Tanning Bed Cancer Control Act of 2011

Lobby Congress regarding ongoing prescription drug shortage crisis and device reclassification - Food and Drug Administration Safety and Innovation Act (S. 3187). Lobby in support of House (HR 1676) and Senate action requesting the FDA examine the current classification of indoor tanning beds. Support the United States Preventive Services Task Force (USPSTF) Transparency and Accountability Act of 2012 (HR 5998) which recognizes the role of specialty physicians in providing expert guidance for developing and updating preventive health recommendations.

Client expense: $223,150 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

National HIV/AIDS Strategy (general); Emergency Contraception (general); H.R. 2679/S. 1440, PREEMIE. H.R. 2954, Health Equity Accountability Act; HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding(general); Medical Liability Reform (general); Health IT (general); H.R. 2029/ S.1131, Birth Defects Prevention, Risk Reduction and Awareness Act; Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); The Meaningful End to Defensive Medicine and Aimless Lawsuits; H.R. 2127, Newborn Act; H.R. 5/ S.1099, HEALTH Act; H.R. 452, Medicare Decisions Accountability Act of 2011; S.668, Health Care Bureaucrats Elimination Act; H.R.666, Birth Certificate Enhancement Act of 2011; H.R. 894, Maternal Health Accountability Act; Imaging (general); H.R. 2194/ S.1221, GEDI Act; H.R. 1676, Tanning Bed Cancer Control Act; National Prevention Strategy (general); H.R. 1216, To Amend Funding for Graduate Medical Education in Teaching Health Centers from Direct to Authorizing Appropriations; H.R. 2085/ S. 1214; Essential Health Benefits (general); Graduate Medical Education (general); H.R. 3418/ S. 1862, Stillbirth & SUID Prevention, Education & Awareness Act; Quality Improvement Measurement (general); H.R. 3620/ S. 1969, Quality Care for Moms and Babies Act; H.R. 3522 Family Act; Contraception (general); Preeclampsia (general); Antibiotics (general); H.R. 3586, Good Samaritan Health Professionals Act, NICHD Reorganization (general); CMS Provider Penalties (general); National Health Services Corps (general); Abortion (general); H.R. 3803, District of Columbia Pain-Capable Unborn Child Protection Act; H.R. 3541, Prenatal Nondiscrimination Act of 2012; H.R. 2299, Child Interstate Abortion Notification Act; S. 2262, Advancing FASD Research, Prevention, and Services Act; CMS Health IT incentive program, meaningful use Stage 2; H.R. 2104/S. 3338, Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011; H.R. 5647, Pregnant Workers Fairness Act; H.R. 4628, Interest Rate Reduction Act.

Client expense: $312,442 · Firm income: Not reported

H.R.1676, Tanning Bed Cancer Control Act of 2011, Issues pertaining to the regulation of tanning beds. Public Law 111-148, Patient Protection and Affordable Care Act, Tax on tanning beds. Public Law 111-152, Health Care and Education Reconciliation Act of 2010, Tax on tanning beds. Public Law 112-144, Food & Drug Administration Safety and Innovation Act, Regulation on tanning beds. H.R.6502, To amend title V of the Federal Food, Drug, and Cosmetic Act to provide for extensions of marketing exclusivity periods for drugs in certain combinations of such drugs, and for other purposes, Tanning bed issues.

Client expense: Not reported · Firm income: $10,000

Government targets: Centers For Disease Control & Prevention (CDC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Lobby Congress regarding prescription drug shortage, medical device reclassification in context of Food and Drug Administration Safety and Innovation Act (S. 3187). Lobby in support of legislation (H.R. 1676) requesting FDA examine current classification of tanning beds.

Client expense: $260,650 · Firm income: Not reported

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

National HIV/AIDS Strategy (general); Emergency Contraception (general); H.R. 2679/S. 1440, PREEMIE. H.R. 2954, Health Equity Accountability Act; Domestic Violence(general); HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding(general); Medical Liability Reform (general); Personal Health Record; Abortion (general); Health IT (general); H.R. 2029/ S.1131, Birth Defects Prevention, Risk Reduction and Awareness Act; Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); The Meaningful End to Defensive Medicine and Aimless Lawsuits; H.R. 2127, Newborn Act; H.R. 5/ S.1099, HEALTH Act; H.R. 452, Medicare Decisions Accountability Act of 2011; S.668, Health Care Bureaucrats Elimination Act; H.R.666, Birth Certificate Enhancement Act of 2011; H.R. 894, Maternal Health Accountability Act; Imaging (general); H.R. 2194/ S.1221, GEDI Act; H.R. 1676, Tanning Bed Cancer Control Act; National Prevention Strategy (general); H.R. 1216, To Amend Funding for Graduate Medical Education in Teaching Health Centers from Direct to Authorizing Appropriations; H.R. 2085/ S. 1214; Essential Health Benefits (general); Graduate Medical Education (general); H.R. 3418/ S. 1862, Stillbirth & SUID Prevention, Education & Awareness Act; Quality Improvement Measurement (general); H.R. 3620/ S. 1969, Quality Care for Moms and Babies Act; H.R. 3522 Family Act; Contraception (general); Blunt Ammendment; Preeclampsia (general); Antibiotics (general); H.R. 3586, Good Samaritan Health Professionals Act, NICHD Reorganization (general); CMS Provider Penalties (general); National Health Services Corps (general); Abortion (general); H.R. 3803, District of Columbia Pain-Capable Unborn Child Protection Act; H.R. 3541, Prenatal Nondiscrimination Act of 2012; H.R. 2299, Child Interstate Abortion Notification Act; S. 2262, Advancing FASD Research, Prevention, and Services Act; CMS Health IT incentive program, meaningful use Stage 2; H.R. 2104/S. 3338, Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011; H.R. 5647, Pregnant Workers Fairness Act; S. 3187, Food and Drug Administration Safety and Innovation Act; FDA medical device reauthorization; Medical Device User Fee and Modernization Act; H.R. 4628, Interest Rate Reduction Act.

H.R.1676, Tanning Bed Cancer Control Act of 2011, Issues pertaining to the regulation of tanning beds. Public Law 111-148, Patient Protection and Affordable Care Act, Tax on tanning beds. Public Law 111-152, Health Care and Education Reconciliation Act of 2010, Tax on tanning beds. H.R.5651/S.3187, Food & Drug Administration Safety and Innovation Act, Regulation on tanning beds.

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

Government targets: Centers For Disease Control & Prevention (CDC), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Lobby in support of House (HR 1676) and Senate (no bill number) legislation requesting the FDA examine the current classification of indoor tanning beds.

Client expense: $242,657 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Comprehensive Sexuality Education funding (general); National HIV/AIDS Strategy (general); Postpartum Depression (general); Emergency Contraception (general); Pre-existing condition exclusion (general); H.R. 2679/S. 1440, PREEMIE. H.R. 2954, Health Equity Accountability Act; Domestic Violence(general); HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding(general); Medical Liability Reform (general); Personal Health Record; Abortion (general); Health IT (general); H.R. 2029/ S.1131, Birth Defects Prevention, Risk Reduction and Awareness Act; Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); The Meaningful End to Defensive Medicine and Aimless Lawsuits; H.R. 2127, Newborn Act; H.R. 5/ S.1099, HEALTH Act; H.R. 452, Medicare Decisions Accountability Act of 2011; S.668, Health Care Bureaucrats Elimination Act; H.R.666, Birth Certificate Enhancement Act of 2011; H.R. 894, Maternal Health Accountability Act; Imaging (general); H.R. 2194/ S.1221, GEDI Act; H.R. 1676, Tanning Bed Cancer Control Act; National Prevention Strategy (general); H.R. 1216, To Amend Funding for Graduate Medical Education in Teaching Health Centers from Direct to Authorizing Appropriations; H.R. 2085/ S. 1214; Essential Health Benefits (general); Graduate Medical Education (general); H.R. 3418/ S. 1862, Stillbirth & SUID Prevention, Education & Awareness Act; Quality Improvement Measurement (general); H.R. 3620/ S. 1969, Quality Care for Moms and Babies Act; HR 3522 Family Act; Contraception (general); Blunt Ammendment; Preeclampsia (general); Essential Health Benefits (general); Antibiotics (general); HR 3586, Good Samaritan Health Professionals Act, NICHD Reorganization (general); Medicaid Nominal Drug Price Rule (general) CMS Provider Penalties (general); National Health Service Corps, Nominations to Advisory Council; National Health Services Corps (general).

H.R.1676, Tanning Bed Cancer Control Act of 2011, Issues pertaining to the regulation of tanning beds. Public Law 111-148, Patient Protection and Affordable Care Act, Tax on tanning beds. Public Law 111-152, Health Care and Education Reconciliation Act of 2010, Tax on tanning beds.

Client expense: Not reported · Firm income: $10,000

Government targets: Centers For Disease Control & Prevention (CDC), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Support legislation for medical liability reform (HR 5) Support for legislation requesting the FDA examine the current classification of indoor tanning beds (HR 1676) Support legislation to repeal the in-office ancillary and physician services exception to the Stark self-referral for pathology services FDA consideration of the existing iPledge program; FDA concerns regarding the escalating drug shortages problem

Client expense: $344,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Support legislation for medical liability reform (HR 5) Support for legislation requesting the FDA examine the current classification of indoor tanning beds (HR 1676) Support legislation to repeal the in-office ancillary and physician services exception to the Stark self-referral law for pathology serv FDA consideration of the existing iPledge program; FDA concerns regarding the escalating drug shortages problem

Client expense: $344,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Comprehensive Sexuality Education funding (general); National HIV/AIDS Strategy (general); Postpartum Depression (general); Emergency Contraception (general); Pre-existing condition exclusion (general); H.R. 2659/S.1415, Birth Control Act; H.R. 2679/S. 1440, PREEMIE; H.R. 2954, Health Equity Accountability Act; Domestic Violence(general); HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding(general); Medical Liability Reform (general); Personal Health Record; Abortion (general); Health IT (general); H.R. 2029/ S.1131, Birth Defects Prevention, Risk Reduction and Awareness Act; Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); The Meaningful End to Defensive Medicine and Aimless Lawsuits; H.R. 2127, Newborn Act; H.R. 5/ S.1099, HEALTH Act; H.R. 452, Medicare Decisions Accountability Act of 2011; S.668, Health Care Bureaucrats Elimination Act; H.R.666, Birth Certificate Enhancement Act of 2011; H.R. 894, Maternal Health Accountability Act; Imaging (general); H.R. 2194/ S.1221, GEDI Act; H.R. 1676, Tanning Bed Cancer Control Act; National Prevention Strategy (general); H.R. 1216, To Amend Funding for Graduate Medical Education in Teaching Health Centers from Direct to Authorizing Appropriations; H.R. 2085/ S. 1214 Military Access to Reproductive Care and Health for Military Women Act; Essential Health Benefits (general); Graduate Medical Education (general); H.R. 3418/ S. 1862, Stillbirth & SUID Prevention, Education & Awareness Act; Quality Improvement Measurement (general); Birth Control Access (general); H.R. 3620/ S. 1969, Quality Care for Moms and Babies Act.

Client expense: $237,170 · Firm income: Not reported

H.R.1676, Tanning Bed Cancer Control Act of 2011, Issues pertaining to the regulation of tanning beds.

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

Government targets: Centers For Disease Control & Prevention (CDC), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Comprehensive Sexuality Education funding (general); National HIV/AIDS Strategy (general); Postpartum Depression (general); Emergency Contraception (general); Pre-existing condition exclusion (general); Stillbirth and SIDS Prevention, Education and Awareness Act of 2011; H.R. 2659/S.1415, Birth Control Act; H.R. 2679/S. 1440, PREEMIE; HIPAA Privacy Rule accounting for disclosures under HITECH Act; H.R. 2954, Health Equity Accountability Act; H.R. 3003, Congressional Gold Medal to Dr. Balazs "Ernie" Bodai; Preventive Care (general); Domestic Violence(general); Medicaid and SCHIP Coverage and Reimbursement; HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding(general); Medical Liability Reform (general); Personal Health Record; Abortion (general); Health IT (general); H.R. 2029/ S.1131, Birth Defects Prevention, Risk Reduction and Awareness Act; Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); The Meaningful End to Defensive Medicine and Aimless Lawsuits; H.R. 2127, Newborn Act; Improve Maternity Care Quality; Healthy Hunger-Free Kids; H.R. 5/ S.1099, HEALTH Act; H.R. 452, Medicare Decisions Accountability Act of 2011; S.668, Health Care Bureaucrats Elimination Act; H.R.666, Birth Certificate Enhancement Act of 2011; H.R. 358, Protect Life Act; H.R. 894, Maternal Health Accountability Act; Imaging (general); H.R. 2194/ S.1221, GEDI Act; State Paid Leave (general); H.R. 1676, Tanning Bed Cancer Control Act; National Prevention Strategy (general); H.R. 1216, To Amend Funding for Graduate Medical Education in Teaching Health Centers from Direct to Authorizing Appropriations; Military Access to Reproductive Care and Health for Military Women Act; FDA Comments on Scientific Evaluation of Modified Risk Tobacco Products.

H.R.1676, Tanning Bed Cancer Control Act of 2011, Issues pertaining to the regulation of tanning beds.

Client expense: Not reported · Firm income: $10,000

Government targets: Centers For Disease Control & Prevention (CDC), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Comprehensive Sexuality Education funding (general); National HIV/AIDS Strategy (general); Sudden Unexpected Infant Deaths (general); Postpartum Depression (general); Emergency Contraception (general); Pre-existing condition exclusion (general); Gender rating (general); Stillbirth. Preventive Care (general); Domestic Violence(general); Medicaid and SCHIP Coverage and Reimbursement; HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding(general); Medical Liability Reform (general); Personal Health Record; Abortion (general); Health Care and Reconciliation Act of 2010; Health IT (general); HR 2029, S 1131, Birth Defects Prevention, Risk Reduction and Awareness Act; Prematurity(general); Obesity (general); Disparities (general); Prevention & Public Health Trust Fund(general); USDA Dietary Guidelines Advisory Committee Report; The Meaningful End to Defensive Medicine and Aimless Lawsuits; HR 2127, Newborn Act; Improve Maternity Care Quality; Healthy Hunger-Free Kids; HR 5, S 1099, HEALTH Act; HR 452, Medicare Decisions Accountability Act of 2011; S 668, Health Care Bureaucrats Elimination Act; HR 666, Birth Certificate Enhancement Act of 2011; HR 358, Protect Life Act; HR 894 Maternal Health Accountability Act; Imaging (general); HR 2194, S 1221, GEDI Act; HR 3, No Taxpayer Funding for Abortion Act; State Paid Leave (general); HR 2020, S 1096, Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act; HR 1676, Tanning Bed Cancer Control Act; National Prevention Strategy (general); HR 1216, To Amend Funding for Graduate Medical Education in Teaching Health Centers from Direct to Authorizing Appropriations; AMDT 298, Foxx Amendment; Military Access to Reproductive Care and Health for Military Women Act.

Client expense: $235,000 · Firm income: Not reported

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Center for Medicare and Medicaid Services (CMS): Support the re-nomination of Don Berwick, MD, as the Administrator of CMS and urge the Finance Committee to approve his nomination in a timely manner; Support delaying the date from Apr. 1, 2011 to no earlier than July 1, 2011 at which CMS would fully enforce the so-called physician face-to-face encounter rule that is the outgrowth of section 6407 of the Patient Protection and Affordable Care Act (PPACA). Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Specifically, in April 2011, urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 2011; Urged Congress to repeal the SGR formula and permanently reform the Medicare physician payment system as part of any final agreement between Congress and the Administration on authorizing an increase in the debt ceiling. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646 in the 111th Congress). Advanced Care Planning: Worked with the sponsors of the Personalize Your Care Act of 2011, H.R. 1589, to modify this legislation that would provide coverage under Medicare for voluntary consultations between doctors and patients to discuss advance care plans. It would also provide states and communities with grants to create or expand programs that assist with advance care planning. ACP expressed concerns regarding section four of the bill that would require that certified electronic health records display current advance directives and physician orders for life sustaining treatment, as this provision would bypass a process, mandated by the HITECH Act, in which CMS conducts extensive consultations with stakeholders to determine the certification standards for electronic health records. Healthcare in the FY2012 Budget: recommend funding of $65 billion for discretionary public health programs (Function 550) in the FY 2012 budget resolution. Appropriations FY2011: Advocated for strong investment in Titles VII and VIII programs in FY 2011 Labor, Health & Human Services & Educations appropriations bills; these programs provide direct financial support for health care workforce development and education. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268 (in the 110th Congress), to provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; implementing a new 2-prong demonstration project consisting of an independent practice-based medical home model and a community-based medical home model, a State Medicaid health (medical) home option, an Independence at Home demonstration project that contains many medical home features, the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions; enacting a 10% bonus payment under Medicare for primary care services. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury; Urge enactment of H.R. 5, the HEALTH Act, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation;; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Administrative simplification; Appointments to the new Workforce Commission, and Patient-Centered Outcomes Research Institute (PCORI), as created under the Patient Protection and Affordable Care Act. Tanning Bed Cancer Control Act of 2011 Supported H.R. 1676, which directs the Commissioner of Food and Drugs (FDA): (1) to complete a study to examine the classification of ultraviolet tanning lamps as class I medical devices; and (2) not later than one year after completion of such study, to either issue a rule providing for the reclassification of an ultraviolet tanning lamp as a class II or class III device or submit to Congress a report providing a justification for not issuing such a rule. The Empowering States to Innovate Act (S. 248, H.R. 844): Supported this legislation, which will allow states to seek waivers three years earlier than the Affordable Care Act to design their own plans to provide comparable levels of coverage to their residents. The Patients Freedom to Choose Act (S. 312, H.R. 605): Supported this legislation, which will repeal a provision in the Affordable Care Act that requires that physicians provide written authorization for over-the-counter drugs reimbursed by a Flexible Spending Account or Health Savings Account.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Center for Medicare and Medicaid Services (CMS): Support the re-nomination of Don Berwick, MD, as the Administrator of CMS and urge the Finance Committee to approve his nomination in a timely manner; Support delaying the date from Apr. 1, 2011 to no earlier than July 1, 2011 at which CMS would fully enforce the so-called physician face-to-face encounter rule that is the outgrowth of section 6407 of the Patient Protection and Affordable Care Act (PPACA). Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Specifically, in April 2011, urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 2011; Urged Congress to repeal the SGR formula and permanently reform the Medicare physician payment system as part of any final agreement between Congress and the Administration on authorizing an increase in the debt ceiling. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646 in the 111th Congress). Advanced Care Planning: Worked with the sponsors of the Personalize Your Care Act of 2011, H.R. 1589, to modify this legislation that would provide coverage under Medicare for voluntary consultations between doctors and patients to discuss advance care plans. It would also provide states and communities with grants to create or expand programs that assist with advance care planning. ACP expressed concerns regarding section four of the bill that would require that certified electronic health records display current advance directives and physician orders for life sustaining treatment, as this provision would bypass a process, mandated by the HITECH Act, in which CMS conducts extensive consultations with stakeholders to determine the certification standards for electronic health records. Healthcare in the FY2012 Budget: recommend funding of $65 billion for discretionary public health programs (Function 550) in the FY 2012 budget resolution. Appropriations FY2011: Advocated for strong investment in Titles VII and VIII programs in FY 2011 Labor, Health & Human Services & Educations appropriations bills; these programs provide direct financial support for health care workforce development and education. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268 (in the 110th Congress), to provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; implementing a new 2-prong demonstration project consisting of an independent practice-based medical home model and a community-based medical home model, a State Medicaid health (medical) home option, an Independence at Home demonstration project that contains many medical home features, the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions; enacting a 10% bonus payment under Medicare for primary care services. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury; Urge enactment of H.R. 5, the HEALTH Act, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation;; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Administrative simplification; Appointments to the new Workforce Commission, and Patient-Centered Outcomes Research Institute (PCORI), as created under the Patient Protection and Affordable Care Act. Tanning Bed Cancer Control Act of 2011 Supported H.R. 1676, which directs the Commissioner of Food and Drugs (FDA): (1) to complete a study to examine the classification of ultraviolet tanning lamps as class I medical devices; and (2) not later than one year after completion of such study, to either issue a rule providing for the reclassification of an ultraviolet tanning lamp as a class II or class III device or submit to Congress a report providing a justification for not issuing such a rule. The Empowering States to Innovate Act (S. 248, H.R. 844): Supported this legislation, which will allow states to seek waivers three years earlier than the Affordable Care Act to design their own plans to provide comparable levels of coverage to their residents. The Patients Freedom to Choose Act (S. 312, H.R. 605): Supported this legislation, which will repeal a provision in the Affordable Care Act that requires that physicians provide written authorization for over-the-counter drugs reimbursed by a Flexible Spending Account or Health Savings Account.

H.R.1676, Tanning Bed Cancer Control Act of 2011, Issues pertaining to the regulation of tanning beds.

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Government targets: Centers For Disease Control & Prevention (CDC), Defense, Dept of (DOD), Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE