Quality Health Care Coalition Act of 2011

Legislation to exempt certain pharmacies from the antitrust laws for purposes of negotiating with payers (HR 1409, HR 1946, HR 1839).

Client expense: $630,728 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, White House Office

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $70,254 · Firm income: Not reported

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

See page five for specific HCR issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $70,254 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. MMM Medicare/Medicaid Issues H.R. 5 - Protecting Access to Healthcare Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 3474 - PRIME Act of 2011 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 Accountable Care Organizations Final Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Medicare SGR and Overseas Contingency Operations funds Inspiring Quality Campaign IPAB CMS RUC Refinement Ambulatory Surgical Centers Medicare Liability Reform Trauma center designation Trauma GAO study Imaging Pediatric subspecialty loan repayment program Rx Drug shortages Cancer programs appropriations Trauma Appropriations Children's Hospitals Graduate Medical Education Payment Program funding RUC Refinement panel valuation problem HHS ASPR/MSET Program Medical Device User Fee and Modernization Act (MDUFMA) Health Information Technology (45 CFR Part 170) NIH Appropriations Electronic Health Record Meaningful Use Stage 2 Proposed Rule Surgical workforce issues Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Medicare audit programs

Client expense: $88,958 · Firm income: Not reported

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

See page five for specific Health Care Issues. HCR Health Care Issues H.R. 5 - Protecting Access to Healthcare Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 3474 - PRIME Act of 2011 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 Accountable Care Organizations Final Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Medicare SGR and Overseas Contingency Operations funds Inspiring Quality Campaign IPAB CMS RUC Refinement Ambulatory Surgical Centers Medicare Liability Reform Trauma center designation Trauma GAO study Imaging Pediatric subspecialty loan repayment program Rx Drug shortages Cancer programs appropriations Trauma Appropriations Children's Hospitals Graduate Medical Education Payment Program funding RUC Refinement panel valuation problem HHS ASPR/MSET Program Medical Device User Fee and Modernization Act (MDUFMA) Health Information Technology (45 CFR Part 170) NIH Appropriations Electronic Health Record Meaningful Use Stage 2 Proposed Rule Surgical workforce issues Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Medicare audit programs

Client expense: $88,958 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (MMM Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $16,647 · Firm income: Not reported

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

See page six for specific Health Care Issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (HCR Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $16,647 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (MMM Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $87,126 · Firm income: Not reported

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

See page six for specific Health Care Issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (HCR Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $87,126 · Firm income: Not reported

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

Issue relating to proposed anti-trust exemption for certain pharmacies and healthcare competition HR 1409 - Quality Health Care Coalition Act of 2011 HR 1839 - Community Pharmacy Fairness Act of 2011 HR 1946 - Preserving Our Hometown Independent Pharmacies Act

Client expense: $2,930,000 · Firm income: Not reported

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

HR531--Access to Frontline Health Care Act; HR452/S 668 -- IPAB Repeal; S454--Medicare AntiFraud; S756--Medicare Data Transparency; HR5/S218--Medical Liability Reform; HR1206/2077--Medical Loss Ratio changes; HR 1256 -- Medicare Physician Payment Transparency; HR 1409--Quality Health are Coalition Act; HR1700/S1042--Medicare Patient Empowerment Act; S1309/HR 3364--Equity and Access for Podiatric Physicians Under Medicaid; PDUFA/MDUFA reauthorization; Budget Sequestration (HR 8); 100th Anniversary of APMA; Medicare Physician payment / SGR; S1958--Medicare Orthotics and Prosthetics Improvement Act; HR 1256--Medicare Relative Update Committee (RUC); HR 1409--Physician Antitrust; HR 2363--Health Care OverUse Reform Today (HealthCOURT) Act; HR 3630/HR 3675--Medicare Physician Payments/SGR; HR 1150--Health Insurer Antitrust Reform; HR 969 Medical Practice Freedom Act; S 756--Claims Data Publication; TRICARE reimbursement issues; VA provider issues

Client expense: $96,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues relating to a proposed anti-trust exemption for certain pharmacies. H.R.1409, Quality Health Care Coalition Act of 2011; H.R.1839, Community Pharmacy Fairness Act of 2011; H.R.1946, Preserving our Hometown Independent Pharmacies Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733:All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 605 / S. 312 -All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 -All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H.R. 2672 the Preserving Access to Orphan Drugs Act H.R. 2182 the Generating Antibiotic Incentives Now Act H.R. 3026 the Safeguarding Americas Pharmaceuticals Act H.R. 2746 the Cancer Drug Coverage Parity Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act

Client expense: $518,430 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 5: All provisions of the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 4 /S.18 / S.72 - All provisions of the Small Business Paperwork Mandate Elimination Act H.R. 605 / S. 312 - All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 - All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs), implementation of approval pathway for generic biologic drugs 340b program H.R. 2245/S. 296 - All provisions of the Preserving Access to Life-Saving Medications Act of 2011

Client expense: $518,430 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson. H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson. H.R.611 -- BEST PRACTICES Act (Rush) - data security. H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information. H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians. H.R. 1707, Data Accountability and Trust Act (Rush) - data security. H.R. 1841, Data Accountability and Trust Act (Stearns) - data security. H.R. 2576, (Black) - eligibility for health care assistance. H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security. H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions. H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) - price transparency. H.R. 5909, Comprehensive Dental Reform Act (Cummings) - expanded access to dental services. Labor, HHS, Education Appropriations Act (Rehburg) - funding for HHS programs and agencies. H.J.Res. 17, Continuing Appropriations Resolution (Rogers) - temporary appropriations for FY 2013. S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions. S. 1099, HEALTH Act (Blunt) - medical liability reform. S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security. S. 1207, Data Security and Breach Notification Act (Pryor) - data security. S. 1408, Data Breach Notification Act (Feinstein) - data security. S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) - data security. S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees. S. 2111, Cyber Crime Protection Security Act (Leahy) - privacy. S. 3272, Comprehensive Dental Reform Act (Sanders) - expanded access to dental services. S. 3295, Labor, HHS, Education Appropriations Act (Harkin) - funding for HHS programs and agencies, ACA related amendments. S. 3333, Data Security and Breach Notification Act (Toomey) - data security. S. 3351, Protect Our Health Privacy Act (Franken) - privacy. S. 3414, Cybersecurity Act (Lieberman) - privacy, data security. S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) - privacy.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation to exempt certain pharmacies from the antitrust laws for purposes of negotiating with payers (HR 1409, HR 1946, HR 1839).

Client expense: $423,292 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, White House Office

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson; 16. Specific Lobbying Issues (continued): H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) price transparency H.R. 5909, Comprehensive Dental Reform Act (Cummings) expanded access to dental services Labor, HHS, Education Appropriations Act (Rehburg) funding for HHS programs and agencies H.J.Res. 17, Continuing Appropriations Resolution (Rogers) temporary appropriations for FY 2013 S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) privacy S. 3272, Comprehensive Dental Reform Act (Sanders) expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) data security S. 3351, Protect Our Health Privacy Act (Franken) privacy S. 3414, Cybersecurity Act (Lieberman) privacy, data security S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to privacy, security, and other regulation of the Internet and electronic commerce; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; dependent coverage; summary of benefits and coverage disclosures; and other issues relating to health care reform implementation.

Client expense: $2,630,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

Issues relating to a proposed anti-trust exemption for certain pharmacies, healthcare competition and the CVS Caremark business model. H.R.1409, Quality Health Care Coalition Act of 2011; H.R.1839, Community Pharmacy Fairness Act of 2011; H.R.1946, Preserving our Hometown Independent Pharmacies Act.

Client expense: Not reported · Firm income: $40,000

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

Issue relating to proposed anti-trust exemption for certain pharmacies and healthcare competition HR 1409 - Quality Health Care Coalition Act of 2011 HR 1839 - Community Pharmacy Fairness Act of 2011 HR 1946 - Preserving Our Hometown Independent Pharmacies Act

Client expense: $2,320,000 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $15,870 · Firm income: Not reported

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

See page six for specific Health Issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $15,870 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $75,279 · Firm income: Not reported

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

See page six for specific Health Issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $75,279 · Firm income: Not reported

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

HR531--Access to Frontline Health Care Act; HR452/S 668 -- IPAB Repeal; S454--Medicare AntiFraud; S756--Medicare Data Transparency; HR5/S218--Medical Liability Reform; HR1206/2077--Medical Loss Ratio changes; HR 1256 -- Medicare Physician Payment Transparency; HR 1409--Quality Health are Coalition Act; HR1700/S1042--Medicare Patient Empowerment Act; S1309/HR 3364--Equity and Access for Podiatric Physicians Under Medicaid; PDUFA/MDUFA reauthorization; Budget Sequestration; 100th Anniversary of APMA; Medicare Physician payment / SGR; S1958--Medicare Orthotics and Prosthetics Improvement Act; HR 1256--Medicare Relative Update Committee (RUC); HR 1409--Physician Antitrust; HR 2363--Health Care OverUse Reform Today (HealthCOURT) Act; HR 3630/HR 3675--Medicare Physician Payments/SGR; HR 1150--Health Insurer Antitrust Reform; HR 969 Medical Practice Freedom Act; S 756--Claims Data Publication; TRICARE reimbursement issues; VA provider issues

Client expense: $90,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues relating to a proposed anti-trust exemption for certain pharmacies, healthcare competition and the CVS Caremark business model; H.R. 1409, Quality Health Care Coalition Act of 2011; H.R. 1839, Community Pharmacy Fairness Act of 2011; H.R. 1946, Preserving our Hometown Independent Pharmacies Act.

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

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

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson 16. Specific Lobbying Issues (continued): H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611, BEST PRACTICES Act (Rush) data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 5652, Sequester Replacement Reconciliation Act (Ryan) ACA provisions, deficit reduction proposals H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) price transparency H.R. 5909, Comprehensive Dental Reform Act (Cummings) expanded access to dental services S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) privacy S. 3272, Comprehensive Dental Reform Act (Sanders) expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) data security S. 3351, Protect Our Health Privacy Act (Franken) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues related to genetics and genetic nondiscrimination; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to privacy, security, and other regulation of the Internet and electronic commerce; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; dependent coverage; summary of benefits and coverage disclosures; and other issues relating to health care reform implementation.

Client expense: $2,240,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

Issues relating to a proposed anti-trust exemption for certain pharmacies and healthcare competition. HR 1409 Quality Health Care Coalition Act of 2011 HR 1839 - Community Pharmacy Fairness Act of 2011 HR 1946 - Preserving Our Hometown Independent Pharmacies Act

Client expense: $2,255,000 · Firm income: Not reported

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

See addendum page. Food and Drug Administration Safety and Innovation Act (S.3187): lobbied in support of the drug shortages bill included in S.3187. Lobbied on changes to the National Childrens Study recruitment procedures and to ask for Congressional review. Lobbied in support of Accelerating the End of Breast Cancer Act of 2011 (H.R. 3067). Lobbied in opposition to Registered Nurse Safe Staffing Act of 2011 (H.R. 876). Reviewed Home Health Care Planning Improvement Act of 2011 (H.R. 2267). CU is neutral on this bill. Reviewed Medicare Cost Contract Extension Act of 2011 (H.R. 2770). CU is neutral on this bill. Reviewed Health Care Cost Reduction Act of 2012 (H.R. 436) and the Protect Medical Innovation Act of 2011 contained therein. CU is neutral on this bill. Reviewed the Quality Health Care Coalition Act of 2011 (H.R. 1409). CU is neutral on this bill.

Client expense: $124,204 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), Patent & Trademark Office (PTO), SENATE

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) - data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) - data security H.R. 1841, Data Accountability and Trust Act (Stearns) - data security H.R. 2576, (Black) - eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions H.R. 5652, Sequester Replacement Reconciliation Act (Ryan) - ACA provisions, deficit reduction proposals H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) - price transparency H.R. 5909, Comprehensive Dental Reform Act (Cummings) - expanded access to dental services S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) - medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) - data security S. 1408, Data Breach Notification Act (Feinstein) - data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) - data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) - privacy S. 3272, Comprehensive Dental Reform Act (Sanders) - expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) - funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) - data security S. 3351, Protect Our Health Privacy Act (Franken) - privacy

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page 6 for specific HCR issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $8,713 · Firm income: Not reported

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

See page three for specific MMM issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $8,713 · Firm income: Not reported

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

See page six for specific HCR issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $70,254 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $70,254 · Firm income: Not reported

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

Implementation of Patient Protection and Affordable Care Act, including Supreme Court case and coverage issues - Proposed legislation re this issues; Executive Branch actions re this issues. Congressional investigation regarding Patient Protection and Affordable Care Act. *Medical Liability reform - HR 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; S 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011. *Data Security - HR 611, BEST PRACTICES Act; HR 1707, Data Accountability and Trust Act; HR 1841, Data Accountability and Trust Act (DATA) of 2011; HR 2577, SAFE Data Act; S 1207, Data Security and Breach Notification Act of 2011; S 1408, Data Breach Notification Act of 2011; S 1535, Personal Data Protection and Breach Accountability Act of 2011; S 3333, Data Security and Breach Notification Act of 2012. *Antitrust exemption for physicians - HR 1409, Quality Health Care Coalition Act of 2011. *Repeal of premium tax and other ACA provisions - HR 2676, Small Business Health Relief Act of 2011; S 1049, Small Business Health Relief Act of 2011. *Privacy, data security - S 1151, Personal Data Privacy and Security Act of 2011. *Eligibility for healthcare assistance - HR 2576, To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. *Privacy - S 2111, Cyber Crime Protection Security Act; S 3351, Protect Our Health Privacy Act. *National Clearinghouse for LTC info - HR 1173, Fiscal Responsibility and Retirement Security Act of 2011. *IPAB repeal, medical liability reform, McCarron-Ferguson - HR 5, Protecting Access to Healthcare Act.; HR 452, Medicare Decisions Accountability Act of 2011. *ACA provisions, deficit reduction proposals - HR 5652, Sequester Replacement Reconciliation Act of 2012. *Price transparency - HR 5800, Health Care Price Transparency Promotion Act of 2012. *Expanded access to dental services - HR 5909, Comprehensive Dental Reform Act of 2012; S 3272, Comprehensive Dental Reform Act of 2012. *Health benefits for postal employees - S 1789, 21st Century Postal Service Act of 2012. *Funding for HHS programs & agencies, ACA-related amendments - S 3295, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013.

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

Government targets: HOUSE OF REPRESENTATIVES

H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733:All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 605 / S. 312 -All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 -All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H.R. 2672 the Preserving Access to Orphan Drugs Act H.R. 2182 the Generating Antibiotic Incentives Now Act H.R. 3026 the Safeguarding Americas Pharmaceuticals Act H.R. 2746 the Cancer Drug Coverage Parity Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act

Client expense: $520,389 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 5: All provisions of the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 4 /S.18 / S.72 - All provisions of the Small Business Paperwork Mandate Elimination Act H.R. 605 / S. 312 - All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 - All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs), implementation of approval pathway for generic biologic drugs 340b program H.R. 2245/S. 296 - All provisions of the Preserving Access to Life-Saving Medications Act of 2011

Client expense: $520,389 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

Legislation to exempt certain pharmacies from the antitrust laws for purposes of negotiating with payers (HR 1409, HR 1946, HR 1839).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, White House Office

HR531--Access to Frontline Health Care Act; HR452/S 668 -- IPAB Repeal; S454--Medicare AntiFraud; S756--Medicare Data Transparency; HR5/S218--Medical Liability Reform; HR1206/2077--Medical Loss Ratio changes; HR 1256 -- Medicare Physician Payment Transparency; HR 1409--Quality Health are Coalition Act; HR1700/S1042--Medicare Patient Empowerment Act; S1309/HR 3364--Equity and Access for Podiatric Physicians Under Medicaid; PDUFA/MDUFA reauthorization; Medicare Physician payment / SGR; S1958--Medicare Orthotics and Prosthetics Improvement Act; HR 1256--Medicare Relative Update Committee (RUC); HR 1409--Physician Antitrust; HR 2363--Health Care OverUse Reform Today (HealthCOURT) Act; HR 3630/HR 3675--Medicare Physician Payments/SGR; HR 1150--Health Insurer Antitrust Reform; HR 969 Medical Practice Freedom Act; S 756--Claims Data Publication; TRICARE reimbursement issues; VA provider issues

Client expense: $90,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Legislation to exempt certain pharmacies from antitrust laws for purposes of negotiating with payers (H.R. 1409, H.R. 1946, H.R. 1839). Advocacy surrounding proposed corporate merger.

Client expense: $1,050,000 · Firm income: Not reported

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

Legislation to exempt certain pharmacies from the antitrust laws for purposes of negotiating with payers (HR 1409, HR 1946, HR 1839). Advocacy surrounding proposed corporate merger.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, U.S. Trade Representative (USTR), White House Office

Issues relating to a proposed anti-trust exemption for certain pharmacies, healthcare competition and the CVS Caremark business model; H.R. 1409, Quality Health Care Coalition Act of 2011; H.R. 1839, Community Pharmacy Fairness Act of 2011; H.R. 1946, Preserving our Hometown Independent Pharmacies Act.

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

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

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) data security 16. Specific Lobbying Issues (continued): H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 2111, Cyber Crime Protection Security Act (Leahy) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues related to genetics and genetic nondiscrimination; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to privacy, security, and other regulation of the Internet and electronic commerce; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; dependent coverage; summary of benefits and coverage disclosures; and other issues relating to health care reform implementation. 18. Lobbyists (continued): K. Callahan: Ross (March 2005- January 2012); Research Assistant, Senator Tim Johnson (October 2001 March 2005). G. Gierer: Legislative Correspondent, Senator Dodd (May 1997 - December 1999); Staff Assistant, Representative DeLauro (March 1996-May 1997). D. Mott-Bronson: (June 1998 - September 2002); Democratic Professional Staff Member, House International Relations Committee, Representative McKinney (September 2002 December 2002).

Client expense: $2,450,000 · Firm income: Not reported

Government targets: Administration on Aging, Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

Implementation of Patient Protection and Affordable Care Act (PPACA), including Supreme Court case and coverage issues - Executive Branch actions re this issues. Efforts to repeal and replace the PPACA - Proposed legislation. Repeal Indpendent Payment Advisory Board provision of PPACA - HR 452, Medicare Decisions Accountability Act of 2011; HR 5, Protecting Access to Healthcare Act; S 2118, Health Care Bureaucrats Elimination Act. *Medical Liability reform - HR 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; S 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011. *Data Security - HR 611, BEST PRACTICES Act; HR 1707, Data Accountability and Trust Act; HR 1841, Data Accountability and Trust Act (DATA) of 2011; HR 2577, SAFE Data Act; S 1207, Data Security and Breach Notification Act of 2011; S 1408, Data Breach Notification Act of 2011; S 1535, Personal Data Protection and Breach Accountability Act of 2011. *Antitrust exemption for physicians - HR 1409, Quality Health Care Coalition Act of 2011. *Repeal of premium tax and other ACA provisions - HR 2676, Small Business Health Relief Act of 2011; S 1049, Small Business Health Relief Act of 2011. *Privacy, data security - S 1151, Personal Data Privacy and Security Act of 2011. *Eligibility for healthcare assistance - HR 2576, To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. *Privacy - S 2111, Cyber Crime Protection Security Act. *National Clearinghouse for LTC info - HR 1173, Fiscal Responsibility and Retirement Security Act of 2011.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to a proposed anti-trust exemption for certain pharmacies and healthcare competition. HR 1409 Quality Health Care Coalition Act of 2011 HR 1839 - Community Pharmacy Fairness Act of 2011 HR 1946 - Preserving Our Hometown Independent Pharmacies Act

Client expense: $2,510,000 · Firm income: Not reported

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

H.R. 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011: Medical liability reform H.R. 5, the Protecting Access to Healthcare Act, which provides medical liability reform H.R. 157, the Health Care Safety Net Enhancement Act of 2011: Medical liability protection for physicians providing EMTALA mandated services H.R. 469, Protections for Student Athletes from Concussions: sports concussion prevention and return to play requirements H.R. 816, Provider Shield Act of 2011: Medical liability reform and protection from expanded legal causes of action in the Patient Protection and Affordable Care Act H.R. 1409, the Quality Health Care Coalition Act: Ensure patient access to quality health care by exempting health care professionals from the Federal antitrust laws in their negotiations with health plans and health insurance issuers. H.R. 1852, Children's Hospital GME Support Reauthorization Act: Support reauthorization of Children's Hospitals Graduate Medical Education H.R.3586, Good Samaritan Health Professionals Act of 2011: Medical liability protection for volunteer medical professionals during a national disaster S. 958, Children's Hospital GME Support Reauthorization Act: Support reauthorization of Children's Hospitals Graduate Medical Education S. 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011: Medical liability reform No Bill: Prescription Drug User Fee Act No Bill: Medical Device User Fee Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE