Equal Access and Parity for Multi-Campus Hospitals Act

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. S. 296 A bill to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages. All Provisions. H.R. 6352 The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act. All Provisions. S. 1627 Resident Physician Shortage Reduction Act of 2011. All Provisions. S. 3201 Graduate Medical Education Reform Act of 2012. All Provisions. H.R. 6611 Patient Access to Drugs In Shortage Act. All Provisions

Client expense: $160,000 · Firm income: Not reported

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

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. Conference Report on H.R. 4348 Surface Transporation Extension Act of 2012/P.L. 112-141. Provisions related to Louisiana Medicaid Federal Medical Assistance Percentage. H.R. 6352 The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act. All Provisions. S. 1627 Resident Physician Shortage Reduction Act of 2011. All Provisions. S. 3201 Graduate Medical Education Reform Act of 2012. All Provisions. H.R. 8 American Taxpayer Relief Act of 2012. All Provisions. H.R. 6611 Patient Access to Drugs In Shortage Act. All Provisions

Client expense: $160,000 · Firm income: Not reported

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

PPACA (ACA) implementation; HR2; HR4; HR1213; HR1214; HR1215: HR1217; HR5 the PATH Act; HR 452; HR1117; HR2500 EHR Incentive Parity for Multi-Campus Hospitals; S3178; HR5651 The Food and Drug Administration Safety and Innovation Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HConRes 34 (Health Related Issues Only); Debt Ceiling Debate (Medicare/Medicaid proposed changes and cuts); S365; HR2674 the 340B Improvement Act of 2011; HR3630 extenders legislation; HConRes 112 (Health Related Issues Only); HR 2500; HR452 the Medicare Decisions Accountability Act; H.R.8, the American Taxpayer Relief Act of 2012

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (P.L. 111-148, 111-152) issues related to insurance coverage for the uninsured and delivery system and reimbursement reforms ; health information technology issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L. 111-5; Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500)); discussion with Congress to support CMMI application to be designated a Hospital Engagement Contractor under the Partnership for Patients Program; organ donation issues; and The Taking Essential Steps for Testing Act (H.R. 6118); issues related to Superstorm Sandy and the supplemental appropriations bills.

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

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

Affordable Care Act (P.L. 111-148, 111-152) issues related to insurance coverage for the uninsured and delivery system and reimbursement reforms ; health information technology issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L. 111-5; Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500)); discussion with Congress to support CMMI application to be designated a Hospital Engagement Contractor under the Partnership for Patients Program; organ donation issues; and The Taking Essential Steps for Testing Act (H.R. 6118); issues related to Superstorm Sandy and the supplemental appropriations bills.

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

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

Medicare wage index, Medicare reimbursement, implementation of Budget Control Act, impact of potential sequestration on Medicare, Affordable Care Act, Medicare physician payment reform, HR. 2500 concerning healthcare technology, incentive funding, rules including IPPA and homecare, veterans healthcare, and general healthcare. HR 452 regarding Medicare Decision Accountability Act.

Client expense: Not reported · Firm income: Not reported

Medicare wage index, Medicare reimbursement, implementation of Budget Control Act, impact of potential sequestration on Medicare, Affordable Care Act, Medicare physician payment reform, HR. 2500 concerning healthcare technology, incentive funding, rules including IPPA and homecare, veterans healthcare, and general healthcare. HR 452 regarding Medicare Decision Accountability Act.

Client expense: Not reported · Firm income: Not reported

H.R.2245 - Preserving Access to Life-Saving Medications Act of 2011. H.R.3849 - Rural Hospital and Provide Equity (R-HoPE) Act. H.R.3839 - Drug Shortage Prevention Act. S.2257 - Excellence in Mental Health Act. S.296 - Preserving Access to Life-Saving Medications Act. S. 319 - Pharmaceutical Market Access and Drug Safety Act of 2011. H.R.3630 - Middle Class Tax Relief and Job Creation Act of 2012; Related Conference Report 112-399 H.R.3519 - To exempt the Medicare Program from fallback sequestration under the Budget Control Act of 2011. H.R.2500 - The Equal Access and Parity for Multi-Campus Hospitals Act. H.R. 2224 - Improving Physician Access to Teaching Hospitals. S.1627 - Resident Physician Shortage Reduction Act. H.R.452 - Medicare Decisions Accountability Act of 2011. S.668 - Health Care Bureaucrats Elimination Act. S.218/H.R.5 - Help Efficient, Accessible, Low-Cost, Timely Healthcare (Health) Act of 2011. Medicare Physician Fee Schedule Fix. Medicare Hospital Wage Index.

Client expense: $238,000 · Firm income: Not reported

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

HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 and HR 2783 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare program; HR 1398 Rural Hospital Protection Act, legislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; S 1486 Long-Term Care Hospital Improvement Act of 201, a bill to amend title XVIII of the Social Security Act to clarify and expand on criteria applicable to patient admission to and care furnished in long-term care hospitals participating in the Medicare program; Raising concerns about CMS flawed methodology that overstates the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to improve the regulation to implement ACOs; Urging CMS to update, streamline, and modernize the Medicare conditions of participation; HR 1852/ S 950 Children's Hospital GME Support Reauthorization Act of 2011, the current CHGME authorization expired in September 2011, and the bills would reauthorize the CHGME program for an additional five years, through fiscal year (FY) 2016, at the current authorization level of up to $330 million a year; HR 1683/ S 868 Medicaid MOE, strikes provisions of ACA related to maintaining Medicaid eligibility levels; HR 1543 Improving Access to Medicare Coverage Act of 2011, to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare; S 1251Medicare and Medicaid FAST Act, a bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs; HR 2500 Equal Access and Parity for Multi-Campus Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 2674 340B Program Improvement Act, a bill to amend section 340B of the Public Health Service Act to improve the provision of discounts on drug purchases for certain safety net providers; HR 3630 Temporary Payroll Tax Cut Continuation Act of 2011 or Middle Class Tax Relief and Job Creation Act of 2011, a bill that cuts hospitals to pay for the doc fix, it contains the Social Security payroll tax cut and the Unemployment Insurance extension; HR 3519 a bill to amend and exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011; S. 1680 Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act of 2011, a bill to amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; Letter to Rehberg and DeLauro in support of the CHGME program that was circulated by Reps. Capps and Bilbray; Wyden/Crapo letter to CMS to actively oppose a Senate Dear Colleague letter to CMS in support of updating Medicare payments to ambulatory surgery centers (ASCs). The letter did not request a payment update for ASCs. Rather, the letter advocated against the Medicare payment rate for services provided in hospital outpatient department settings; HR 2954 and S 2474 Health Equity and Accountability Act of 2011, Comprehensive bill focused on eliminating racial and ethnic disparities in health care through improved data collection and reporting, culturally and linguistically-appropriate health care, workforce diversity, health information technology, and other actions; Discussions with the Administration (CMS) on applying the therapy cap to hospital outpatient departments; Worked to change CMS definition of allowed EHR costs for CAH Meaningful Use incentive payments to include capital lease purchases of EHRs; HR 3859 Rural Hospital and Provider Equity (R-HOPE) Act of 2012, to amend title XVIII of the SSA to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; HR 4245 Veterans Co-Pay Fairness Act, to amend title 38, United States Code, to require the Secretary of Veterans Affairs to reimburse eligible veterans who are entitled to Medicare benefits for Medicare deductibles and other expenses that are owed by the veterans for emergency medical treatment provided in non-Department of Veterans affairs facilities; S 2620 and HR 5943 Rural Hospital Access Act of 2012, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; S 3187 and HR 5651Prescription Drug User Fee Amendments of 2012, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs and medical devices, to establish user-fee programs for generic drugs and biosimilars.

Client expense: $3,550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Office of Management & Budget (OMB), SENATE, White House Office

- S.3187, Food and Drug Administraton Safety and Innovation Act (drug shortages in hospitals) and Related Conference Report P.L.112-144. - S.296/H.R.2245, Preserving Access to Life-Saving Medications Act (drug shortages in hospitals). - H.R.3839, Drug Shortage Prevention Act (drug shortages in hospitals) - S.319, Pharmaceutical Market Access and Drug Safety Act (drug shortages in hospitals). - H.R.5651, Food and Drug Administration Reform Act (drug shortages in hospitals). - Medicaid provider taxes. - Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, CAH payments, IPPS coding offset, rural hospital payments, section 508 wage index reclassification, Medicare Dependent Hospital authorization, inpatient coding offset, small rural clinical hold harmless, Sole Community Hospital (SCH) outpatient department hold harmless, outpatient therapy cap moratorium, and hospital outpatient department (HOPD) evaluation and management (E/M) service. - Medicare physician fee schedule fix. - Medicare hospital wage index. - H.R.3519, To exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011. - S.2620/H.R.5943, Rural Hospital Access Act (MDH/LV Adjustment 1-year extension). - S.1680/H.R.3859, Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act. - H.R.2500, The Equal Access and Parity for Multi-Campus Hospitals Act (Electronic Health Record multi-campus incentive bill). - H.R.2224, Improving Physician Access to Teaching Hospitals Act (Medicare residency slots). - S.1627/H.R.6562, Resident Physician Shortage Reduction Act (Medicare residency slots). - H.R.452, Medicare Decisions Accountability Act of 2011 (IPAB repeal). - S.668, Health Care Bureaucrats Elimination Act (IPAB repeal). - Medicare and Medicaid Programs; Electronic Health Record Incentive ProgramStage 2; Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology; Final Rules (CMS and ONC Medicare and Medicaid EHR Meaningful Use Incentive Program Stage 2 final rules). - New York State 1115 Medicaid Waiver Application to CMS. - H.R.6118, Taking Essential Steps for Testing (TEST) Act (unintentional proficiency testing laboratory referrals). - Medicare and Medicaid Recovery Audit Contractor (RAC) Programs.

Client expense: $190,000 · Firm income: Not reported

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

S.913: Do-Not-Track Online Act of 2011-privacy implications. S.799: The Commercial Privacy Bill of Rights-privacy implications. S.501: Fostering Independence Through Technology Act-any health IT implications. S.539: Behavior Health Information Technology Act-expanding health IT incentives to additional covered entities. S. 1789: The 21st Century Postal Service Act. This bill contains language that would limit federal agency employees participation and attendance at association conferences. H.R.3239: Safeguarding Access For Every Medicare Patient Actinterested in the safe harbor issues with regard to the implementation of certified health IT. H.R.2500: Equal Access and Parity for Multi-Campus Hospitals Actexpanding HIT incentives to new covered entities. H.R.1895: A Bill to Amend the Children's Online Privacy Protection Actprivacy implications. H.R.1841: Data Accountability and Trust Act (DATA) of 2011privacy implications. H.R.1473: A bill to make further continuing appropriations for Fiscal Year 2011 (updated)provisions concerning ONC funding, health IT and the rider concerning a unique healthcare identifier for individuals. H.R.1363: A bill to further continuing appropriations for Fiscal Year 2011any health IT implications H.R.1: Continuing Resolution and Consolidated Appropriations Act of 2011any health IT implications. H.R.408: To reduce Federal spending by $2.5 trillion through fiscal year 2021any health IT implications. H.R.2: Repealing of the Job-Killing Health Care Law Actany health IT implications and provisions concerning ICD-10 mapping and operating rules for HIPAA transactions. H.R. 2146: Digital Accountability and Transparency Act. This bill includes language that would limit federal employees from attending association conferences. HR 6079: Repeal of Obamacare Act. This will overturn most provisions in the Patient Protection and Affordable Care Act. H.R. 6107: The VETS Act, which would allow Veterans Affairs providers to deliver telemedicine services to vets regardless of site of origin or delivery. H.R. 6043: Behavioral Health Information Technology Act, which would expand the MU program to mental and behavioral health care providers. The bill also incorporates the Marino SAFE act, which would create liability protections for providers and vendors who report errors in use of technology.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid issues. Payment issues. Health reform issues. H.R.2500, Equal Access and Parity for Multi-Campus Hospitals Act, Incentive payment related issues. S.2243, Medicare Better Health Rewards Program Act of 2012, Wellness related issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PPACA (ACA) implementation; HR2; HR4; HR1213; HR1214; HR1215: HR1217; HR5 the PATH Act; HR452; HR1117; HR2500 EHR Incentive Parity for Multi-Campus Hospitals; S3178; HR5651 The Food and Drug Administration Safety and Innovation Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HConRes34 (Health Related Issues Only); Debt Ceiling Debate (Medicare/Medicaid proposed changes and cuts); S365; HR2674 the 340B Improvement Act of 2011; HR3630 Extenders Legislation; HConRes112 (Health Related Issues Only); HR2500; HR452 The Medicare Decisions Accountability Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. S. 296 A bill to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages. All Provisions. H.R. 6352 The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act. All Provisions. S. 1627 Resident Physician Shortage Reduction Act of 2011. All Provisions. S. 3201 Graduate Medical Education Reform Act of 2012. All Provisions.

Client expense: $160,000 · Firm income: Not reported

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

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. Conference Report on H.R. 4348 Surface Transporation Extension Act of 2012/P.L. 112-141. Provisions related to Louisiana Medicaid Federal Medical Assistance Percentage. H.R. 6352 The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act. All Provisions. S. 1627 Resident Physician Shortage Reduction Act of 2011. All Provisions. S. 3201 Graduate Medical Education Reform Act of 2012. All Provisions.

Client expense: $160,000 · Firm income: Not reported

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

Affordable Care Act (P.L. 111-148, 111-152) issues related to insurance coverage for the uninsured and delivery system and reimbursement reforms ; health information technology issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L. 111-5; Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500)); discussion with Congress to support CMMI application to be designated a Hospital Engagement Contractor under the Partnership for Patients Program; organ donation issues; and The Taking Essential Steps for Testing Act (H.R. 6118).

Client expense: $210,000 · Firm income: Not reported

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

S. 3187, Food and Drug Administration Safety and Innovation Act (drug shortages in hospitals) and Related Conference Report PL 112-144 S. 296/H.R. 2245, Preserving Access to Life-Saving Medications Act (drug shortages in hospitals) S. 319, Pharmaceutical Market Access and Drug Safety Act (drug shortages in hospitals) H.R. 5651, Food and Drug Administration Reform Act (drug shortages in hospitals) H.R. 3839, Drug Shortage Prevention Act (drug shortages in hospitals) H.R. 5652, Sequester Replacement Reconciliation Act (Medicaid provider taxes) Medicare physician fee schedule fix Medicare hospital wage index H.R. 3519, To exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011 S. 2620/H.R. 5943, Rural Hospital Access Act (MDH/LV Adjustment 1-year extension) S. 1680/H.R. 3859, Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act H.R. 2500, The Equal Access and Parity for Multi-Campus Hospitals Act (Electronic Health Record multi-campus incentive bill) H.R. 2224, Improving Physician Access to Teaching Hospitals Act (Medicare residency slots) S.1627, Resident Physician Shortage Reduction Act (Medicare residency slots) H.R. 452, Medicare Decisions Accountability Act of 2011 (IPAB repeal) S. 668, Health Care Bureaucrats Elimination Act (IPAB repeal) S.218/H.R. 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (Medical liability reform)

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. The Budget Control Act of 2011 (Pub. L. No. 112-25, S. 365), provisions relating to the use of sequestration and payment cuts to hospitals. 2. H.R. 1852/S. 958, funding for the children's hospital graduate medical education program. 3. The Long-Term Care Hospital Improvement Act of 2011 (S. 1486), relating to the creation of patient criteria and elimination of the 25 percent rule. 4. The Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630), provisions related to Medicare physician payments, cuts to hospital reimbursement, and the elimination of rural hospital payment programs. 5. Provided education to Members of Congress and their staff about the submission of a Medicare 1115 Waiver by the State of Texas to modify payments made under the Upper Payment Limit (UPL) Program. 6. The Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500), incentive payments to hospitals for the implementations of electronic health records and achieving meaningful use. 7. The Rural Hospital Access Act of 2012 (H.R. 5943), legislation would reauthorize the Medicare-Dependent Hospital Program and extend the enhanced low-volume Medicare adjustment for prospective payment system hospitals for one year through September 2013. 8. Requested members sign a letter to Secretary Kathleen Sebelius that expressed concern regarding the recently proposed FY2013 Medicare update rule for long-term care hospitals. 9. The Preserving Access to Life Saving Medications Act (H.R. 2245/S. 296) and the Drug Shortage Prevention Act (H.R. 3839), legislation that addresses prescription drug shortages and processes at the Food & Drug Administration. 10. The Patient Protection and Affordable Care Act, provisions related to the expansion of health insurance coverage and $155 billion in cuts to hospital payments.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. The Budget Control Act of 2011 (Pub. L. No. 112-25, S. 365), provisions relating to the use of sequestration and payment cuts to hospitals. 2. The Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630), provisions related to Medicare physician payments, cuts to hospital reimbursement, and the elimination of rural hospital payment programs. 3. The Long-Term Care Hospital Improvement Act of 2011 (S. 1486), relating to the creation of patient criteria and elimination of the 25 percent rule. 4. Provided education to Members of Congress and their staff about the submission of a Medicare 1115 Waiver by the state of Texas to modify payments made under the Upper Payment Limit (UPL) Program. 5. The Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500), incentive payments to hospitals for the implementations of electronic health records and achieving meaningful use. 6. The Rural Hospital Access Act of 2012 (H.R. 5943), legislation would reauthorize the Medicare-Dependent Hospital Program and extend the enhanced low-volume Medicare adjustment for prospective payment system hospitals for one year through September 2013. 7. Requested members sign a letter to Secretary Kathleen Sebelius that expressed concern regarding the recently proposed FY2013 Medicare update rule for long-term care hospitals.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 and HR 2783 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare program; HR 1398 Rural Hospital Protection Act, legislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; S 1486 Long-Term Care Hospital Improvement Act of 201, a bill to amend title XVIII of the Social Security Act to clarify and expand on criteria applicable to patient admission to and care furnished in long-term care hospitals participating in the Medicare program; Raising concerns about CMS flawed methodology that overstates the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to improve the regulation to implement ACOs; Urging CMS to update, streamline, and modernize the Medicare conditions of participation; HR 1852/ S 950 Children's Hospital GME Support Reauthorization Act of 2011, the current CHGME authorization expired in September 2011, and the bills would reauthorize the CHGME program for an additional five years, through fiscal year (FY) 2016, at the current authorization level of up to $330 million a year; HR 1683/ S 868 Medicaid MOE, strikes provisions of ACA related to maintaining Medicaid eligibility levels; HR 1543 Improving Access to Medicare Coverage Act of 2011, to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare; S 1251Medicare and Medicaid FAST Act, a bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs; HR 2500 Equal Access and Parity for Multi-Campus Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 2674 340B Program Improvement Act, a bill to amend section 340B of the Public Health Service Act to improve the provision of discounts on drug purchases for certain safety net providers; HR 3630 Temporary Payroll Tax Cut Continuation Act of 2011 or Middle Class Tax Relief and Job Creation Act of 2011, a bill that cuts hospitals to pay for the doc fix, it contains the Social Security payroll tax cut and the Unemployment Insurance extension; HR 3519 a bill to amend and exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011; S. 1680 Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act of 2011, a bill to amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; Letter to Rehberg and DeLauro in support of the CHGME program that was circulated by Reps. Capps and Bilbray; Wyden/Crapo letter to CMS to actively oppose a Senate Dear Colleague letter to CMS in support of updating Medicare payments to ambulatory surgery centers (ASCs). The letter did not request a payment update for ASCs. Rather, the letter advocated against the Medicare payment rate for services provided in hospital outpatient department settings; HR 2954 Health Equity and Accountability Act of 2011, Comprehensive bill focused on eliminating racial and ethnic disparities in health care through improved data collection and reporting, culturally and linguistically-appropriate health care, workforce diversity, health information technology, and other actions; Discussions with the Administration (CMS) on applying the therapy cap to hospital outpatient departments; Worked to change CMS definition of allowed EHR costs for CAH Meaningful Use incentive payments to include capital lease purchases of EHRs; HR 3859 Rural Hospital and Provider Equity (R-HOPE) Act of 2012, to amend title XVIII of the SSA to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program. HR 4245 Veterans Co-Pay Fairness Act, to amend title 38, United States Code, to require the Secretary of Veterans Affairs to reimburse eligible veterans who are entitled to Medicare benefits for Medicare deductibles and other expenses that are owed by the veterans for emergency medical treatment provided in non-Department of Veterans Affairs facilities; S 2620 and HR 5943 Rural Hospital Access Act of 2012, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; S 3187 and HR 5651Prescription Drug User Fee Amendments of 2012, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs and medical devices, to establish user-fee programs for generic drugs and biosimilars.

Client expense: $4,150,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Office of Management & Budget (OMB), SENATE, White House Office

Bill S.913: Do-Not-Track Online Act of 2011-privacy implications. Bill S.799: The Commercial Privacy Bill of Rights-privacy implications. Bill S.501: Fostering Independence Through Technology Act-any health IT implications. Bill S.539: Behavior Health Information Technology Act-expanding health IT incentives to additional covered entities. S. 1789, the 21st Century Postal Service Act. This bill contains language that would limit federal agency employees participation and attendance at association conferences. Bill H.R.3239: Safeguarding Access For Every Medicare Patient Actinterested in the safe harbor issues with regard to the implementation of certified health IT. Bill H.R.2500: Equal Access and Parity for Multi-Campus Hospitals Actexpanding HIT incentives to new covered entities. Bill H.R.1895: A Bill to Amend the Children's Online Privacy Protection Actprivacy implications. Bill H.R.1841: Data Accountability and Trust Act (DATA) of 2011privacy implications. Bill H.R.1473: A bill to make further continuing appropriations for Fiscal Year 2011 (updated)provisions concerning ONC funding, health IT and the rider concerning a unique healthcare identifier for individuals. Bill H.R.1363: A bill to further continuing appropriations for Fiscal Year 2011any health IT implications Bill H.R.1: Continuing Resolution and Consolidated Appropriations Act of 2011any health IT implications. Bill H.R.408: To reduce Federal spending by $2.5 trillion through fiscal year 2021any health IT implications. Bill H.R.2: Repealing of the Job-Killing Health Care Law Actany health IT implications and provisions concerning ICD-10 mapping and operating rules for HIPAA transactions. H.R. 2146, the Digital Accountability and Transparency Act. This bill includes language that would limit federal employees from attending association conferences. HR 6079, Repeal of Obamacare Act. This will overturn most provisions in the Patient Protection and Affordable Care Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PPACA (ACA) Implementation; HR2; HR4; HR1213; HR1214; HR1215; HR1217; HR5 the PATH Act; HR452; HR1117; HR2500 EHR Incentive Parity for Multi-Campus Hospitals; S3187 and HR5651 The Food and Drug Administration Safety and Innovation Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HConRes34 (Health Related Issues Only); Debt Ceiling Debate (Medicare/Medicaid proposed changes and cuts); S365; HR2674 the 340B Improvement Act of 2011; HR3630 Extenders legislation; HConRes112 (Health Related Issues Only); HR2500; HR452 The Medicare Decisions Accountability Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.3187, Food and Drug Administration Safety and Innovation Act (drug shortages in hospitals) and Related Conference Report PL 112-144; S.296/H.R.2245, Preserving Access to Life-Saving Medications Act (drug shortages in hospitals); S.319, Pharmaceutical Market Access and Drug Safety Act (drug shortages in hospitals); H.R. 5651, Food and Drug Administration Reform Act (drug shortages in hospitals); H.R. 3839, Drug Shortage Prevention Act (drug shortages in hospitals); H.R. 5652, Sequester Replacement Reconciliation Act (Medicaid provider taxes); H.R. 3560, Middle Class Tax Relief and Job Creation Act and Related Conference Committee Report PL 112-399: Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, CAH payments, IPPS coding offset, rural hospital payments, section 508 wage index reclassification, Medicare Dependent Hospital authorization, inpatient coding offset, small rural clinical hold harmless, Sole Community Hospital (SCH) outpatient department hold harmless, outpatient therapy cap moratorium, and hospital outpatient department (HOPD) evaluation and management (E/M) service; Medicare physician fee schedule fix; Medicare hospital wage index; H.R. 3519, To exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011; S. 2620/H.R. 5943, Rural Hospital Access Act (MDH/LV Adjustment 1-year extension); H.R. 6064 Temporary Surface Transportation Act and Related Conference Report PL 112-140 (Pension provisions); S. 1680/H.R. 3859, Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act; H.R. 2500, The Equal Access and Parity for Multi-Campus Hospitals Act (Electronic Health Record multi-campus incentive bill); H.R. 2224, Improving Physician Access to Teaching Hospitals Act (Medicare residency slots); S.1627, Resident Physician Shortage Reduction Act (Medicare residency slots); H.R. 452, Medicare Decisions Accountability Act of 2011 (IPAB repeal); S. 668, Health Care Bureaucrats Elimination Act (IPAB repeal); S.218/H.R. 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (Medical liability reform). Recovery Auditor Contractor program modifications

Client expense: $210,000 · Firm income: Not reported

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

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. Conference Report on H.R. 4348 Surface Transporation Extension Act of 2012/P.L. 112-141. Provisions related to Louisiana Medicaid Federal Medical Assistance Percentage.

Client expense: $160,000 · Firm income: Not reported

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

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. S. 296 A bill to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages. All Provisions.

Client expense: $160,000 · Firm income: Not reported

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

Affordable Care Act (P.L. 111-148, 111-152) issues related to insurance coverage for the uninsured and delivery system and reimbursement reforms ; health information technology issues (American Recovery and Reinvestment Act of 2009, H.R. 1 (P.L. 111-5; Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500)); discussion with Congress to support CMMI application to be designated a Hospital Engagement Contractor under the Partnership for Patients Program; organ donation issues.

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

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

Medicare and Medicaid issues. Payment issues. Health reform issues. H.R.2500, Equal Access and Parity for Multi-Campus Hospitals Act, Incentive payment related issues. S.2243, Medicare Better Health Rewards Program Act of 2012, Wellness related issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Bill S.913: Do-Not-Track Online Act of 2011-privacy implications. Bill S.799: The Commercial Privacy Bill of Rights-privacy implications. Bill S.501: Fostering Independence Through Technology Act-any health IT implications. Bill S.539: Behavior Health Information Technology Act-expanding health IT incentives to additional covered entities. Bill H.R.3239: Safeguarding Access For Every Medicare Patient Actinterested in the safe harbor issues with regard to the implementation of certified health IT. Bill H.R.2500: Equal Access and Parity for Multi-Campus Hospitals Actexpanding HIT incentives to new covered entities. Bill H.R.1895: A Bill to Amend the Children's Online Privacy Protection Actprivacy implications. Bill H.R.1841: Data Accountability and Trust Act (DATA) of 2011privacy implications. Bill H.R.1473: A bill to make further continuing appropriations for Fiscal Year 2011 (updated)provisions concerning ONC funding, health IT and the rider concerning a unique healthcare identifier for individuals. Bill H.R.1363: A bill to further continuing appropriations for Fiscal Year 2011any health IT implications Bill H.R.1: Continuing Resolution and Consolidated Appropriations Act of 2011any health IT implications. Bill H.R.408: To reduce Federal spending by $2.5 trillion through fiscal year 2021any health IT implications. Bill H.R.2: Repealing of the Job-Killing Health Care Law Actany health IT implications and provisions concerning ICD-10 mapping and operating rules for HIPAA transactions.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. The Budget Control Act of 2011 (Pub. L. No. 112-25, S. 365), provisions relating to the use of sequestration and payment cuts to hospitals. 2. The Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630), provisions related to Medicare physician payments, cuts to hospital reimbursement, and the elimination of rural hospital payment programs. 3. The Long-Term Care Hospital Improvement Act of 2011 (S. 1486), relating to the creation of patient criteria and elimination of the 25 percent rule. 4. Provided education to Members of Congress and their staff about the submission of a Medicare 1115 Waiver by the State of Texas to modify payments made under the Upper Payment Limit (UPL) Program. 5. The Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500), incentive payments to hospitals for the implementations of electronic health records and achieving meaningful use.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. The Budget Control Act of 2011 (Pub. L. No. 112-25, S. 365), provisions relating to the use of sequestration and payment cuts to hospitals. 2. H.R. 1852/S. 958, funding for the children's hospital graduate medical education program. 3. The Long-Term Care Hospital Improvement Act of 2011 (S. 1486), relating to the creation of patient criteria and elimination of the 25 percent rule. 4. The Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630), provisions related to Medicare physician payments, cuts to hospital reimbursement, and the elimination of rural hospital payment programs. 5. Provided education to Members of Congress and their staff about the submission of a Medicare 1115 Waiver by the State of Texas to modify payments made under the Upper Payment Limit (UPL) Program. 6. The Equal Access and Parity for Multi-Campus Hospitals Act (H.R. 2500), incentive payments to hospitals for the implementations of electronic health records and achieving meaningful use.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 and HR 2783 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare program; HR 1398 Rural Hospital Protection Act, legislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; S 1486 Long-Term Care Hospital Improvement Act of 201, a bill to amend title XVIII of the Social Security Act to clarify and expand on criteria applicable to patient admission to and care furnished in long-term care hospitals participating in the Medicare program; Raising concerns about CMS flawed methodology that overstates the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to improve the regulation to implement ACOs; Urging CMS to update, streamline, and modernize the Medicare conditions of participation; HR 1852/ S 950 Children's Hospital GME Support Reauthorization Act of 2011, the current CHGME authorization expired in September 2011, and the bills would reauthorize the CHGME program for an additional five years, through fiscal year (FY) 2016, at the current authorization level of up to $330 million a year; HR 1683/ S 868 Medicaid MOE, strikes provisions of ACA related to maintaining Medicaid eligibility levels; HR 1543 Improving Access to Medicare Coverage Act of 2011, to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare; S 1251Medicare and Medicaid FAST Act, a bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs; HR 2500 Equal Access and Parity for Multi-Campus Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 2674 340B Program Improvement Act, a bill to amend section 340B of the Public Health Service Act to improve the provision of discounts on drug purchases for certain safety net providers; HR 3630 Temporary Payroll Tax Cut Continuation Act of 2011 or Middle Class Tax Relief and Job Creation Act of 2011, a bill that cuts hospitals to pay for the doc fix, it contains the Social Security payroll tax cut and the Unemployment Insurance extension; HR 3519 a bill to amend and exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011; S. 1680 Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act of 2011, a bill to amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; Letter to Rehberg and DeLauro in support of the CHGME program that was circulated by Reps. Capps and Bilbray; Wyden/Crapo letter to CMS to actively oppose a Senate Dear Colleague letter to CMS in support of updating Medicare payments to ambulatory surgery centers (ASCs). The letter did not request a payment update for ASCs. Rather, the letter advocated against the Medicare payment rate for services provided in hospital outpatient department settings; HR 2954 Health Equity and Accountability Act of 2011, Comprehensive bill focused on eliminating racial and ethnic disparities in health care through improved data collection and reporting, culturally and linguistically-appropriate health care, workforce diversity, health information technology, and other actions; Discussions with the Administration (CMS) on applying the therapy cap to hospital outpatient departments; Worked to change CMS definition of allowed EHR costs for CAH Meaningful Use incentive payments to include capital lease purchases of EHRs; HR 3859 Rural Hospital and Provider Equity (R-HOPE) Act of 2012, to amend title XVIII of the SSA to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, White House Office

S.296/H.R.2245, Preserving Access to Life-Saving Medications Act (drug shrotages in hospitals) S.319, Pharmaceutical Market Access and Drug Safety Act (drug shortages in hospitals) H.R.3389, Drug Shortage Prevention Act (drug shortages in hospitals) S.218/H.R.5 Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (medical liability reform) H.R. 3560, Middle Class Tax Relief and Job Creation Act and Related Conference Committee Report PL 112-399: oMedicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, CAH payments, IPPS coding offset, rural hospital payments, section 508 wage index reclassification, Medicare Dependent Hospital authorization, inpatient coding offset, small rural clinical hold harmless, Sole Community Hospital (SCH) outpatient department hold harmless, outpatient therapy cap moratorium, and hospital outpatient department (HOPD) evaluation and management (E/M) service. Medicare physician fee schedule fix Medicare hospital wage index H.R. 3519, To exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011 S. 1680/H.R. 3859, Rural Hospital and Provider Equity (R-HoPE) Act H.R. 2500, The Equal Access and Parity for Multi-Campus Hospitals Act (Electronic Health Record multi-campus incentive bill) H.R. 2224, Improving Physician Access to Teaching Hospitals Act (Medicare residency slots) S.1627, Resident Physician Shortage Reduction Act (Medicare residency slots) H.R. 452, Medicare Decisions Accountability Act of 2011 (IPAB repeal) S. 668, Health Care Bureaucrats Elimination Act (IPAB repeal)

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

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

S. 296/H.R. 2245, Preserving Access to Life-Saving Medications Act (drug shortages in hospitals) S. 319, Pharmaceutical Market Access and Drug Safety Act (drug shortages in hospitals) H.R. 3839, Drug Shortage Prevention Act (drug shortages in hospitals) H.R. 3560, Middle Class Tax Relief and Job Creation Act and Related Conference Committee Report PL 112-399: oMedicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, CAH payments, IPPS coding offset, rural hospital payments, section 508 wage index reclassification, Medicare Dependent Hospital authorization, inpatient coding offset, small rural clinical hold harmless, Sole Community Hospital (SCH) outpatient department hold harmless, outpatient therapy cap moratorium, and hospital outpatient department (HOPD) evaluation and management (E/M) service. Medicare physician fee schedule fix Medicare hospital wage index H.R. 3519, To exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011 S. 1680/H.R. 3859, Rural Hospital and Provider Equity (R-HoPE) Act H.R. 2500, The Equal Access and Parity for Multi-Campus Hospitals Act (Electronic Health Record multi-campus incentive bill) H.R. 2224, Improving Physician Access to Teaching Hospitals Act (Medicare residency slots) S.1627, Resident Physician Shortage Reduction Act (Medicare residency slots) H.R. 452, Medicare Decisions Accountability Act of 2011 (IPAB repeal) S. 668, Health Care Bureaucrats Elimination Act (IPAB repeal) S.218/H.R. 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (Medical liability reform)

Client expense: Not reported · Firm income: Not reported

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

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals.

Client expense: $160,000 · Firm income: Not reported

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

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals.

Client expense: $160,000 · Firm income: Not reported

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

Implementation of Health Reform (PPACA) The Health Information Technology for Economic and Clinical Health Act (HITECH), Regarding Implementation of Act H.R. 3630 - Middle-Class Tax Relief & Job Creation Act Prescription Drug User Fee Act (PDUFA) Issues Related to the Medicare & Medicaid Protection Act of 1987 that Regulate Group Purchasing Organizations Under HHS Medical Device Manufacturers Gag Clause on Hospital Contracting H.R. 5 - The Help Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act Unique Device Identification (Food and Drug Administration Amendments Act of 2007) P.L. #110-85 S.296/H.R. 2245 - Preserving Access to Life-Saving Medications Act Deficit Reduction/Federal Budget Proposals S.365 - Budget Control Act of 2011 H.R. 1852 - Children's Hospital GME Support Reauthorization Act H.R. 2500 - Equal Access and Parity for Multi-Campus Hospitals Act Medicare Physician Payment - Sustainable Growth Rate Healthcare Disparities H.R. 3586 - Good Samaritan Health Professional Act Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network H.R. 3630 - Temporary Payroll Tax Cut Continuation Act of 2011 S.2193 - Ensuring Safe Medical Devices for Patients

Client expense: $332,340 · Firm income: Not reported

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

H.Con. Res. 34 (Health related issues); Debt Ceiling Debate (Medicare/Medicaid proposed changes and cuts); S.365; HR2674; HR3630 Extenders legislation; H.Con.Res.112 (Health related issues); H.R.2500;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PPACA Implementation; HR2; HR4; HR1213; HR1214; HR1215; HR1217; HR5; HR452; HR1117; HR2500

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2245: Preserving Access to Life-Saving Medications Act of 2011. H.R. 3859: Rural Hospital and Provide Equity (R-HoPE) Act. H.R. 3839: Drug Shortage Prevention Act. S. 2257: Excellence in Mental Health Act. S. 296: Preserving Access to Life-Saving Medications Act. S. 319: Pharmaceutical Market Access and Drug Safety Act of 2011. H.R. 3630: Middle Class Tax Relief and Job Creation Act of 2012. -- Related Conference Report 112-399 H.R. 3519: To exempt the Medicare program from fallback sequestratio under the Budget Control Act of 2011. H.R. 2500: The Equal Access and Parity for Multi-Campus Hospitals Act. H.R. 2224: Improving Physician Access to Teaching Hospitals. S. 1627: Resident Physician Shortage Reduction Act. H.R. 452: Medicare Decisions Accountability Act of 2011. S. 668: Health Care Bureaucrats Elimination Act. S. 218/H.R. 5: Help Efficient, Accessible, Low-cost, Timely Healthcare (Health) Act of 2011 Medicare Physician Fee Schedule Fix Medicare Hospital Wage Index

Client expense: $298,000 · Firm income: Not reported

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

Afforadable Care Act implementation activities related to hospital and physician issues, Accountable Care Organizations and Geographic Variations in Health Care/Medicare Spending. HR 2500, Equal Access and Parity for Multi-Campus Hospitals Act Issues related to Graduate Medical Education (GME), physician and hospital reimbursement,and Medicaid reform issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Afforadable Care Act implementation activities related to hospital and physician issues, Accountable Care Organizations and Geographic Variations in Health Care/Medicare Spending. HR 2500, Equal Access and Parity for Multi-Campus Hospitals Act Issues related to Graduate Medical Education (GME), physician and hospital reimbursement,and Medicaid reform issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE