To amend the American Recovery and Reinvestment Act of 2009 to extend for 6 months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP).

H.R. 2847:Hiring Incentives to Restore Employment Act - FMAP Extension Efforts ( all provisions about FMAP) H.R. 4213: American Workers, State, and Business Relief Act of 2010 -FMAP Extension Efforts (all provisions about FMAP) H.R. 3962: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (all provision regarding Medicaid) H.R. 5471: To amend the American Recovery and Reinvestment Act of 2009 to extend for 6 months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP). (all provisions) Increase in Medicaid reimbursement for primary services Section 1202 of the Patient Protection and Affordable Care Act

Client expense: $370,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE, White House Office

H.R. 3590: An act entitled The Patient Protection and Affordable Care Act.-all provisions related to health, coverage, benefits and Medicaid (all provisions). H.R. 4872: An act to provide reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010. (S. Con. Res. 13). (all provisions) H.R. 1: American Recovery and Reinvestment Act of 2009 (all provisions) H.R. 1585: FIT Kids Act (all provisions) H.R.1586: FAA Air Transportation Modernization and Safety Improvement Act (all provisions related to FMAP) H.R. 3081: Continuing Appropriations Act, 2011 H.R. 4851: Continuing Extension Act of 2010 - Fiscally Responsible Relief for Our States Act of 2010 (all provisions related to health coverage, benefits and Medicaid) H.R.5471: To amend the American Recovery and Reinvestment Act of 2009 to extend for 6 months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP). H.R.5712: Veterans', Seniors', and Children's Health Technical Corrections Act of 2010 (all provision regarding Childern's Health) H.R.6258: Fit for LIFE Act of 2010 (all provisions related to health coverage, benefits and Medicaid) S. 1796: Provide affordable, quality health care for all Americans and reduce the growth in health care spending (all provisions related to health coverage, benefits and Medicaid). S. 2898: Child Safety Care and Educational Continuity Act of 2010 (all provisions regarding Medicaid and CHIP) S. 3551: Fiscally Responsible Relief for Our States Act of 2010 (all provisions related to health coverage, benefits and Medicaid) HIT Certification Standards for Meaningful Use - 45 CFR Part 170 Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology; Final Rule (All provisions) State Exchanges - 45 CFR Part 170 Planning and Establishment of State-Level Exchanges; Request for Comments Regarding Exchange- Related Provisions in Title I of the Patient Protection and Affordable Care Act (Provisions affecting children) Medical homes for individuals with chronic conditions - Section 2703 of the Patient Protection and Affordable Care Act (PPACA) Non-payment for Hospital-Acquired Conditions - Section 2702 of the Patient Protection and Affordable Care Act Childrens Hospitals Graduate Medical Education -- Changes to Hospital Outpatient Prospective Payment System and CY 2011 Payment Rates; Changes to the Ambulatory System and CY 2011 Payment Rates; Proposed Changes to Payments to Hospitals for Certain Inpatient Hospital Services and for Graduate Medical Education Costs; and Proposed Changes to Physician Self-Referral Rules and Related Changes to Provider Agreement Regulations (Provisions affecting CHGME)

H.R. 4213, The American Jobs and Closing Tax Loophole Act of 2010, section 512, the repeal of the RUGs IV delay and section 521, physician payment update. H.R. 4851, The Continuing Extension Act of 2010, section 4, the increase in physician payment update. H.R. 4263, State Medicaid Assistance Act of 2009, to extend for one year the period of temporary increase in the Medicaid FMAP. S. 3000, To extend the increase in the FMAP provided in the American Recovey and Reinvestment Act of 2009 for an additional six months. H.R. 5471, To extend the increase in the FMAP provided in the American Recovey and Reinvestment Act of 2009 for an additional six months. H.R. 5457, Nursing Home Patient and Medicaid Assistance Act of 2010, to provide supplemental payments to nursing facilities serving Medicare and Medicaid patients, all sections. HR. 5712 Veterans, Seniors and Childrens Health Technical Corrections Act of 2010, Section 3 (repeal of delay of RUG-IV) HE 1586 FAA Air Transportation Modernization and Safety Improvement Act, Title II, subtitle A State Fiscal Relief and other provisions (FMAP)

Client expense: $580,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 5471, A bill to amend the American Recovery and Reinvestment Act of 2009 to extend for six months the increase provided under that act in the Medicaid federal medical assistance percentage (FMAP)., all provisions S. 3000, A bill to amend the American Recovery and Reinvestment Act of 2009 to extend for six months the increase provided under that act in the Medicaid federal medical assistance percentage (FMAP), all provisions S. 3551, Fiscally Responsible Relief for Our States Act of 2010, all provisions

Client expense: $431,413 · Firm income: Not reported

Government targets: Energy, Dept of, HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE, State, Dept of (DOS), White House Office

H.R. 4213, The American Jobs and Closing Tax Loophole Act of 2010, section 512, the repeal of the RUGs IV delay and section 521, physician payment update. H.R. 4851, The Continuing Extension Act of 2010, section 4, the increase in physician payment update. H.R. 4263, State Medicaid Assistance Act of 2009, to extend for one year the period of temporary increase in the Medicaid FMAP. S. 3000, To extend the increase in the FMAP provided in the American Recovey and Reinvestment Act of 2009 for an additional six months. H.R. 5471, To extend the increase in the FMAP provided in the American Recovey and Reinvestment Act of 2009 for an additional six months. H.R. 5457, Nursing Home Patient and Medicaid Assistance Act of 2010, to provide supplemental payments to nursing facilities serving Medicare and Medicaid patients, all sections. HR. 5712 Veterans, Seniors and Childrens Health Technical Corrections Act of 2010, Section 3 (repeal of delay of RUG-IV) HE 1586 FAA Air Transportation Modernization and Safety Improvement Act, Title II, subtitle A State Fiscal Relief and other provisions (FMAP)

Client expense: $580,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 3590: An act entitled The Patient Protection and Affordable Care Act.-all provisions related to health, coverage, benefits and Medicaid (all provisions). H.R. 4872: An act to provide reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010. (S. Con. Res. 13). (all provisions) H.R. 1: American Recovery and Reinvestment Act of 2009 (all provisions) H.R. 1585: FIT Kids Act (all provisions) H.R.1586: FAA Air Transportation Modernization and Safety Improvement Act (all provisions related to FMAP) H.R. 3081: Continuing Appropriations Act, 2011 H.R. 4851: Continuing Extension Act of 2010 - Fiscally Responsible Relief for Our States Act of 2010 (all provisions related to health coverage, benefits and Medicaid) H.R.5471: To amend the American Recovery and Reinvestment Act of 2009 to extend for 6 months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP). H.R.5712: Veterans', Seniors', and Children's Health Technical Corrections Act of 2010 (all provision regarding Childern's Health) H.R.6258: Fit for LIFE Act of 2010 (all provisions related to health coverage, benefits and Medicaid) S. 1796: Provide affordable, quality health care for all Americans and reduce the growth in health care spending (all provisions related to health coverage, benefits and Medicaid). S. 2898: Child Safety Care and Educational Continuity Act of 2010 (all provisions regarding Medicaid and CHIP) S. 3551: Fiscally Responsible Relief for Our States Act of 2010 (all provisions related to health coverage, benefits and Medicaid) Dependent Coverage up to age 26 - Group Health Plans and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the Patient Protection and Affordable Care Act; Interim Final Rule and Proposed Rule (all provisions) 45 CFR Part 170 HIT Certification Standards for Meaningful Use - Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology; Final Rule (All provisions) Private Insurance reforms for children -- Patient Protection and Affordable Care Act; Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable Care Act Relating to Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections; Final Rule and Proposed Rule (All provisions) Preventive Services for children - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services (All provisions related to children) Grandfathered health plans - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection and Affordable Care Act (all provisions) 45 CFR Part 170 - State Exchanges- Planning and Establishment of State-Level Exchanges; Request for Comments Regarding Exchange- Related Provisions in Title I of the Patient Protection and Affordable Care Act (Provisions affecting children) Section 2702 & 2703 - of the Patient Protection and Affordable Care Act (PPACA) (All provisions related to children) Childrens Hospitals Graduate Medical Education -- Changes to Hospital Outpatient Prospective Payment System and CY 2011 Payment Rates; Changes to the Ambulatory System and CY 2011 Payment Rates; Proposed Changes to Payments to Hospitals for Certain Inpatient Hospital Services and for Graduate Medical Education Costs; and Proposed Changes to Physician Self-Referral Rules and Related Changes to Provider Agreement Regulations (Provisions affecting CHGME)

H.R. 2847:Hiring Incentives to Restore Employment Act - FMAP Extension Efforts ( all provisions about FMAP) H.R. 4213: American Workers, State, and Business Relief Act of 2010 -FMAP Extension Efforts (all provisions about FMAP) H.R. 3962: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (all provision regarding Medicaid) H.R. 5471: To amend the American Recovery and Reinvestment Act of 2009 to extend for 6 months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP). (all provisions) 42 CFR Part 410, 413 and 414- Medicare Payment for End Stage Renal Disease Services - Medicare Program; End-Stage Renal Disease Prospective Payment System (all provisions) 42 CFR Parts 412, 413, 422 et al. - Meaningful Use Regulation - Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Final Rule (Medicaid Provisions) Pediatric Quality - Medicaid Program; Request for Comments on Legislative Changes To Provide Quality of Care to Children (all provisions)

Client expense: $220,000 · Firm income: Not reported

H.R. 4213, American Jobs and Closing Tax Loopholes Act: Medicare payment issues. (Became PL 111-205 on 7-22-10) H.R. 5471, to amend the American Recovery and Reinvestment Act of 2009 to extend for six months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP) (FMAP issues) See continuation page ... S. 3551, Fiscally Responsible Relief for Out States Act of 2010, a bill to provide a fully offset extension of unemployment insurance, enhanced FMAP, and summer youth employment (FMAP issues) Quality payments to providers.

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

Health reform issues related to children's hospitals, including reimbursement for children's hospitals and providers. Medicaid reform and reimbursement issues, State Medicaid funding issues. (continued on next page) H.R. 4213, American Jobs and Closing Tax Loopholes Act of 2010 (Became PL 111-205 on July 22, 2010) H.R. 5471, To amend the American Recovery and Reinvestment Act of 2009 to extend for 6 months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP) S. 3551, Fiscally Responsible Relief for our States Act of 2010

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

H.R. 2847:Hiring Incentives to Restore Employment Act - FMAP Extension Efforts ( all provisions about FMAP) H.R. 4213: American Workers, State, and Business Relief Act of 2010 -FMAP Extension Efforts (all provisions about FMAP) H.R. 3962: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (all provision regarding Medicaid) H.R. 5471: To amend the American Recovery and Reinvestment Act of 2009 to extend for 6 months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP). (all provisions) N.A.C.H. sent a letter to the Senate Finace Committee supporting the nomination of Dr. Don Berwick as the Administrator of CMS

Client expense: $332,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE, White House Office

H.R. 4213, American Jobs and Closing Tax Loopholes Act: Medicare payment issues. H.R. 5471, to amend the American Recovery and Reinvestment Act of 2009 to extend for six months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP) (FMAP issues) See continuation page ... S. 3551, Fiscally Responsible Relief for Out States Act of 2010, a bill to provide a fully offset extension of unemployment insurance, enhanced FMAP, and summer youth employment (FMAP issues) H.R. 3962, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (FMAP issues).

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

Health reform issues related to children's hospitals, including reimbursement for children's hospitals and providers. Medicaid reform and reimbursement issues, State Medicaid funding issues. H.R. 3962, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010; (continued on next page) H.R. 4213, American Jobs and Closing Tax Loopholes Act of 2010 H.R. 4851, Continuing Extension Act of 2010 H.R. 5471, To amend the American Recovery and Reinvestment Act of 2009 to extend for 6 months the increase provided under that Act in the Medicaid Federal medical assistance percentage (FMAP) S. 3551, Fiscally Responsible Relief for our States Act of 2010

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

H.R. 4213, The American Jobs and Closing Tax Loophole Act of 2010, section 512, the repeal of the RUGs IV delay and section 521, physician payment update. H.R. 4851, The Continuing Extension Act of 2010, section 4, the increase in physician payment update. H.R. 4263, State Medicaid Assistance Act of 2009, to extend for one year the period of temporary increase in the Medicaid FMAP. S. 3000, To extend the increase in the FMAP provided in the American Recovey and Reinvestment Act of 2009 for an additional six months. H.R. 5471, To extend the increase in the FMAP provided in the American Recovey and Reinvestment Act of 2009 for an additional six months. H.R. 5457, Nursing Home Patient and Medicaid Assistance Act of 2010, to provide supplemental payments to nursing facilities serving Medicare and Medicaid patients, all sections.

Client expense: $660,000 · Firm income: Not reported

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