection and Affordable Care Act and enact the Empowering Patients First Act in order to provide incentives to encourage health insurance coverage; HR 4919, To repeal the Patient Protection and Affordable Care Act; HR 4972, To repeal the Patient Protection and Affordable Care Act; HR 5005, To repeal the Patient Protection and Affordable Care Act; HR 5073, To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 and enact the OPTION Act of 2009; HR 5216, To repeal the Patient Protection and Affordable Care Act; HR 5421, To repeal the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, repeal the 7.5 percent threshold on the deduction for medical expenses, provide for increased funding for high-risk pools, allow acquiring health insurance across State lines, and allow for the creation of association health plans; HR 5424, Reform Americans Can Afford Act of 2010 ; HR 5444, Private Option Health Care Act; HR 6355, STAT Act of 2010; S 3147, Patient Choice Restoration Act; S 3152, A bill to repeal the Patient Protection and Affordable Care Act. Medicare physician reimbursement - HR 4994, Medicare and Medicaid Extenders Act of 2010. *Medicaid FMAP extension - HR 4263, State Medicaid Assistance Extension Act of 2009; S 3000, A bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months; S 3000, A bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months. *Enhanced Medicaid FMAP - HR 1586, FAA Air Transportation Modernization and Safety Improvement Act. *Guaranteed-issue MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. *HHS Secretary's role in negotiating Part D drug prices - HR 4752, Medicare Prescription Drug Price Negotiation Act of 2010. *Medicare Part D formulary changes - HR 4917, To amend part D of title XVIII of the Social Security Act to prohibit mid-year changes in the formularies of Medicare Part D plans. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, MediGap changes, Medicare FFS payment reform - HR 3590, Patient Protection and Affordable Care Act. *Medicare physician payment - S 3421, Protecting Against Indebting our Descendants through Fully Offset Relief (PAID FOR) Temporary Extension Act of 2010. *Changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding - HR 4872, Health Care and Education Reconciliation Act of 2010. *Medicaid and CHIP technical corrections - HR 5712, Veterans', Seniors', and Children's Health Technical Corrections Act of 2010; S 3793, Job Creation and Tax Cuts Act of 2010. *MA open enrollment - HR 6303, Medicare Beneficiary Choice Preservation Act of 2010. *Medicare physician payment, Medicaid & CHIP technical corrections - HR 4994, Medicare and Medicaid Extenders Act of 2010. *Medicare open enrollment - HR 6502, Medicare Beneficiary Preservation of Choice Act of 2010; S 4040, Medicare Beneficiary Preservation of Choice Act of 2010. *Price negotiations, plan information - S 4024, Medicare Enhancements for Needed Drugs Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare/Medicaid drug coverage including pharmacy payments (average manufacturer price), reimbursements, competition and plan administration, electronic prescribing, chronic care and PBM disclosure. Issues related to implementation of the Patient Protection and Affordable Care Act including prescription drug coverage, formulary requirements, generic drug co-payments, direct negotiation, Medicaid rebate changes, applying Medicaid rebates in Medicare, closure of Part D coverage gap, retiree drug subsidy, funding/revenues for Health Care Reform, H.R. 3200, S1679 America's Health Future Act, H.R. 3950 Patient Protection and Affordable Care Act. H.R. 4752 - Medicare Prescription Drug Price Negotiation Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 4199 - Patient Health and Real Medication Access Cost Savings Act of 2009 H.R. 4813 - To provide for insurance reform (including health insurance reform), amend Title XVIII of the Social Security Act to reform Medicare Advantage and reduce disparities in the Medicare Program, regulate the importation of prescription drugs, and for other purposes.

Client expense: $525,828 · Firm income: Not reported

H.R. 3590, Patient Protection and Affordable Care Act: Part D coverage gap discounts, Part D rebates, Part D issues generally, Medicare payment issues, Medicaid rebate issues, transparency issues, comparative effectiveness, health reform fee and health reform issues generally. H.R. 4872, Healthcare & Education Reconciliation Act 2010. H.R. 4752, Medicare Prescription Drug Price Negotiation Act of 2010: Non-interference provisions. H.R. 4213, American Jobs & Closing Tax Loopholes Act of 2010: (AMP) issues. H.R. 4899, Supplemental Appropriations Act, 2010: AMP issues.

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

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 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 Medciare 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; all setions S. 1793 - America's Health Future Act of 2009; 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: $960,000 · Firm income: Not reported

H.R. 1586 (Rangel) enhanced Medicaid FMAP; H.R. 4213, Tax Extenders Act (Rangel/Baucus) Medicare physician payment, Medicaid FMAP, Medicaid and CHIP technical corrections (cont.) H.R. 4263, State Medicaid Assistance Extension Act (Baldwin) Medicaid FMAP extension; H.R. 4752, Medicare Prescription Drug Price Negotiation Act (Welch) HHS Secretarys role in; H.R. 4917 (Schauer) Medicare Part D formulary changes; H.R. 5712, Veterans', Seniors', and Children's Health Technical Corrections Act (Levin) Medicaid and CHIP technical corrections; H.R. 6303, Medicare Beneficiary Choice Preservation Act (Arcuri) MA open enrollment; S. 1669, Equal Access to Medicare Options Act (Kerry) guaranteed issue Medigap, Medicare Advantage enrollment; S. 3000 (Rockefeller) Medicaid FMAP extension; S. 3421, Temporary Extension Act (Grassley) Medicare physician payment; S. 3793, Job Creation and Tax Cuts Act (Baucus) Medicaid and CHIP technical corrections MMM (Regulatory Issues): Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, data, and audit issues, bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training, and Medicare/Medicaid integration and contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; implementation of MA and Part D changes made in the Accountable Care Act (ACA), including application of the MA STAR system for payment purposes starting 2012 and changes to the Part D coverage gap; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including the managed care organization (MCO) prescription drug rebate provisions; and health information technology standards and policies.

H.R. 1586, FAA Air Transportation Modernization and Safety Improvements: AMP issues H.R. 3590, Patient Protection and Affordable Care Act: comparative effectiveness, Part D coverage gap discounts, Part D issues generally, Medicare payment issues including the Independent Payment Advisory Board (IPAB), and Medicaid issues H.R. 4752, Medicare Prescription Drug Price Negotiation Act of 2010: non-interference provisions H.R. 4213, American Jobs and Closing Tax Loopholes Act of 2010: average manufacturer price (AMP) issues H.R. 4872, Health Care and Education Reconciliation Act of 2010: Part D coverage gap discounts, Part D issues generally, Medicaid rebate issues, health reform fee, and other health reform implementation issues generally H.R. 4899, Supplemental Appropriations Act, 2010: AMP issues

Client expense: $5,180,000 · Firm income: Not reported

Implementation of healthcare reform legislation; Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - Executive Branch actions re PL 111-148 and PL 111-152. *Medicaid FMAP extension - HR 4263, State Medicaid Assistance Extension Act of 2009; S 3000, A bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months; S 3000, A bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months. *Enhanced Medicaid FMAP - HR 1586, FAA Air Transportation Modernization and Safety Improvement Act. *Guaranteed-issue MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. *HHS Secretary's role in negotiating Part D drug prices - HR 4752, Medicare Prescription Drug Price Negotiation Act of 2010. *Medicare Part D formulary changes - HR 4917, To amend part D of title XVIII of the Social Security Act to prohibit mid-year changes in the formularies of Medicare Part D plans. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, MediGap changes, Medicare FFS payment reform - HR 3590, Patient Protection and Affordable Care Act. *Medicare physician payment - S 3421, Protecting Against Indebting our Descendants through Fully Offset Relief (PAID FOR) Temporary Extension Act of 2010. *Changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding - HR 4872, Health Care and Education Reconciliation Act of 2010. *Medicare physician payment, Medicaid FMAP, Medicaid and CHIP technical corrections - HR 4213, Unemployment Compensation Extension Act of 2010. *Medicaid and CHIP technical corrections - HR 5712, Veterans', Seniors', and Children's Health Technical Corrections Act of 2010; S 3793, Job Creation and Tax Cuts Act of 2010. *MA open enrollment - HR 6303, Medicare Beneficiary Choice Preservation Act of 2010.

Medicare/Nomination. Nomination of the Administrator of Centers for Medicare and Medicaid Services (CMS). Medicare/Part A hospital inpatient status. H.R. 5950: provisions to ensure that beneficiaries receiving hospital services are deemed inpatients to ensure coverage of prescription drugs and post-acute care under Part A. Medicare/Part D program (No bill). Pertaining to negotiating with Part D plan sponsors to ensure that beneficiaries find meaningful differences in coverage between drug plans offered by each sponsor. Medicare/Part B Premium Hold Harmless. H.R. 3631: provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. P.L. 111-148 (H.R. 3590), P.L. 111-152 (H.R. 4872): implementation of provisions relating to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Parts B and D, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services, establishing a Medicare Commission, providing expanded Medicaid coverage for home and community-based services, expanding Medicaid coverage of attendant and other home services and supports, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements. Medicare/Commission. P.L. 111-148 (H.R. 3590), P.L. 111-152 (H.R. 4872): pertaining to the repeal or modification of provisions creating an independent commission authorized to establish Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authorizing coverage under Part B for medically necessary dental procedures. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. P.L. 110-275, P.L. 108-173: implementation of regulations and guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and appeals processes under Medicare Parts C and D. Medicare/Negotiation of Part D Drug Prices. H.R. 4752, S. 3413, S. 3415: provisions requiring the Secretary of the Department of Health and Human Services to negotiate price concessions from pharmaceutical manufacturers for drugs purchased under the Part D program. Medicare/Prescription Drug Plan. S. 330, H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Combating Waste, Fraud, Abuse. H.R. 5044: relating to provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment. Medicare and Medicaid. (No bill): pertaining to planning for the activities of the Federal Coordinated Health Care Office and improved management of the Part D low-income subsidy and the Medicare Savings Programs. Medicaid/Federal Medical Assistance Percentage. P.L. 111-226: provisions to provide an enhanced federal match for states Medicaid programs.

Issues related to Medicare/Medicaid drug coverage including pharmacy payments (average manufacturer price), reimbursements, competition and plan administration, electronic prescribing, chronic care and PBM disclosure. Health reform proposals impacting prescription drug coverage including formulary requirements, generic drug co-payments, direct negotiation, Medicaide rebate changes, applying Medicaid rebates in Medicare, closure of Part D coverage gap, retiree drug subsidy, funding/revenues for Health Care Reform, H.R. 3200, S1679 America's Health Future Act, H.R. 3950 Patient Protection and Affordable Care Act. H.R. 4752 - Medicare Prescription Drug Price Negotiation Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 4199 - Patient Health and Real Medication Access Cost Savings Act of 2009 H.R. 4813 - To provide for insurance reform (including health insurance reform), amend Title XVIII of the Social Security Act to reform Medicare Advantage and reduce disparities in the Medicare Program, regulate the importation of prescription drugs, and for other purposes.

Client expense: $644,766 · Firm income: Not reported

H.R. 3590, Patient Protection and Affordable Care Act (Reid) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; (cont.) H.R. 3962, Americas Affordable Health Choices Act (Dingell) Medicare physician payment; H.R. 4213, Tax Extenders Act (Rangel/Baucus) Medicare physician payment, Medicaid FMAP, Medicaid and CHIP technical corrections; H.R. 4263 (Baldwin) Medicaid FMAP extension; H.R. 4691, Temporary Extension Act (Rangel) Medicare physician payment; H.R. 4752, Medicare Prescription Drug Price Negotiation Act (Welch) HHS Secretarys role in negotiating Part D drug prices; H.R. 4851, Continuing Extension Act (Levin) Medicare physician payment; H.R. 4872, Health Care and Education Reconciliation Act (Spratt) changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding; H.R. 4917 (Schauer) Medicare Part D formulary changes; S. 1669, Equal Access to Medicare Options Act (Kerry) guaranteed issue Medigap, Medicare Advantage enrollment; S. 3000 (Rockefeller) Medicaid FMAP extension; S. 3153, Continuing Extension Act (Grassley) Medicare physician payment; S. 3421, Temporary Extension Act (Grassley) Medicare physician payment MMM (Regulatory Issues): Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, data, and audit issues, bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration and contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; implementation of MA and Part D changes made in the Accountable Care Act (ACA), including application of the MA star system for payment purposes starting 2011 and changes to the Part D coverage gap; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including the managed care organization (MCO) prescription drug rebate provisions; and health information technology standards and policies.

health care ceform, health care regulations, Medicare Part D, proposed antitrust exemptions for certain pharmacists, 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. 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. 4199 - Patient Health and Real Medication Access Cost Savings Act of 2009; all sections H.R. 3962 - Affordable Health Care for America Act; all sections S 1793 - America's Healthy Future Act of 2009; all sections H.R. 4752 - Medicare Prescription Drug Price Negotiations Act of 2010; all sections Public Law 111-152 - Health Care and Education Reconciliation Act of 2010 (formerly H.R. 4872); all sections

Client expense: $600,000 · Firm income: Not reported

H.R. 3590, Patient Protection and Affordable Care Act: comparative effectiveness, Part D coverage gap discounts, Part D issues generally, Medicare payment issues including the Independent Payment Advisory Board (IPAB), and Medicaid issues H.R. 4752, Medicare Prescription Drug Price Negotiation Act of 2010: non-interference provisions H.R. 4213, American Jobs and Closing Tax Loopholes Act of 2010: Medicaid rebate issues H.R. 4872, Health Care and Education Reconciliation Act of 2010: Part D coverage gap discounts, Part D issues generally, Medicaid rebate issues, health reform fee, and other health reform implementation issues generally H.R. 4899, Supplemental Appropriations Act, 2010: Medicaid rebate issues

Client expense: $4,650,000 · Firm income: Not reported

Issues related to Medicare/Medicaid drug coverage including pharmacy payments (average manufacturer price), reimbursements, competition and plan administration, electronic prescribing, chronic care and PBM disclosure. Health reform proposals impacting prescription drug coverage including formulary requirements, generic drug co-payments, direct negotiation, Medicaide rebate changes, applying Medicaid rebates in Medicare, closure of Part D coverage gap, retiree drug subsidy, funding/revenues for Health Care Reform, H.R. 3200, S1679 America's Health Future Act, H.R. 3950 Patient Protection and Affordable Care Act. H.R. 4752 - Medicare Prescription Drug Price Negotiation Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 4199 - Patient Health and Real Medication Access Cost Savings Act of 2009 H.R. 4813 - To provide for insurance reform (including health insurance reform), amend Title XVIII of the Social Security Act to reform Medicare Advantage and reduce disparities in the Medicare Program, regulate the importation of prescription drugs, and for other purposes.

Client expense: $551,889 · Firm income: Not reported

Issues related to Medicare/Medicaid drug coverage including pharmacy payments (average manufacturer price), reimbursements, competition and plan administration, electronic prescribing, chronic care and PBM disclosure. Health reform proposals impacting prescription drug coverage including formulary requirements, generic drug co-payments, direct negotiation, Medicaide rebate changes, applying Medicaid rebates in Medicare, closure of Part D coverage gap, retiree drug subsidy, funding/revenues for Health Care Reform, H.R. 3200, S1679 America's Health Future Act, H.R. 3950 Patient Protection and Affordable Care Act. H.R. 4752 - Medicare Prescription Drug Price Negotiation Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 4199 - Patient Health and Real Medication Access Cost Savings Act of 2009 H.R. 4813 - To provide for insurance reform (including health insurance reform), amend Title XVIII of the Social Security Act to reform Medicare Advantage and reduce disparities in the Medicare Program, regulate the importation of prescription drugs, and for other purposes.

Client expense: $551,889 · Firm income: Not reported

Medicare/Nomination of Administrator of Centers for Medicare and Medicaid Services (CMS). Issue of the President's nomination of Dr. Donald Berwick to be Administrator of CMS. Medicare/Part B Premium Hold Harmless. H.R. 3631: Provisions extending the current "hold harmless" policy to all Medicare enrollees to ensure 2010 Part B monthly premiums remain at the current rate. Comprehensive Health Care Reform. P.L. 111-148 (H.R. 3590), P.L. 111-152 (H.R. 4872): implementation of provisions relating to reducing Medicare Advantage plan payments, reducing the coverage gap in Part D, requiring wealthier Medicare beneficiaries to pay a greater share of the cost of their premiums under Medicare Parts B and D, expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS), improving the process for reassigning LIS beneficiaries to new plans, expanding coverage of prevention services, establishing a Medicare Commission, providing expanded Medicaid coverage for home and community-based services, expanding Medicaid coverage of attendant and other home services and supports, establishing a new national insurance program for long-term supports and services, authorizing funding to provide language services to limited English proficiency beneficiaries, authorizing the collection of data regarding disparities in the provision of care, providing safeguards and subsidies to assure affordability of health coverage for seniors, preserving state benefit laws and requirements. Medicare/Commission. P.L. 111-148 (H.R. 3590), P.L. 111-152 (H.R. 4872): repeal or modification of provisions creating an independent commission authorized to establish Medicare payment and policy designed to reduce Medicare spending growth. Medicare/Hearing Coverage. H.R. 504: authorizing coverage of hearing aids and auditory rehabilitation services under Medicare Part B. Medicare/Dental Coverage. H.R. 870: authorizing coverage under Part B for medically necessary dental procedures. Medicare/Part D Premiums. H.R. 1832: limiting Part D premium increases to no more than the Social Security cost-of-living adjustment and requiring the Secretary of Health and Human Services to negotiate lower prescription drug prices. P.L. 110-275, P.L. 108-173: implementation of regulations and guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and appeals processes under Medicare Parts C and D. Medicare/Negotiation of Part D Drug Prices. H.R. 4752, S. 3413, S. 3415: provisions requiring the Secretary of the Department of Health and Human Services to negotiate price concessions from pharmaceutical manufacturers for drugs purchased under the Part D program. Medicare/Prescription Drug Plan. S. 330, H.R. 684: authorizing the establishment of a Medicare-operated prescription drug plan; S. 266: authorizing the Secretary of Health and Human Services to negotiate lower prescription drug prices. Medicare/Combating Waste, Fraud, Abuse. P.L. 111-148 (H.R. 3590), P.L. 111-152 (H.R. 4872), H.R. 27, H.R. 5044: relating to provisions to combat waste, fraud, and abuse within Medicare; H.R. 203: increasing civil and criminal penalties for acts involving fraud and abuse and increasing the surety bond amount for suppliers of durable medical equipment.

Medicare physician payment rates - HR 3962, America's Affordable Health Choices Act; HR 4213, American Jobs and Closing Tax Loopholes Act of 2010. *Medicare physician payments - S 3153, Continuing Extension Act of 2010. *Medicaid FMAP extension - HR 4263, State Medicaid Assistance Extension Act of 2009; S 3000, A bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months. *Guaranteed-issue MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. *HHS Secretary's role in negotiating Part D drug prices - HR 4752, Medicare Prescription Drug Price Negotiation Act of 2010. *Medicare Part D formulary changes - HR 4917, To amend part D of title XVIII of the Social Security Act to prohibit mid-year changes in the formularies of Medicare Part D plans. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, MediGap changes, Medicare FFS payment reform - HR 3590, Patient Protection and Affordable Care Act. *Medicare physician payment - HR 4691, Temporary Extension Act of 2010; HR 4851, Continuing Extension Act of 2010; S 3421, Protecting Against Indebting our Descendants through Fully Offset Relief (PAID FOR) Temporary Extension Act of 2010. *Changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding - HR 4872, Health Care and Education Reconciliation Act of 2010. *Medicaid FMAP extension - S 3000, A bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months.

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

Health Care Reform, Medicare Part D, Antitrust Exemption for Independent Pharmacists, IVIG Payments, Medicare Demonstration Project for Durable Medical Equipment, Importation of Prescription Drugs, Home Infusion HR 574 and S. 254 - Medicare Home Infusion Therapy Coverage Act of 2009; all sections HR 1204 - Community Pharmacy Fairness Act of 2009; all sections HR 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 HR 4199 - Patient Health and Real Medication Access Cost Savings Act of 2009; all sections HR 3962 - Affordable Health Care for America Act; all sections HR 3590 - Patient Protection and Affordable Care Act; all sections S1793 - America's Healthy Future Act of 2009; all sections HR 4752 - Medicare Prescription Drug Price Negotiation Act of 2010 HR 4872 - Healthcare and Education Reconciliation Act of 2010; all sections

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

H.R. 684, Medicare Prescription Drug Savings and Choice Act (Berry) Part D reforms; H.R. 904, Medicaid Prescription Drug Rebate Equalization Act (Stupak) Medicaid drug costs; H.R. 1407, Medicare Part D Home and Community Services Copayment Equity Act (Doggett) Part D cost sharing; H.R. 1670, Community Choice Act (Davis) Medicaid coverage; H.R. 1832, Medicare Prescription Drug Affordability Act (Wexler) Part D reforms; (cont.) MMM (Legislative) H.R. 2501, Medicare Cost Contract Extension and Refinement Act (Pomeroy) Medicare cost plans; H.R. 2686, Medicare Advantage Payments (Israel) Medicare Advantage benchmark adjustments; H.R. 2688, Empowered at Home Act (Pallone) home and community-based services under Medicaid; H.R. 2700, Prescription Coverage Now Act (Doggett) low-income assistance under Medicare Part D; H.R. 2718, MedPAC Reform Act (Cooper) implementation of Medicare payment policies; H.R. 2758, Medicare Specialty Care Improvement and Protection Act (Kind) Medicare Advantage special needs plans; H.R. 2847, Jobs for Main Street Act (Mollohan) Medicaid FMAP; H.R. 2860, Medicare Drug Savings Through Choice Act (Murphy) Part D reforms; H.R. 3152, Helping Seniors Choose their Medicare Drug Plan Act (Holt) Part D enrollment; H.R. 3200, Americas Affordable Health Choices Act (Dingell) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform; H.R. 3418, Medicare Prescription Drug Cost Equalization Act (Ellsworth) Part D exceptions process; H.R. 3590, Patient Protection and Affordable Care Act (Reid) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; H.R. 3631, Medicare Premium Fairness Act (Titus) Part B premiums; H.R. 3961, Medicare Physician Payment Reform Act (Dingell) Medicare physician payment; H.R. 3962, Americas Affordable Health Choices Act (Dingell) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform; H.R. 4213, Tax Extenders Act (Rangel) MA Special Needs Plans, Cost Plans, Medicare physician payment, Medicaid FMAP; H.R. 4263 (Baldwin) Medicaid FMAP extension; H.R. 4691, Temporary Extension Act (Rangel) Medicare physician payment; H.R. 4752, Medicare Prescription Drug Price Negotiation Act (Welch) HHS Secretarys role in negotiating Part D drug prices; H.R. 4851, Continuing Extension Act (Levin) Medicare physician payment; H.R. 4872, Health Care and Education Reconciliation Act (Spratt) changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding; H.R. 4917 (Schauer) Medicare Part D formulary changes; H.J.Res. 45 Medicare physician payment, pay-as-you-go budget rules; S. 75, Generics First Act (Kohl) Part D reforms; S. 266, Medicare Prescription Drug Gap Reduction Act (Nelson) Part D reforms; S. 330, Medicare Prescription Drug Savings and Choice Act (Durbin) Part D reforms; S. 534, Home and Community Services Copayment Equity Act (Nelson) Part D reforms; S. 547, Drug Rebate Equalization Act (Bingaman) Medicaid drug costs; S. 677, REPAIR Act (Ensign) means-testing Part D premiums; S. 683, Community Choice Act (Harkin) Medicaid coverage; S. 960, Medicare Early Access Act (Rockefeller) Medicare buy-in option; S. 1079, Medicare Cost Contract Extension and Refinement Act (Klobuchar) Medicare cost plans; S. 1307, Medicare Specialty Care Improvement and Protection Act (Feingold) Medicare Advantage special needs plans; S. 1380, MedPAC Reform Act (Rockefeller) implementation of Medicare payment policies; S. 1634, Medicare Prescription Drug Coverage Improvement Act (Rockefeller) government operated Part D plan, dual eligibles; S. 1669, Equal Access to Medicare Options Act (Kerry) guaranteed issue Medigap, Medicare Advantage enrollment; S. 1776, Medicare Physician Fairness Act (Stabenow) Medicare physician payment; S. 1796, Americas Healthy Future Act (Baucus) Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform; S. 2949, (Baucus) Medicaid QI Program funding; S. 3000 (Rockefeller) Medicaid FMAP extension; S. 3153, Continuing Extension Act (Grassley) Medicare physician payment MMM (Regulatory Issues) Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, data, and audit issues, bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, compliance/fraud and abuse training, and Medicare/Medicaid integration and contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education program; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost/rebate issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; and health information technology standards and policies.

HR 3590 - Patient Protection and Affordable Care Act HR 4752 - Medicare Prescription Drug Price Negotiation Act of 2010 HR 3200, HR 3962, S 1796 - Health Care Reform

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

Government targets: Agriculture, Dept of (USDA), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Vice President of the U.S., White House Office

HR 3590 - Patient Protection and Affordable Care Act HR 4872 - Health Care and Education Reconciliation Act of 2010 HR 4213 - American Workers, State and Business Relief Act of 2010, increasing FMAP HR 4752 - Medicare Prescription Drug Price Negotiation Act of 2010 HR 3200, HR 3962, S 1796 - Health Care Reform Psychiatric Care HR 2847, S 3000 - Jobs for Main Street Act, extension and expansion of federal contribution to Medicaid

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

Government targets: Agriculture, Dept of (USDA), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Vice President of the U.S., White House Office

Issues related to Medicare/Medicaid drug coverage including pharmacy payments (average manufacturer price), reimbursements, competition and plan administration, electronic prescribing, chronic care, PBM disclosure. Health reform proposals impacting prescription drug coverage including formulary requirements, generic drug co-payments, direct negotiation, Medicaid rebate changes, applying Medicaid rebates in Medicare, closure of Part D coverage gap, retiree drug subsidy, funding/revenues for Health Care Reform, HR 3200, S1679 America's Health Future Act, HR 3962, HR3950 Patient Protection and Affordable Care Act. H.R.4752 - Medicare Prescription Drug Price Negotiation Act of 2010 H.R. 4872 - Health Care and Education Reconciliation Act of 2010 H.R. 4199 - Patient Health and Real Medication Access Cost Savings Act of 2009 H.R. 4813 - To provide for insurance reform (including health insurance reform), amend title XVIII of the Social Security Act to reform Medicare Advantage and reduce disparities in the Medicare Program, regulate the importation of prescription drugs, and for other purposes.

Client expense: $676,558 · Firm income: Not reported

H.R. 3590, Patient Protection and Affordable Care Act: Part D coverage gap discounts, Part D rebates, Part D issues generally, Medicare payment issues, Medicaid rebate issues, transparency issues, comparative effectiveness, health reform fee and health reform issues generally H.R. 3962, Affordable Health Care for America Act: Part D coverage gap, Part D rebates, Part D issues generally, Medicaid rebate issues, transparency issues, comparative effectiveness, and health reform issues generally H.R. 4752, Medicare Prescription Drug Price Negotiation Act of 2010: non-interference provisions H.R. 4872, Health Care and Education Reconciliation Act of 2010: Part D coverage gap discounts, Part D issues generally, Medicaid rebate issues, health reform fee and health reform issues generally

Client expense: $7,010,000 · Firm income: Not reported

Medicare Advantage, Part D, special needs plans, medicare cost plans, medicaid issues including MCO provider taxes, eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3962, America's Affordable Health Choices Act. Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug pricing, Medigap changes, Medicare FFS payment reform - HR 3590, An act entitled The Patient Protection and Affordable Care Act. Changes to Medicare Advantage funding, Medicare Part D coverage gap, Medicaid funding - HR 4872, Health Care and Education Reconciliation Act of 2010. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes, eligibility expansion, Medigap open enrollment, Medicare FFS payment reform - HR 3200, To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes; proposed legislation re this issue; HR 3590, An act entitled The Patient Protection and Affordable Care Act. *Part D reforms - HR 684, To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program; HR 1832, To amend part D of title XVIII of the Social Security Act to limit the increase in premium costs for beneficiaries under the Medicare prescription drug program to no more than the Social Security cost-of-living adjustment, and to direct the Secretary of Health and Human Services to negotiate lower prescription drug prices on behalf of Medicare beneficiaries; S 75, A bill to amend title XVIII of the Social Security Act to require the use of generic drugs under the Medicare part D prescription drug program when available unless the brand name drug is determined to be medically necessary; S 266, A bill to amend title XVIII of the Social Security Act to reduce the coverage gap in prescription drug coverage under part D of such title based on savings to the Medicare program resulting from the negotiation of prescription drug prices; S 330, A bill to amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare program; S 534, A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals; HR 2860, To amend title XVIII of the Social Security Act to provide for a Medicare operated prescription drug plan option to deliver a meaningful drug benefit and lower prescription drug prices under the Medicare Program. *Medicaid drug costs - HR 904, To amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations; S 547, A bill to amend title XIX of the Social Security Act to reduce the costs of prescription drugs for enrollees of Medicaid managed care organizations by extending the discounts offered under fee-for-service Medicaid to such organizations. *Part D cost sharing - HR 1407, To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including MCO provider taxes and eligibility expansion, Medigap open enrollment, Medicare FFS payment reform - HR 3200, America's Affordable Health Choices Act. *Medicare physician payments - HR 3961, Medicare Physician Payment Reform Act of 2009; HR 4691, Temporary Extension Act of 2010; HR 4851, Continuing Extension Act of 2010; S 3153, Continuing Extension Act of 2010. *MA special needs plans, cost plans, Medicare physician payments, Medicaid FMAP - HR 4213, American Workers, State, and Business Relief Act of 2010. *Medicaid FMAP extension - HR 4263, State Medicaid Assistance Extension Act of 2009; S 3000, A bill to extend the increase in the FMAP provided in the American Recovery and Reinvestment Act of 2009 for an additional 6 months. *Medicaid coverage - HR 1670, To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes; S 683, A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. *Means-testing Part D premiums - S 677, A bill to amend title XVIII of the Social Security Act to require wealthy beneficiaries to pay a greater share of their premiums under the Medicare prescription drug program. *Medicare cost plans - HR 2501, To amend title XVIII of the Social Security Act to extend reasonable cost contracts under Medicare; S 1079, A bill to amend title XVIII of the Social Security Act to extend reasonable cost contracts under the Medicare program. *Medicare Advantage benchmark adjustments - HR 2686, To amend title XVIII of the Social Security Act to provide for a Medicare Advantage benchmark adjustment for certain local areas with VA medical centers and for certain contiguous areas. *Low-income assistance under Medicare Part D - HR 2700, To amend part D of title XVIII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. *Implementation of Medicare payment policies - HR 2718, To amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the Commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy.; S 1380, A bill to amend title XVIII of the Social Security Act to create a sensible infrastructure for delivery system reform by renaming the Medicare Payment Advisory Commission, making the commission an executive branch agency, and providing the Commission new resources and authority to implement Medicare payment policy. *Medicare Advantage special needs plans - HR 2758, To amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes; S 1307, A bill to amend part C of title XVIII of the Social Security Act with respect to Medicare special needs plans and the alignment of Medicare and Medicaid for dually eligible individuals, and for other purposes. *Home and community-based services under Medicaid - HR 2688, To amend title XIX of the Social Security Act to improve the State plan amendment option for providing home and community-based services under the Medicaid Program, and for other purposes. *Part D enrollment - HR 3152, To amend titles XVIII of the Social Security Act to ensure that low-income beneficiaries have improved access to prescription drugs under the Medicare and Medicaid programs. *Part D exceptions process, HR 3418, To amend part D of title XVIII of the Social Security Act to apply the exceptions process for tiered formulary drugs to specialty tier drugs. *Part B premiums - HR 3631, To amend title XVIII to provide for the application of a consistent Medicare part B premium for all Medicare beneficiaries in a budget neutral manner for 2010. *Government-operated Part D plan, dual eligibles - S 1634, A bill to amend titles XVIII and XIX of the Social Security Act to protect and improve the benefits provided to dual eligible individuals under the Medicare and Medicaid programs. *Guaranteed-issue MediGap, Medicare Advantage enrollment - S 1669, A bill to provide all Medicare beneficiaries with the right to guaranteed issue of a Medicare supplemental policy. *Medicaid FMAP - HR 2847, Making appropriations for the Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2010, and for other purposes. *Medicare physician payments - S 1776, A bill to amend title XVIII of the Social Security Act to provide for the update under the Medicare physician fee schedule for years beginning with 2010 and to sunset the application of the sustainable growth rate formula, and for other purposes. *Medicare Advantage, Part D, special needs plans, Medicare cost plans, Medicaid issues including eligibility expansion and prescription drug rebates, Medigap restrictions, Medicare FFS payment reform - 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. *HHS Secretary's role in negotiating Part D drug prices - HR 4752, Medicare Prescription Drug Price Negotiation Act of 2010. *Medicare Part D formulary changes - HR 4917, To amend part D of title XVIII of the Social Security Act to prohibit mid-year changes in the formularies of Medicare Part D plans. *Medicare physician payment, pay-as-you-go budget rules - HJRes 45, Increasing the statutory limit on the public debt. *Medicaid QI Program funding - S 2949, Emergency Aid to American Survivors of the Haiti Earthquake Act.