Urban Medicare-Dependent Hospitals Preservation Act of 2011

Medicare payment issues (H.R. 1656, S. 1900)

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

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

Medicaid Funding in the Federal Budget, Medicare Funding in the Federal Budget, H.R. 1656 & S.1900 Urban Medicare Dependent Hospital Act, Sustainable Growth Rate Formula - Permanent Medicare Doctor Payment Fix , H.R.1543 & S.818 Improving Access to Medicare Coverage Act, MedPac Recommendations on Area Wage Index Adjustments, Demonstration Projects, H.R.5943 Rural Hospital Access Act, H.R.6532 Resident Physician Shortage Reduction and Graduate Medical Education

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

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

Medicaid Funding in the Federal Budget, Medicare Funding in the Federal Budget, Middle Class Tax Relief and Job Creaton Act of 2012 (Medicare, Medicaid, Social Security Tax Reduction Extenders) H.R. 3630, Urban Medicare Dependent Hospital Act H.R. 1656 & S. 1900, Sustainable Growth Rate Formula - Permanent Medicare Doctor Payment Fix, Improving Access to Medicare Coverage Act H.R. 1543 & S. 818, MedPac Recommendations on Area Wage Index Adjustments, Demonstration Projects

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

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

Medicare payment issues (H.R. 1656, S. 1900)

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

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

Medicaid Funding in the Federal Budget, Medicare Funding in the Federal Budget, Middle Class Tax Relief and Job Creation Act of 2012 (Medicare, Medicaid, Social Security Tax Reduction Extenders) H.R. 3630, Urban Medicare Dependent Hospital Act H.R. 1656 & S.1900, Sustainable Growth Rate formula - Permanent Medicare doctor payment fix, Improving Access to Medicare Coverage Act H.R.1543 & S. 818, MedPac recommendations on area wage index adjustments, Demonstration Projects

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

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

Medicaid Funding in the Federal Budget, Medicare Funding in the Federal Budget, Middle Class Tax Relief and Job Creation Act of 2012 (Medicare, Medicaid, Social Security Tax Reduction Extenders) H.R.3630, Urban Medicare Dependent Hospital Act H.R. 1656 & S.1900, Sustainable Growth Rate formula - Permanent Medicare doctor payment fix, Improving Access to Medicare Coverage Act H.R. 1543 & S.818, MedPAC recommendations on area wage index adjustments, Demonstration Projects

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

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

Medicare payment issues (H.R. 1656 S. 1900)

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

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

Medicaid Tunding in the Federal Budget, Medicare Funding in the Federal Budget, Cost reporting treatment of provider taxes, The Rural Hospital Protection Act , H.R. 1398, Urban Medicare Dependent Hospital (UMDH), H.R. 1656, S. 1900, Permanent medicare doctor payment fix (SGR), Direct physician supervision of hospital outpatient services, Demonstration projects - Center for Medicare and Medicaid Innovation, H. R. 3630, Middle Class Tax Relief and Job Creation Act of 2011

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

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

Medicare payment issues (H.R. 1656, S. 1900)

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

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

Deficit Reduction/Super Committee: While the bipartisan super committee was charged with crafting a plan to reduce the national deficit by at least $1.2 trillion by Nov. 23, NJHA urged Congress to oppose any further reductions to NJ's acute and post acute providers. These reductions would endanger access to care and jeopardize jobs in an already struggling economy. The committee's failure to reach an agreement means automatic spending cuts totaling $1.2 trillion effective January 2013, including a 2% reduction in Medicare payments to hospitals and other providers over nine years (2013 to 2021). For New Jersey, the automatic Medicare cuts would total $130 million in 2013 and nearly $1.3 billion by 2021, on top of $4.5 billion in cuts under the Affordable Care Act (ACA). Medicare: NJHA supported eliminating the scheduled reduction of 27.4 percent in Medicare payments to physicians set to begin on Jan. 1, but not by reducing payments to hospitals. Expressed opposition to efforts that cut payments to providers to pay for a patch to the sustainable growth rate (SGR) adjustment for physicians. Support Congressional letter to the Chairmen and Ranking Members of the House Committee on Ways & Means and the House Committee on Energy & Commerce asking them to reject proposals that would inappropriately reduce payments for rehabilitation hospitals and units. NJHA opposed provisions in H.R. 3630, the Middle Class Tax Relief and Job Creation Act of 2011 , which would of cut more than $17 billion in hospital funding as part of a year-end tax and unemployment package that included a two-year fix for physician payment under Medicare. NJHA supported efforts to extend the following provisions: Section 508 of MMA, exceptions process for Medicare therapy caps, physician fee schedule, outpatient hold harmless payments, mental health add-on payments; and Medicare work geographic adjustment floor, and temporary assistance for needy families program. Support introduction of S. 1900, The Urban, Medicare-Dependent Hospitals (UMDH) Preservation Act of 2011. Companion bill in the House is H.R. 1656. Support H.R. 2500/S. 3708, legislation that clarifies that electronic health records incentive payments under Medicare and Medicaid should go to each campus of a multi-campus hospital system.

Medicaid Funding in the Federal budget, Medicare funding in the Federal budget, Cost reporting treatment of provider taxes, The Rural Hospital Protection Act, H.R. 1398, Urban Medicare Dependent Hospital (UMDH), H.R. 1656, Permanent Medicare doctor payment fix (SGR), Direct physician supervision of hospital outpatient services, Demonstration projects - Center for Medicare and Medicaid Innovation.

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

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

Medicare payment issues (H.R. 1656)

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

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

Medicare: Continue to strongly advocate for NJs Medicare Wage Index Floor to be made permanent or extended in final FY2012 IPPS rule; Support Senate and House Congressional letters to CMS urging the agency to make changes to the proposed coding offset in the FY2012 IPPS rule; Request Senate and House Appropriators to include stable funding for the Childrens Hospitals Graduate Medical Education (CHGME) program in the FY2012 appropriations bills; Support H.R. 1656, the Urban Medicare Dependent Preservation Act of 2011; Support relief from 25 percent rule, LTCH payment policies, and oppose reduction in skilled nursing facilities; Support H.R. 2500, the Equal Access and Parity for Multi-Campus Hospitals Act, which would ensure that multi-campus hospitals are treated fairly under the Medicare and Medicaid electronic health records incentive programs authorized in the ARRA. The bill clarifies that the EHR incentive payments should go to each campus of a multi-campus hospital system, as long as each campus meets the meaningful use requirements. Deficit Reduction/Joint Select Committee on Deficit Reduction: The bipartisan joint select committee on deficit reduction has begun its work to crafting a plan by Nov. 23 to reduce the national deficit by at least $1.2 trillion. If Congress fails to adopt the committee's recommendations by Dec. 23, or if the committee cannot find enough savings, automatic spending cuts totaling $1.2 trillion split between defense spending and non-defense programs will take effect. Under the trigger, reductions in Medicare payments to hospitals and other providers of up to 2 percent over nine years (2013 to 2021) would automatically take effect. Those cuts would reach an estimated $41 billion in hospital payments alone and $119 billion in Medicare overall. NJHA continues to strongly urge lawmakers to protect healthcare programs under Medicare and Medicaid as Congress continues to debate strategies and discuss the numerous Congressional proposals to rein in the national debt. Organized and participated in advocacy day on deficit reduction (July 13 and planning another one Oct 4th) to strongly urge lawmakers to oppose any additional cuts to provider payments while the debt limit discussions continue. Express concern and opposition to certain recommendations in the Administrations proposal to the Joint Select Committee on Deficit Reduction that includes cutting Medicare by $248 billion and Medicaid by $73 billion over 10 years. The healthcare recommendations included in the proposal include reducing bad debt payments; reducing indirect medical education payments; adjusting payment updates for certain post-acute care providers, including skilled nursing facilities, long-term care hospitals, inpatient rehabilitation facilities, a proposal to create a home health co-pay; and strengthening the IPAB which would jeopardize hospitals ability to care for patients and the training of our next generation of physicians. Any additional cuts to providers could result in threats to patient care could result in services eliminated; longer waits for care; ERs shut down; staffing reduced. Hospitals are doing more with less. There are other ways to reduce the deficit, but not on the backs of providers. In September, NJHA sent strong letters to the Joint Select Committee on Deficit Reduction Co-Chairs and the New Jersey Congressional Delegation urging them to reject any further reductions to healthcare providers. The letters requests that provider reductions stay off the table and asks that our N.J. Congressional Delegation express strong opposition with the Administration and the Joint Select Committee to healthcare provider reductions and to please ensure patients have the access to the hospital care they need and the continued economic benefits that hospitals bring to their communities. In New Jersey, hospitals provide nearly 145,000 jobs and about $19 billion in total contributions to the state economy.

Medicaid Funding in the Federal budget, Medicare funding in the Federal budget, Cost reporting treatment of provider taxes, Urban Medicare Dependent Hospital (UMDH), H.R. 1656, Pemanent medicare doctor payment fix (SGR), Direct physician supervision of hospital outpatient services, The Rural Hospital Protection Act, H.R 1398, Demonstration projects - Center for Medicare and Medicaid Innovation

Client expense: $140,000 · Firm income: Not reported

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

Medicare payment issues (S. 1218, H.R. 2574, H.R. 3590, H.R. 3962, H.R. 4872, H.R. 1656)

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

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

Medicare:Continue to strongly urge CMS to extend or make permanent NJ's Medicare Imputed Wage Index Floor in the final FY2012 IPPS rule. Support Congresssional letters to CMS to extend floor and Congressional efforts; Continue to advocate for relief for NJ's DSH hospitals on the onerous retroactive recouping by CMS of DSH payments made to providers between 2005 and 2006; Continue to ask Congress for additional Medicare-supported physician-training positions and to maintain or increase funding for Graduate Medical Education (GME); support the simplification of the meaningful use requirements for electronic health records and payments for hospitals with multiple campuses; urge support for Urban Medicare-Dependent Hospital (UMDH) legislation; and passage of medical malpractice reform; Support Congressional letter to CMS expressing concerns on the final rule for section 6407 of the PPACA. This rule requires documentation of face-to-face encounters prior to certification for home health services and could negatively impact access to home health services for Medicare recipients; Support Congressional letter to CMS strongly urging the agency to make changes, reevaluate, and mitigate the reductions to the coding and documentation offset in the proposed FY2012 IPPS rule. The reduction was first included in last years final FY2011 IPPS rule. Support H.R. 1656, Urban, Medicare-Dependent Hospitals (UMDH) Preservation Act of 2011, a bill that would provide UMDHs with the same Medicare payment protection that is currently being afforded to rural Medicare-dependent hospitals; Support H. R. 1852, a measure that would reauthorize the Childrens Hospitals Graduate Medical Education program for five years to train the nations pediatric workforce; Support H.R.2500, legislation that clarifies that electronic health record incentive payments under Medicare and Medicaid should go to each campus of a multi-campus hospital system; Support H.R. 2267/S. 227, the Home Health Care Planning Improvement Act which would allow nurse practitioners (NPs), clinical nurse specialists (CNSs), certified nurse midwives (CNMs) and physician assistants (PAs) to order home health services under Medicare.