Medicare Prescription Drug Savings and Choice Act of 2009

Federal Medical Assistance Percentage Increase HR 684/ S 330 -Medicare Prescription Drug Savings and Choice Act of 2009 S. 1217 - Medicaid Services Restoration Act of 2009 S 960 - Medicare Early Access Act of 2009

Client expense: $57,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Employment & Training Administration, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

Medicare/Home Health Benefits (No bill): Pertaining to potential regulation regarding the face-to-face physician encounter requirement to qualify for the Medicare home health benefit. Medicare/Part A Hospital Inpatient Status. H.R. 5950: provisions ensuring that beneficiaries receiving hospital services are designated inpatients, thereby assuring coverage of prescription drugs and post-acute care under Part A. Medicare/Physician Fees (P.L. 111-309): provisions relating to maintaining current levels of physician fees under Part B; extension of the therapy caps exceptions process; the extension of the Qualified Individual program (no bill). Medicare/Part B Premium. S. 3950, H.R. 3631: provisions extending the current "hold harmless" policy to all Medicare enrollees ensuring 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; authorizing the collection of data regarding disparities in the provision of care; providing safeguards and subsidies to assure affordability of health coverage for seniors. Medicare/Commission. P.L. 111-148 (H.R. 3590), P.L. 111-152 (H.R. 4872), S. 3653, H.R. 4985: 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/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. Medicare/Parts C and D. P.L. 110-275, P.L. 108-173. implementation of regulations and issuance of guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and the appeals processes under Medicare Parts C and D. Medicare/Negotiation of Part D Drug Prices (No bill): pertaining to 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. 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/ Federal Coordinated Health Care Office (No bill): proposals for the activities of the Federal Coordinated Health Care Office intended to improve the management of the Part D low-income subsidy, the Medicare Savings Programs, and Special Needs Plans for dually-eligible beneficiaries. Medicare and Medicaid/ Center for Medicare and Medicaid Innovations (No bill): relating to planning for the Center for Medicare and Medicaid Innovations, and the approach this office will take toward coordinated programs for dually-eligible Medicare and Medicaid beneficiaries.

Client expense: $420,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), President of the U.S., SENATE

HR 1 American Recovery and Reinvestment Act (increase FMAP, and moratorium on Medicaid regulations) HR 2, SCHIP. HR 904/S 547 (Medicaid drug rebates) HR 684/S. 330 (to establish government-run PDP) S. 266 (government run negotiation of drug prices in Medicare) S. 75 (to promote generic drugs in Medicare). S. 677 (to means-test Part B Premiums). S. 1832 (to regulate Part D plan prices). S.960 (Medicare Buy in); HR 3961 ("Doc Fix"); S. 2128 (MM Fraud & Abuse); S. 1776 (SGR). HR 3590/HR 48

Client expense: $998,150 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform and inquired about eligibility criteria and implementation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act in Patient Protection and Affordable Care Act (P.L.111-148) - Discussed implementation of criminal background checks for employees of long-term care providers in healthcare reform law. Discussed implementation of healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed implementation of certain enacted provisions. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of and on new implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of and on implementation of health care law to make improvements in the Patient Protection and Affordable Care Act and implementation of certain provisions. H.R. 4993/S. 2814, Home Health Planning Improvement Act of 2010 - Wrote letters in support of Nurse Practitioners, Clinical Nurse Specialists, and Physician Assistants being able to order Medicare funded home health care. Extension of enhanced FMAP (no bill number) H. R. 3962/P.L. 111-192, Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Which among other things, postpones the reduction of Medicare reimbursements for physician services until November 30, 2010. H.R. 6130, Strengthening Medicare Anti-Fraud Measures Act - Discussed medicare fraud. H.R. 5044/S. 3632, Medicare Fraud Enforcement and Prevention Act - Discussed medicare fraud. H.R. 5546, no official title, anti-fraud measure -Discussed medicare fraud. H.R. 5950, Improving Access to Medicare Coverage Act - To count a periof of observation status in a hospital exceeding 24 hours toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare. H.R. 2773/S. 1295, Medicare Transitional Care Act and S. Amdt. 3273, Protection and Affordable Care Act - To cover transitional care services to improve the quality and care under the Medicare Program. S. 3632, The Medicare and Medicaid Fraud Enforcement and Prevention Act of 2010 - Fraud bill would seek to curtail wasted fraud and abuse in the Medicare and Healthcare Programs. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. H.R. 4213 American Workers, State, and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR. S. 3686, Labor, HHS, Education and related agencies Appropriations Act, FY 2011 - Lobbied for FMAP fix and related health care programs. H.R. 3081, Continuing Resolution, FY 2011 - Lobbied for FMAP fix inclusion in appropriations legislation. S. 2814/H.R. 4993, Home Health Care Planning Improvements Act of 2010 - Legislation would allow advanced practice nurses and physician assistants to order medicare supported home health care. Discussed Durable Medical Equipment bidding. (no bill)

Client expense: $4,710,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

- CMS 4138-IFC4, "Medicare Advantage and Prescription Drug Programs MIPPA Drug Formulary and Protected Classes Policies", regarding all provisions. - H.R. 684 / S. 330, "To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program", regarding all provisions. - S. 883, "A bill to amend title XIX of the Social Security Act to permit States the option to provide Medicaid coverage for low-income individuals infected with HIV", regarding all provisions. - H. R. 1616, "To amend title XIX of the Social Security Act to permit States the option to provide Medicaid coverage for low-income individuals infected with HIV", regarding all provisions. - H. R. 1392 / S. 1221, "A bill to amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sale price", regarding all provisions. - H.R. 3138/ S. 301, "A bill to amend title XI of the Social Security Act to provide for transparancy in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP. - Implementation of Health Care Reform Bill: Medicare Wellness Benefit. - H.R. 6130, "Strengthening Medicare Anti-Fraud Measures 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

HR 4899 Supplemental Appropriations (340B-1 and AMP), Part D general issues, Protected Classes, Comparative Effectiveness, general Medicare/Medicaid expansions and reform (see HCR bills); End Stage Renal Disease proposed rules; TRICARE, HR 684/S330 Medicare prescription drug price negotiation Act of 2010, HR 4872 Health Care Reconcilation Act of 2010, HR 3590 Patient Protection and Affordable Care Act, Tax Extenders bills, HR 904 Medicaid Prescription Drug Rebate Equalization

Client expense: $510,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

Federal Medical Assistance Percentage Increase HR 684/ S 330 -Medicare Prescription Drug Savings and Choice Act of 2009 S. 1217 - Medicaid Services Restoration Act of 2009 S 960 - Medicare Early Access Act of 2009

Client expense: $51,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

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.

Client expense: $440,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 1 American Recovery and Reinvestment Act (increase FMAP, and moratorium on Medicaid regulations) HR 2, SCHIP. HR 904/S 547 (Medicaid drug rebates) HR 684/S. 330 (to establish government-run PDP) S. 266 (government run negotiation of drug prices in Medicare) S. 75 (to promote generic drugs in Medicare). S. 677 (to means-test Part B Premiums). S. 1832 (to regulate Part D plan prices). S.960 (Medicare Buy in); HR 3961 ("Doc Fix"); S. 2128 (MM Fraud & Abuse); S. 1776 (SGR). HR 3590/HR 48

Client expense: $638,299 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Patient Protection and Affordable Care Act Implementation H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009

Client expense: $2,250,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

- H.R. 1392, "To amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price", regarding all provisions. - CMS 4138-IFC4, "Medicare Advantage and Prescription Drug Programs MIPPA Drug Formulary and Protected Classes Policies", regarding all provisions. - H.R. 684 / S. 330, "To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program", regarding all provisions. - S. 883, "A bill to amend title XIX of the Social Security Act to permit States the option to provide Medicaid coverage for low-income individuals infected with HIV", regarding all provisions. - H. R. 1616, "To amend title XIX of the Social Security Act to permit States the option to provide Medicaid coverage for low-income individuals infected with HIV", regarding all provisions. - H. R. 1392 / S. 1221, "A bill to amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sale price", regarding all provisions. - H.R. 3138/ S. 301, "A bill to amend title XI of the Social Security Act to provide for transparancy in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP.

Client expense: $1,150,000 · Firm income: Not reported

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

Lobbying on scope of Physician Payments Sunshine Act (S. 301); general Medicare and Medicade reform issues (America's Affordable Health Choices Act of 2009 H.R. 3200, Affordable Health Choices Act S. 1679); electronic prescribing issues (no specific legislation); anti-counterfeiting legislation concerning drugs/pedigree drug legislation; legislation on drug and device safety (Food and Drug Administration Globalization Act of 2009 H.R. 759); generic drug legislation (H.R. 573); follow-on biologics (Pre-existing Condition Patient Protection Act of 2009 S. 623); Medicare Prescription Drug Savings and Choice Act of 2009 (S. 330 & H.R. 684); drug disposal legislation (Secure and Responsible Drug Disposal Act of 2009 H.R. 1359 and Safe Drug Disposal Act of 2009 H.R. 1191, S. 1292, S. 1336); federal preemption issues in Medical Device Safety Act of 2009 (S. 540 and H.R. 1346); National Pain Care Policy Act of 2009 (H.R. 756 & S. 660); drug reimportation issues (Pharmaceutical Market Access and Drug Safety Act of 2009, S. 525 & H.R. 1298); disposal of drugs (H.R. 1191, H.R. 1359, S. 1292 & S. 1336); biosimilar drugs (H.R. 1427, H.R. 1548, S. 726); tax on pharmaceutical companies (H.R. 3590, S. 1796); health care reform (America's Affordable Health Choices Act of 2009 H.R. 3200, Affordable Health Choices Act S. 1679, America's Healthy Future Act S. 1796, H.R. 3590, H.R. 3962, H.R. 3200, H.R. 4872); modify approval of oxycodone (H.R. 4956); reauthorization of Prescription Drug User Fee Act; health care technical corrections (H.R. 5712); life sciences research tax credit legislation.

Client expense: $360,000 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, SENATE

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.

Client expense: $320,000 · Firm income: Not reported

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

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform and inquired about eligibility criteria. S.245, Retooling the Health Care Workforce for an Aging America Act - Discussed moving forward provisions not in healthcare reform. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Drafted comment letter on implementation of criminal background checks for employees of long-term care providers in healthcare reform law. Discussed implementation of healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed implementation of certain enacted provisions. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of and on new implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care law to make improvements in the Patient Protection and Affordable Care Act and implementation of certain provisions. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. H.R. 4213 American Workers, State, and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR.

Client expense: $4,250,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform and inquired about eligibility criteria. S.245, Retooling the Health Care Workforce for an Aging America Act - Discussed moving forward provisions not in healthcare reform. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Drafted comment letter on implementation of criminal background checks for employees of long-term care providers in healthcare reform law. Discussed implementation of healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed implementation of certain enacted provisions. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of and on new implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care law to make improvements in the Patient Protection and Affordable Care Act and implementation of certain provisions. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments. H.R. 4213 American Workers, State, and Business Relief Act/American Jobs and Closing Tax Loopholes Act - Lobbied for extension of UI, COBRA, FMAP, and SGR.

Client expense: $4,250,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

HR 1 American Recovery and Reinvestment Act (increase FMAP, and moratorium on Medicaid regulations) HR 2, SCHIP. HR 904/S 547 (Medicaid drug rebates) HR 684/S. 330 (to establish government-run PDP) S. 266 (government run negotiation of drug prices in Medicare) S. 75 (to promote generic drugs in Medicare). S. 677 (to means-test Part B Premiums). S. 1832 (to regulate Part D plan prices). S.960 (Medicare Buy in); HR 3961 ("Doc Fix"); S. 2128 (MM Fraud & Abuse); S. 1776 (SGR).

Client expense: $1,568,045 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Federal Medical Assistance Percentage Increase HR 684/ S 330 -Medicare Prescription Drug Savings and Choice Act of 2009 S. 1217 - Medicaid Services Restoration Act of 2009 S 960 - Medicare Early Access Act of 2009

Client expense: $67,500 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

S. 54; Registered Nurse Safe Staffing Act of 2009 S. 63; Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2009 H.R. 3185/S. 1569; Medicare Graduate Nursing Education Act H.R. 684/S. 330; Medicare Prescription Drug Savings and Choice Act of 2009 S. 1796: America's Health Future Act SA 2908; "Support for Family Caregivers Under Medicare and Medicaid" H.R. 4872; The Health Care and Education Affordability Reconciliation Act S. 1776; Medicare Physician Fairness Act of 2009 H.R. 5527/S. 3991; Registered Nurse Safe Staffing Act

Client expense: $468,758 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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.

Client expense: $2,700,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of

- H.R. 1392, "To amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price", regarding all provisions. - CMS 4138-IFC4, "Medicare Advantage and Prescription Drug Programs MIPPA Drug Formulary and Protected Classes Policies", regarding all provisions. - H.R. 684 / S. 330, "To amend title XVIII of the Social Security Act to deliver a meaningful benefit and lower prescription drug prices under the Medicare Program", regarding all provisions. - S. 883, "A bill to amend title XIX of the Social Security Act to permit States the option to provide Medicaid coverage for low-income individuals infected with HIV", regarding all provisions. - H. R. 1616, "To amend title XIX of the Social Security Act to permit States the option to provide Medicaid coverage for low-income individuals infected with HIV", regarding all provisions. - H. R. 1392 / S. 1221, "A bill to amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sale price", regarding all provisions. - H.R. 3138/ S. 301, "A bill to amend title XI of the Social Security Act to provide for transparancy in the relationship between physicians and manufacturers of drugs, devices, biologicals, or medical supplies for which payment is made under Medicare, Medicaid, or SCHIP.

Client expense: $2,110,000 · Firm income: Not reported

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

Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009

Client expense: $4,340,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Medicaid drug rebates including S. 547/H.R. 904, Drug Rebate Equalization Act of 2009; H.R. 1725, Voluntary State Discount Prescription Drug Plan Act of 2009 H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Medicare drug price negotiation, payment, and coverage including S. 330/H.R. 684, Medicare Prescription Drug Savings and Choice Act of 2009; S. 266, Medicare Prescription Drug Gap Reduction Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid drug rebates including S. 547/H.R. 904, Drug Rebate Equalization Act of 2009; H.R. 1725, Voluntary State Discount Prescription Drug Plan Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Medicare drug price negotiation, payment, and coverage including S. 330/H.R. 684, Medicare Prescription Drug Savings and Choice Act of 2009; S. 266, Medicare Prescription Drug Gap Reduction Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid drug rebates including S. 547/H.R. 904, Drug Rebate Equalization Act of 2009; H.R. 1725, Voluntary State Discount Prescription Drug Plan Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Medicare drug price negotiation, payment, and coverage including S. 330/H.R. 684, Medicare Prescription Drug Savings and Choice Act of 2009; S. 266, Medicare Preemption Drug Gap Reduction Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Medicare payment for diagnostic testing; and Medicare payment/coverage for telemedicine.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid drug rebates including S. 547/H.R. 904, Drug Rebate Equalization Act of 2009; H.R. 1725, Voluntary State Discount Prescription Drug Plan Act of 2009; and H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Medicare drug price negotiation, payment, and coverage including S. 330/H.R. 684, Medicare Prescription Drug Savings and Choice Act of 2009; S. 266, Medicare Prescription Drug Gap Reduction Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare drug benefit, Medicare drug price negotiation, coverage, and payment including S. 330/H.R. 684, Medicare Prescription Drug Savings and Choice Act of 2009; S. 266, Medicare Prescription Drug Gap Reduction Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid drug rebates including S. 547/H.R. 904, Drug Rebate Equalization Act of 2009; H.R. 1725, Voluntary State Discount Prescription Drug Plan Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Medicare drug payment and coverage including S. 330/H.R. 684, Medicare Prescription Drug Savings and Choice Act of 2009; S. 266, Medicare Prescription Drug Gap Reduction Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbying on scope of Physician Payments Sunshine Act (S. 301); general Medicare and Medicade reform issues (America's Affordable Health Choices Act of 2009 H.R. 3200, Affordable Health Choices Act S 1679); electronic prescribing issues (no specific legislation); anti-counterfeiting legislation concerning drugs/pedigree drug legislation; legislation on drug and device safety (Food and Drug Administration Globalization Act of 2009 H.R. 759); generic drug legislation (H.R. 573); follow-on biologics (Pre-existing Condition Patient Protection Act of 2009 S. 623); Medicare Prescription Drug Savings and Choice Act of 2009 (S. 330 & H.R. 684); drug disposal legislation (Secure and Responsible Drug Disposal Act of 2009 H.R. 1359 and Safe Drug Disposal Act of 2009 H.R. 1191, S. 1292, S. 1336); federal preemption issues in Medical Device Safety Act of 2009 (S. 540 and H.R. 1346); National Pain Care Policy Act of 2009 (H.R. 756 & S. 660); drug reimportation issues (Pharmaceutical Market Access and Drug Safety Act of 2009, S. 525 & H.R. 1298); disposal of drugs (H.R. 1191, H.R. 1359, S. 1292, & S. 1336); biosimilar drugs (H.R. 1427, H.R. 1548, S. 726); tax on pharmaceutical companies (H.R. 3590, S. 1796); health care reform (America's Affordable Health Choices Act of 2009 H.R. 3200, Affordable Health Choices Act S. 1679, America's Healthy Future Act S. 1796, H.R. 3590, H.R. 3962, H.R. 3200, H.R. 4872); modify approval of oxycodone (H.R. 4956); reauthorization of Prescription Drug User Fee Act.

Client expense: $550,000 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, SENATE

Medicaid drug rebates including S. 547/H.R. 904, Drug Rebate Equalization Act of 2009; H.R. 1725, Voluntary State Discount Prescription Drug Plan Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010. Medicare drug price negotiation, payment, and coverage including S. 330/H.R. 684, Medicare Prescription Drug Savings and Choice Act of 2009; S. 266, Medicare Prescription Drug Gap Reduction Act of 2009; H.R. 3962, Affordable Health Care for America Act; H.R. 3590, Patient Protection and Affordable Care Act; H.R. 4872, the Health Care and Education Reconciliation Act of 2010.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR. 444 340B Program Improvement and Integrity Act of 2009, HR 684/S 330 The Medicare Prescription Drug Savings and Choice Act of 2009, HR 904 Medicaid Prescription Drug Rebate Equalization Act of 2009, Part D general issues, Protected Classes, Comparative Effectiveness, general Medicare/Medicaid expansions and reform (see HCR bills); S 7, Generics First Act of 2009; End Stage Renal Disease proposed rules; TRICARE, HR 3590/4872

Client expense: $421,094 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE

H.R. 2560/S. 1131; Independence at Home Act of 2009. Provisions in Health Care Reform related to nursing and nurse led models of care. H.R. 1101/S. 662; The Midwifery Care Access and Reimbursement Equity Act. Provisions in Health Care Reform related to reimbursement for certified nurse midwives.. S. 54; Registered Nurse Safe Staffing Act of 2009 S. 63; Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2009. H.R. 3185/S. 1569; Medicare Graduate Nursing Education Act. H.R. 684/S. 330; Medicare Prescription Drug Savings and Choice Act of 2009. Provisions related to Advanced Practic Nurses and Registered nurses related to general health care reform initiatives. H.R. 3590; Patient Protection and Affordable Care Act. Provisions related to medical underwriting. H.R. 3200; Affordable Health Choices Act of 2009 Provisions related to affordability and privacy, health care disparities, and graduate nurse education. S. 1796; America's Healthy Future Act Provisions related to health care and nursing. SA 2908; "Support for Family Caregivers Under Medicare and Medicaid" S. 1776; Medicare Physician Fairness Act of 2009 Provisions related to the sustainable growth rate formula in medicare. H.R. 3962; Affordable Health Care for America Act. Provisions related to mental health and addiction, prevention, treatment and recovery and support services, and all other health care provisions. Provisions in HCR which would encourage the formation of health care choice compacts. Provisions related to payment rate for primary care services to equal the payment rate for Medicare. H.R. 4872 The Health Care and Education Affordability Reconciliation Act.

Client expense: $327,083 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and provisions included in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation in healthcare reform on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reduce wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). S.750 Caring for an Aging America Act - Discussed as possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of health care legislation that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care legislation to make improvements in the Patient Protection and Affordable Care Act. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act/ S.1796, America's Healthy Future Act - Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments.

Client expense: $3,970,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

S.330/H.R.684, Medicare Prescription Drug Savings and Choice Act of 2009 - Discussed legislation which would create a government-operated Medicare prescription drug plan. Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). S.683/H.R.1670, Community Choice Act - Supported Community First Choice Option version of this legislation in health care reform. S.245/H.R. 468/S.434/H.R.2688, Retooling the Health Care Workforce for an Aging America Act and possible amendments, in healthcare reform, including Family Caregiving provisions. S.113/H.R.2560, Empowered at Home Act and the Independence at Home Act - Discussed long-term care and chronic care legislation that AARP endorsed and provisions included in health reform legislation. S.631/H.R.2223, Patient Safety and Abuse Prevention Act - Support for legislation in healthcare reform on criminal background checks for employees of long-term care providers and specific bill provisions. S. 697/H.R.1721, Class Act - Discussed provisions of CLASS in House and Senate health reform bills and urged inclusion of CLASS in Senate and House HCR legislation. S.1131/H.R.2560 Independence at Home Act - Discussed AARP's support for this Medicare care coordination bill; and it's inclusion in health reform legislation. Discussed healthcare coverage for the 50-64 year old population, age rating, and closing the doughnut hole. S.1133/H.R. 2580, Empowering Medicare Patient Choices Act - Discussed legislation that would promote patient decision aids to help people make informed, evidence-based decisions about health care treatment options. H.R. 2773/S 1295, Medicare Transitional Care Act of 2009 - Discussed legislation that would reduce unnecessary hospital readmissions, improve quality for Medicare beneficiaries, and reduce wasteful spending in Medicare; worked to incorporate bill and its elements into health reform legislation. S. 960, Medicare Early Access Act of 2009 - Support for legislation to let Americans aged 55-64 who are otherwise without access to group or public coverage buy into Medicare. H.R. 2700, Prescription Coverage Now Act of 2009 - Discussed legislation that would assist low-invome 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. S. 1185, Medicare Financial Stability for Beneficiaries Act of 2009 - Discussed legislation that would ensure that low-income beneficiaries have improved access to health care under the Medicare and Medicaid programs. H.R. 2716, Medicare Savings Program Improvement Act of 2009 - Discussed legislation that would provide financial stability for older Americans and people with disabilities through improvements in the Medicare Savings Program. Advocated for modernizing Medicare funding so that nursing education funds are directed to advanced nurse practice programs to help produce more highly-skilled nurses to care for the Medicare population (no bill). S.750 Caring for an Aging America Act - Discussed as possible amendment to health reform bill. S.1257/H.R.2852 Project 2020: Building the Promise of Home and Community Based Services Act - Lobbied in support of legislation. Discussed ideas to improve medicare for medicare beneficiaries. (no bill) Discussed Medicare physician payment issues and SGR. (no bill) S. 2128, Prevent Healthcare Fraud Act - Discussed Medicare Fraud. Discussed idea of an annual physical for Medicare beneficiaries (no bill). S.1009 Medicare Care Transitions Program Act - Discussed provisions of Medicare Care Transitions Program Act. S.975 Seniors and Taxpayers Obligation and Protection Act - Lobbied in support of legislation. S.1256 Home and Community Balanced Incentives Act - Discussed inclusion of this legislation in health reform legislation and advocated for amendment in Senate healthcare reform legislation. H.R. 3631, Medicare Premium Fairness Act - Lobbied to pass legislation to allow premiums for Medicare Part B to remain at 2009 levels for all beneficiaries. S. 2926, the Economic Fairness for Seniors Act - Discussed the implications of legislation to provide $250 in economic relief to seniors, veterans and the disabled in response to the lack of a COLA in 2010; allow Medicare Part B premiums to remain at 2009 levels for all beneficiaries and to study the use of a new Consumer Price Index for use in calculating future Social Security COLAs. H.R. 3590, Patient Protection and Affordable Care Act - Lobbied in support of health care legislation that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. H.R. 4872, Health Care and Education Reconciliation Act - Lobbied in support of health care legislation to make improvements in the Patient Protection and Affordable Care Act. H.R. 3200 America's Affordable Health Choices Act/S. 1679, Americas Health Choices Act/ S.1796, America's Healthy Future Act - Discussed need for affordable quality healthcare, delivery system reform, ending age discrimination in the health insurance industry, "ending rating by health condition or any proxy," closing the doughnut hole, creating a pathway for generic biologics, allowing and funding states to provide home and community based services, creating a transitional benefit in medicare and expanding the asset limit to qualify for low-income programs in medicare, and modifying medicare advantage. House Amendment to Senate Amendment to H.R. 2847 "Jobs for Main Street Act" - Discussed redirection of some TARP funds to extend unemployment insurance and COBRA eligibility and FMAP assistance to state governments.

Client expense: $3,970,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Energy, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Vice President of the United States, SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Federal Medical Assistance Percentage Increase HR 684/ S 330 -Medicare Prescription Drug Savings and Choice Act of 2009 S. 1217 - Medicaid Services Restoration Act of 2009 S 960 - Medicare Early Access Act of 2009 Medicare Therapy Caps

Client expense: $51,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), State, Dept of (DOS), White House Office

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.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

H.R. 1458/S. 565 - Comprehensive Immunosuppresive Drug Coverage for Kidney Transplant Patients Act of 2007 - Lobbied to provide longer payment periods for immunosuppresive drugs. H.R. 684 and S. 330 - Medicare Prescription Drug Savings and Choice Act - Lobbied against establishing a government sponsored fall-back plan in Medicare Part D. H.R. 574 and S. 254 - The Medicare Home Infusion Therapy Coverage Act - Lobbied to improve reimbursements for Medicare home infusion therapy. No Bill - Medicare Part D Oversight - Lobbied to educate on the benefits of private negotiation in Medicare Part D.

Client expense: $1,060,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1 ARRA (increase in FMAP and moratorium on Medicaid Regulations). HR 2 SCHIP, HR 904/S 547 (Medicaid drug rebates). HR 684/S 330 (establish Government PDPs). S 266 (government run negotiation of drug prices in Medicare.) S 75 (to promote generic drugs in Medicare). S 677 (means-test Part B premiums). S 1832 (to regulate Part D plan prices). S 960 (Medicare Buy-In for age 55-64). HR 3961 ("Doc Fix"). S. 2128 (MM Fraud & Abuse) S 1776 (SGR).

Client expense: $1,641,400 · 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), Office of Management & Budget (OMB), SENATE

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, P.L. 111-152, H.R. 4872, H.R. 3590: provisions related 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, permitting the Department of Health and Human Services to negotiate drug prices for the Part D program, simplifying plan benefit designs under Part C, 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, reducing permitted age rating ratio for insurance premiums, inclusion of patient-centered quality reporting requirements for providers, creating new claims reviews processes and provider certification, requiring reporting by practitioners of gifts received from pharmaceutical and medical device manufacturers. Medicare/Commission. P.L. 111-148, P.L. 111-152, H.R. 4872: creating an independent commission authorized to establish Medicare payment and policy designed to reduce Medicare spending growth. 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/Part D Generics. S. 75: requiring the use of generics where available unless the brand name drug is determined to be medically necessary. Medicare/Part D cost-sharing. S. 1630: establishing limits on required beneficiary cost-sharing under Part D drug plans. Medicare/Part D dual eligibles. P.L. 111-148, P.L. 111-152, H.R. 4872, S. 1634: removing enrollment barriers for low-income beneficiaries and establishing a Medicare-operated prescription drug plan. Medicare/Combating Waste, Fraud, Abuse. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 27: 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/Therapy Caps. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 43, S. 46: repealing or extending exceptions to outpatient rehabilitation therapy caps. Medicare/Private Contracts. H.R. 164: prohibiting denial of Social Security benefits to persons who elect not to participate in Medicare. 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/Rural Improvements. H.R. 902/S. 382: provision authorizing improvements to services provided to beneficiaries residing in rural areas. Medicare/Shingles Vaccine. H.R. 1038: extending Part B coverage to the shingles vaccine. Medicare/Home Health. H.R. 1094: authorizing home health care agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation services. Medicare/Health Care Vouchers. H.R. 1118: authorizing Medicare-eligible seniors to elect to receive vouchers for a health savings account, premiums for a high deductible health insurance plan, or both, in lieu of regular Medicare benefits and suspending Medicare late enrollment penalties between ages 65 and 70. Medicare/Skilled Nursing Facilities. H.R. 1125, S. 647: provisions related to requiring the reporting of expenditures for nursing services at skilled nursing facilities and requiring disclosure of corporate ownership. Medicare/Prevention. H.R. 1213: provisions authorizing ultrasound screening for abdominal aortic aneurysms to at-risk Medicare beneficiaries between the ages of 65 and 75 without the requirement of a prior initial preventive physical examination; H.R. 1894, S. 769: expanding access to bone mass measurement benefits under Part B. Medicare/Part B Drug Payments. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 1392: relating to appropriate Part B payment amounts for drugs and biologicals. Medicare/Low Income Prescription Drug Benefits. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, H.R. 1407, S. 534: authorizing a reduction in cost-sharing under Part D for non-institutionalized, full-benefit dual eligible individuals. Medicare/Disability Benefits. S. 700, H.R. 1708, H.R. 2881: phasing-out the 24-month waiting period for disabled individuals to become eligible for Medicare benefits and eliminating the waiting period for individuals with life-threatening conditions. Medicare/Prescription Drugs for kidney transplants. H.R. 1458, S. 565: provision related to continued coverage for immunosuppressive drugs furnished to beneficiaries that have received kidney transplants and whose entitlement to coverage would otherwise expire. Medicare/Intravenous Drugs. H.R. 1765, S.701: relating to the payment for intravenous immune globulin (IVIG) for the treatment of primary immune deficiency diseases in a patient's home and for certain disposable pumps as durable medical equipment in place of non-disposable pumps. Medicare/Home Infusion Therapy. H.R. 574, S.254: extending Medicare coverage to home infusion therapy. Medicare/Physical Therapy Services. H.R. 1829: authorizing physical therapists to evaluate and treat Medicare beneficiaries without physician referral. 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. Medicare/Cancer Hospice and Palliative Care. H.R. 1844: provisions authorizing coverage of comprehensive cancer care planning, establishing a Medicare hospice care demonstration, and authorizing grant programs for cancer palliative care and symptom management, provider education, and related research. Medicare/Hospice and Advanced Care Planning. S. 1150, H.R. 2911: provisions related to changing hospice payments and providing advance care planning resources. Medicare/Physician-Manufacturer Transparency. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 301: increasing the transparency of the relationship between physicians and the manufacturers of drugs, devices, biologicals, and medical supplies. Medicare/Care Coordination Services. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 1131, H.R. 2560: provisions establishing pilot care coordination programs. Medicaid/Home and Community-based Long Term Care. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 434, S.1257, H.R. 28552: provisions to remove barriers to providing home and community-based services including providing a state option to provide home and community-based services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care and authorizing the implementation of assistance grants for states electing to provide home and community-based services under Medicaid; provisions to provide a single point of entry to long term services; provisions to support nursing home diversion programs. Medicaid/Community-based Attendant Services and Supports. P.L. 111-148, P.L. 111-152, H.R. 4872, H.R. 3590, S. 683, H.R. 1670: authorizing coverage of community-based attendant services and supports under Medicaid, increasing funding and establishing a demonstration program for beneficiaries dually eligible for Medicare and Medicaid. 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.

Client expense: $350,000 · Firm income: Not reported

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

Implementation of DMEPOS Competitive Acquistion Program H.R. 684/S. 330 Medicare Prescription Drug Savings and Choice Act of 2009

Client expense: $770,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Implementation of DMEPOS Competitive Acquistion Program H.R. 684/S. 330 Medicare Prescription Drug Savings and Choice Act of 2009 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).

Client expense: $1,940,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), HOUSE OF REPRESENTATIVES, SENATE

H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009 H.R. 574 - Medicare Home Infusion Therapy Coverage Act of 2009 S. 75 - Generics First Act of 2009 (Part D) H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 S. 1630 - Affordable Access to Prescription Medicine Act of 2009 S. 1679 - Affordable Heath Choices Act of 2009 Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Medicare Secondary Payer Guidance

Client expense: $6,200,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

H.R. 684 - The Medicare Prescription Drug Savings and Choice Act of 2009 H.R. 574 - Medicare Home Infusion Therapy Coverage Act of 2009 S. 75 - Generics First Act of 2009 (Part D) H.R. 2502 - Comparative Effectiveness Research Act H.R. 3200 - America's Affordable Heath Choices Act of 2009. H.R. 3675 - National Quality Cancer care Demonstration Project Act of 2009 S. 1630 - Affordable Access to Prescription Medicine Act of 2009 S. 1679 - Affordable Heath Choices Act of 2009 Medicare Prescription Drug Benefit Implementation Medicaid Rebates Medicare Coverage Average Manufacturer Price Regulation Medicare Secondary Payer Guidance

Client expense: $5,490,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

HR 684, The Medicare Prescription Drug Savings and Choice Act of 2009 S. 75, Generics First Act of 2009 (Part D) HR 574, Medicare Home Infusion Therapy Coverage Act of 2009 Medicare Prescription Drug Benefit Implementation - retain Medicaid Rebates - retain the general issues section Medicare Coverage Average Manufacturer Price Regulation

Client expense: $5,860,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, Veterans Affairs, Dept of (VA)

NO BILL, Medicare Part D Oversight. Lobbied Members of Congress to educate on the benefits of private negotiation in Medicare Part D. H.R. 1458/S. 565, Comprehensive Immunosuppresive Drug Coverage for Kidney Transplant Patients Act of 2007. Lobbied for passage of bills. S. 547, Drug Rebate Equalization Act of 2009. Lobbied against extending the Medicaid rebate to managed care organizations. H.R. 684/S. 330, Medicare Prescription Drug Savings and Choice Act of 2009. Lobbied against establishing a government sponsored fall-back plan in Medicare Part D. H.R. 574/S. 254, Medicare Home Infusion Therapy Coverage Act of 2009. Lobbied for passage of bills. S. 301, Physician Payments Sunshine Act of 2009. Lobbied to ensure access to prescription drugs. H.R. 1616, Early Treatment of HIV/AIDS. Lobbied in support of early treatment of HIV/AIDS.

Client expense: $860,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR)

HR. 444 340B Program Improvement and Integrity Act of 2009, HR 684/S 330 The Medicare Prescription Drug Savings and Choice Act of 2009, HR 904 Medicaid Prescription Drug Rebate Equalization Act of 2009, Part D general issues, Protected Classes, Comparative Effectiveness, general Medicare/Medicaid expansions and reform, H.R. 3200/S. _____ America's Affordable Health Choices Act of 2009 and Senate Finance Committee Roundtable health reform options,

Client expense: $525,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE