To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs.

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed family caregiving, long-term care, Older Americans Act, private LTC insurance. (no bill) Discussed Medicaid long-term services and supports. (no bill) Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) S. 1439 - Discussed and endorsed the Care Planning Act of 2013. Discussed status of regulations regarding disclosure of nursing home ownership. (no bill) Discussed regulations defining whether a home and community-based setting in medicaid and state data on ome and community-based services spending. (no bill) Discussed family caregiver assessment in proposed regulations and shared a report on the topics. (no bill) Discussed measures for re-balancing in medicaid managed LTSS waivers and dual demonstration programs in sign on letter to CMS. (no bill) H.R. 1717 - Discussed Medicare DMEPOS Market Pricing Program Act. H.R. 3531 - Discussed Creating Access to Rehabilitation for Every Senior (CARES) Act.Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Medicaid managed care and long-term services and supports broadly. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) Discussed the AARP Initiative called "You've Earned a Say". (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas and Florida managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013.H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship and advancement of the bill. Discussed comments regarding Medicare and You handbook. (no bill) Discussed CMS information regarding healthcare marketplaces. H. R. 933, Consolidated and Further Continuing Appropriations Act, 2013 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. S. Con. Res. 8, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. H.Con. Res. 25, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.Lobbied on expected "QM" safe harbor amendment. (The amendment was not offered) H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill) Discussed the Medicare Adult Day Services Act. (no bill) Discussed the Commission on Long-Term Care and Senate Aging Committee hearing and long-term care generally. H.J.R. 59/H.R. 2775, Continuing Appropriations Resolution, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. S. 1284, Labor, Health and Human Services Appropriations Act, 2014 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiares. (no bill) Discussed pending U.S. trade agreement negotiations, including trade promotional or 'fast track' authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S. 1871 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program. Discussed fraud, Medicare home healthcare, ways to find savings in Medicare without harming Medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). Discussed new report on observation services that included policy recommendations. Discussed you've earned a say, ways to find savings in medicare without harming medicare beneficiaries (care coordination, prescriotion drugs, waste, fraud and abuse).Discussed and shared invitation for a Hill briefing on innovation and progress in long-term services and supports. (no bill) Submitted and shared written testimony for the record for the Senate Aging Committee hearing on the future of Long-Term Care Policy and Continuing the Conversation. (no bill) Discussed Medicare Advantage. H.R. 3616, Protecting Seniors from Medicare Act- Sent letters endorsing bill. H.R. 2810, The SGR Repeal and Medicare Beneficiary Improvement Act - Sent letters endorsing bill. Discussed observation care and "two-midnight rule".

Client expense: $2,500,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Council on Disability, Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed family caregiving, long-term care, Older Americans Act, private LTC insurance. (no bill) Discussed Medicaid long-term services and supports. (no bill) Discussed Florida's managed long-term services and supports medicaid waiver and their 1115 waiver proposal. Discussed Senior Navigation and Planning and feedback (S.3684 in 112th Congress/no bill # in 113th Congress). Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill)Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Medicaid managed care and long-term services and supports broadly. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) Discussed the AARP Initiative called "You've Earned a Say". (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas and Florida managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013.H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship. Discussed comments regarding Medicare and You handbook. (no bill) Discussed CMS information regarding healthcare marketplaces. H.R. 1173, Personalize Your Care Act - Discussed the bill and advance care planning issues. Bill provides coverage for voluntary advance care planning consultations. H. R. 933, Consolidated and Further Continuing Appropriations Act, 2013 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. S. Con. Res. 8, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. H.Con. Res. 25, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.Lobbied on expected "QM" safe harbor amendment. (The amendment was not offered) H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) H.R. 1588/S.740, Medicare Drug Savings Act - Would require drug manufacturers to provide rebates for durgs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill) Discussed the Medicare Adult Day Services Act. (no bill) Discussed the Commission on Long-Term Care. H.J.R. 59, Continuing Appropriations Resolution, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. S. 1284, Labor, Health and Human Services Appropriations Act, 2014 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.

Client expense: $2,520,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Council on Disability, Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed family caregiving, long-term care, Older Americans Act, private LTC insurance. (no bill) Discussed Medicaid long-term services and supports. (no bill) Discussed Florida's managed long-term services and supports medicaid waiver and their 1115 waiver proposal. Discussed Senior Navigation and Planning and feedback (S.3684 in 112th Congress/no bill # in 113th Congress). Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship.Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Medicaid managed care and long-term services and supports broadly. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) Discussed the AARP Initiative called "You've Earned a Say". (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill. Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas and Florida managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013.H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship. Discussed comments regarding Medicare and You handbook. (no bill) Discussed cost-sharing for medicaid home and community-based services. (no bill) Discussed CMS information regarding healthcare marketplaces. H.R. 1173, Personalize Your Care Act - Discussed the bill and advance care planning issues. Bill provides coverage for voluntary advance care planning consultations. H. R. 933, Consolidated and Further Continuing Appropriations Act, 2013 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. S. Con. Res. 8, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. H.Con. Res. 25, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.Lobbied on expected "QM" safe harbor amendment. (The amendment was not offered) H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) H.R. 1588/S.740, Medicare Drug Savings Act - Would require drug manufacturers to provide rebates for durgs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill)

Client expense: $2,460,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Council on Disability, Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) S. 1206/H.R. 2190 of 2011, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed family caregiving, Green Houses long-term care, Older Americans Act, Lifespan Respite Care, private LTC insurance. (no bill) Discussed Community Based Care Transitions Program. (no bill) Discussed criminal background check programs. (no bill) Discussed Medicaid long-term services and supports. (no bill) Discussed Florida's managed long-term services and supports medicaid waiver and their 1115 waiver proposal. Discussed Alabama and Money Follows the Person Rebalancing Demostrations. (no bill) Discussed the process regarding 1915(b)(c) medicaid waivers. Discussed caregiving meeting, logistics for and participated in/hosted CMS quarterly. (no bill) Discussed Senior Navigation and Planning and feedback (S.3684 in 112th Congress/no bill # in 113th Congress). Discussed status of implementation of some ACA nursing home provisions regarding nature of facility closure and state nursing home websites. (no bill) Discussed medicare home health family caregiver training. (no bill) Discussed Medicare Reform in a meeting with House Energy and Commerce minority staff. (no bill)Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and communityof care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Medicaid managed care and long-term services and supports broadly. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) Discussed You've Earned a Say. (no bill) Discussed Affordable Care Act Medicaid expansion issues. Discussed Medicaid reform, Medicare-Medicaid "dual eligibles" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill. Discussed Kansas managed long-term services and supports waiver proposal, Administration. Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed the Kansas and Florida managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) Discussed mediare demonstration project replacing standard medicare cards with Smart Card technology. H.R. 574 - The Medicare Physician Payment Innovation Act of 2013.H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship. Discussed comments regarding Medicare and You handbook. (no bill) Discussed cost-sharing for medicaid home and community-based services. (no bill) Discussed CMS information regarding healthcare marketplaces. H.R. 1173, Personalize Your Care Act - Discussed the bill and advance care planning issues. Bill provides coverage for voluntary advance care planning consultations. H.R. 152, Disaster Relief Appropriations Act, 2013 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. H.R. 325, Debt Limit Extension - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline on bill to suspend the public debt limit through May 18, 2013, and to prevent repeal of certain financial and health care-related regulation. H. R. 933, Consolidated and Further Continuing Appropriations Act, 2013 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. S. Con. Res. 8, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. H.Con. Res. 25, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.Lobbied on expected "QM" safe harbor amendment. (The amendment was not offered) oluntary advance care planning consultations.

Client expense: $2,130,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Council on Disability, Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson, H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson, H.R.611 -- BEST PRACTICES Act (Rush) - data security, H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information, H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians, H.R. 1707, Data Accountability and Trust Act (Rush) - data security, H.R. 1841, Data Accountability and Trust Act (Stearns) - data security, H.R. 2576, (Black) - eligibility for health care assistance, H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security, H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions, H.R. 4310, National Defense Authorization Act (McKeon) - TRICARE provisions, H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) - price transparency, H.R. 5817, Eliminate Privacy Notice Confusion Act (Luetkemeyer) - privacy, H.R. 5909, Comprehensive Dental Reform Act (Cummings) - expanded access to dental services, H.R. 6684, Spending Reduction Act (Ryan) - ACA provisions, deficit reduction proposals, H.J.Res. 17, Continuing Appropriations Resolution (Rogers) - temporary appropriations for FY 2013, S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions, S. 1099, HEALTH Act (Blunt) - medical liability reform, S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security, S. 1207, Data Security and Breach Notification Act (Pryor) - data security, S. 1223, Location Privacy Protection Act (Franken) - privacy, S. 1408, Data Breach Notification Act (Feinstein) - data security, S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) - data security, S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees, S. 2111, Cyber Crime Protection Security Act (Leahy) - privacy, S. 3254, National Defense Authorization Act (Levin) - TRICARE provisions, S. 3272, Comprehensive Dental Reform Act (Sanders) - expanded access to dental services, S. 3295, Labor, HHS, Education Appropriations Act (Harkin) - funding for HHS programs and agencies, ACA related amendments, S. 3333, Data Security and Breach Notification Act (Toomey) - data security, S. 3351, Protect Our Health Privacy Act (Franken) - privacy, S. 3414, Cybersecurity Act (Lieberman) - privacy, data security, S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) - privacy

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5, HEALTH Act (Gingrey) IPAB repeal, medical liability reform, McCarran-Ferguson 16. Specific Lobbying Issues (continued): H.R. 452, Medicare Decisions Accountability Act (Roe) IPAB repeal, medical liability reform, McCarran-Ferguson H.R.611 -- BEST PRACTICES Act (Rush) data security H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 4310, National Defense Authorization Act (McKeon) TRICARE provisions H.R. 5800, Health Care Price Transparency Promotion Act (Burgess) price transparency H.R. 5817, Eliminate Privacy Notice Confusion Act (Luetkemeyer) privacy H.R. 5909, Comprehensive Dental Reform Act (Cummings) expanded access to dental services H.R. 6684, Spending Reduction Act (Ryan) ACA provisions, deficit reduction proposals H.J.Res. 17, Continuing Appropriations Resolution (Rogers) temporary appropriations for FY 2013 S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1223, Location Privacy Protection Act (Franken) privacy S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1789, 21st Century Postal Service Act (Lieberman) -- health benefits for postal employees S. 2111, Cyber Crime Protection Security Act (Leahy) privacy S. 3254, National Defense Authorization Act (Levin) TRICARE provisions S. 3272, Comprehensive Dental Reform Act (Sanders) expanded access to dental services S. 3295, Labor, HHS, Education Appropriations Act (Harkin) funding for HHS programs and agencies, ACA related amendments S. 3333, Data Security and Breach Notification Act (Toomey) data security S. 3351, Protect Our Health Privacy Act (Franken) privacy S. 3414, Cybersecurity Act (Lieberman) privacy, data security S. 3432 Identity Theft and Tax Fraud Prevention Act (Nelson/Coburn) privacy Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal Regulatory Descriptions (con't): requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters for 2014; essential health benefits, actuarial value, and accreditation; and other issues relating to health care reform implementation.

Client expense: $2,020,000 · Firm income: Not reported

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

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). H.R.3630, SGR - Discussed physician payment reform. Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. S.3295, the Labor-HHS Appropriations bill for FY 2013 - Lobbied to protect funding for program authorized under the Affordable Care Act, including CMS State Health insurance exchanges, state survey & demonstrations and preventative health. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. H.R. 8, the American Taxpayer Relief Act of 2012 - Lobbied against inclusion of Social Security, Medicare and Medicaid legislation affecting benefit levels or service delivery in any end-of-the-session budget deal, and urged congress to not reduce spending levels below current services levels for various non-security discretionary programs, including Health Care (including Rx, medical research and premium support), Social Security (administrative expenses), Older Americans Act Supportive Service, Nutrition and Caregiver programs, Low Income Home Energy Assistance, Weatherization, Elderly Housing and Transit/Transportation, Legal and Taxpayer Assistance, Consumer and Worker Protections and Postal Services. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles. Discussed Medicaid managed care and long-term services and supports broadly. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) S.2243, Discussed Medicare Better Health Rewards Program. Discussed You've Earned a Say. (no bill) S. 3271, Discussed Equal Access to Medicare Options Act of 2012. H.R. 2925/S.1551, the Medicare Common Access Card Act - Discussed AARP's support of the bipartisan bill. Discussed Affordable Care Act Medicaid expansion issues. Discussed Medicaid reform, Medicare-Medicaid "dual eligibles" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill. Discussed Kansas managed long-term services and supports waiver proposal, Administration. Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill)

Client expense: $2,490,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Energy Regulatory Commission (FERC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). H.R.3630, SGR - Discussed physician payment reform; and discussed the implementation of dual-eligibles as through the implementation of various demonstration projects. Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. S.3295, the Labor-HHS Appropriations bill for FY 2013 - Lobbied to protect funding for program authorized under the Affordable Care Act, including CMS State Health insurance exchanges, state survey & demonstrations and preventative health. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) Discussed methods for fighting additional fraud and waste in Healthcare. (no bill) Discussed Medicare physician payment issues. (no bill) S.2243, Discussed Medicare Better Health Rewards Program. Discussed You've Earned a Say. (no bill) S. 3271, Discussed Equal Access to Medicare Options Act of 2012. H.R. 2925/S.1551, the Medicare Common Access Card Act - Discussed AARP's support of the bipartisan bill. Discussed Affordable Care Act Medicaid expansion issues. Discussed Medicaid reform, Medicare-Medicaid "dual eligibles" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill.

Client expense: $2,720,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Energy Regulatory Commission (FERC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

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

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

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

Implementation of Affordable Care Act HR 452 - Medicare Decisions Accountability Act of 2011 HR 5 - Protecting Access to Health Care Act and Help Efficient, Accessible Low Cost Timely Healthcare Act of 2012 HR 3887 - Retiree Health Coverage Protection Act S 2047 - Student-to-School Nurse Ratio Improvement Act of 2012 HR 2341, S 1273 - Direct Care Job Quality Improvement Act of 2011 HR 3066 - Companionship Exemption Protection Act Proposals to cut Medicare and Medicaid HConRes 112 and amendments - Budget for FY 2013 Fair Labor Standards Act HR 1173 - CLASS Act Program S 2068 - Access to Independent Health Insurance Advisors Act S Amdt 1520 to S 1813 - which would amend the Affordable Care Act HR 2, HR 2576, S 720 - Health Care Reform

Client expense: $730,000 · Firm income: Not reported

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

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES

Implementation of Affordable Care Act Medicare Benefit Redesign HR 2341, S 1273 - Direct Care Job Quality Improvement Act of 2011 HR 3066, S 3230, S 3280 - Companionship Exemption Protection Act Proposals to reform, cut Medicare and Medicaid Fair Labor Standards Act S Res 453 - Sense of Senate on Caring Across Generations S 3187 - Food and Drug User Fee Program HR 436 - Medical Device Tax repeal HR 2, HR 5, HR 2576, HR 1173, S 720 - Health Care Reform Affordable Care Act Medicaid Regulations

Client expense: $670,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). H.R.3630, SGR - Discussed physician payment reform; and discussed the implementation of dual-eligibles as through the implementation of various demonstration projects. Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. S.3295, the Labor-HHS Appropriations bill for FY 2013 - Lobbied to protect funding for program authorized under the Affordable Care Act, including CMS State Health insurance exchanges, state survey & demonstrations and preventative health. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) Discussed methods for fighting additional fraud and waste in Healthcare. (no bill) Discussed Medicare physician payment issues. (no bill) S.2243, Discussed Medicare Better Health Rewards Program. Discussed You've Earned a Say. (no bill) S. 3271, Discussed Equal Access to Medicare Options Act of 2012.

Client expense: $2,740,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Energy, Dept of, Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Energy Regulatory Commission (FERC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed opposition to Florida medicaid waivers (including letter), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; discussed implementation of some Medicaid HCBS provisions. Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Medicaid reform, Medicare-Medicaid "dual eligible" integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed "Medicare Better Health Rewards Program Act of 2012". (no bill) Discussed You've Earned A Say. (no bill) Discussed health disparities. (no bill)

Client expense: $1,950,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Energy, Dept of, Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Energy Regulatory Commission (FERC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of Affordable Care Act HR 452 - Medicare Decisions Accountability Act of 2011 HR 5 - Protecting Access to Health Care Act and Help Efficient, Accessible Low Cost Timely Healthcare Act of 2012 HR 3887 - Retiree Health Coverage Protection Act S 2047 - Student-to-School Nurse Ratio Improvement Act of 2012 HR 2341, S 1273 - Direct Care Job Quality Improvement Act of 2011 HR 3066 - Companionship Exemption Protection Act Proposals to cut Medicare and Medicaid HConRes 112 and amendments - Budget for FY 2013 Fair Labor Standards Act HR 1173 - CLASS Act Program S 2068 - Access to Independent Health Insurance Advisors Act S Amdt 1520 to S 1813 - which would amend the Affordable Care Act HR 2, HR 2576, S 720 - Health Care Reform

Client expense: $720,000 · Firm income: Not reported

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

H.R. 5, HEALTH Act (Gingrey) - IPAB repeal, medical liability reform, McCarran-Ferguson. H.R. 452, Medicare Decisions Accountability Act (Roe) - IPAB repeal, medical liability reform, McCarran-Ferguson. H.R. 1173, Fiscal Responsibility and Retirement Security Act (Boustany) - National Clearinghouse for LTC Information. H.R. 1409, Quality Health Care Coalition Act (Conyers) - antitrust exemption for physicians. H.R. 2576, (Black) - eligibility for health care assistance. H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) - data security. H.R. 2676, Small Business Health Relief Act (Schweikert) - repeal of premium tax and other ACA provisions. S. 1049, Small Business Health Relief Act (Kyl) - repeal of premium tax and other ACA provisions. S. 1099, HEALTH Act (Blunt) - medical liability reform. S. 1151, Personal Data Privacy and Security Act (Leahy) - privacy, data security. S. 1207, Data Security and Breach Notification Act (Pryor) - data security. S. 1408, Data Breach Notification Act (Feinstein) - data security.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2576 - To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. S. 1680 - Rural Hospital and Provider Equity Act of 2011. H.R.3519 - To amend to exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011. H.R.3516 - To amend title XVIII of the Social Security Act with respect to Medicare payment for long-term care hospital services. H.R.3587 - To amend title XIX of the Social Security Act to provide for the application of Medicaid prompt pay requirement to claims for payment for covered items and services furnished by any Medicaid health care entity. H.R.3630 - Temporary Payroll Tax Cut Continuation Act of 2011; and, H.R.3765 - Temporary Payroll Tax Cut Continuation Act of 2011. Pub.L. 112-25 - Budget Control Act of 2011. Joint Select Committee on Deficit Reduction negotiations (Super committee created by Budget Control Act). H.R.2112 - Consolidated and Further Continuing Appropriations Act, 2012.

Client expense: $201,000 · Firm income: Not reported

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

H.R. 2576: To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. S. 1680: Rural Hospital and Provider Equity Act of 2011. H.R.3519: To amend to exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011. H.R.3516: To amend title XVIII of the Social Security Act with respect to Medicare payment for long-term care hospital services. H.R.3587: To amend title XIX of the Social Security Act to provide for the application of Medicaid prompt pay requirement to claims for payment for covered items and services furnished by any Medicaid health care entity. H.R.3630: Temporary Payroll Tax Cut Continuation Act of 2011; and, H.R.3765: Temporary Payroll Tax Cut Continuation Act of 2011. Pub.L. 112-25: Budget Control Act of 2011. Joint Select Committee on Deficit Reduction negotiations (Super committee created by Budget Control Act). H.R.2112: Consolidated and Further Continuing Appropriations Act, 2012.

Client expense: $820,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA)

S. 1738 Repeal health care surtax Amendment 769 to H.R. 2112 H.R. 2576 PPACA subsidy eligibility

Client expense: $44,963 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148) S. 600, Use It or Lose It Act of 2011. S. 660, PATIENTS Act of 2011. S. 668, Health Care Bureaucrats Elimination Act. S. 1042, Medicare Patient Empowerment Act. H.R. 1700, Medicare Patient Empowerment Act. S. 1107, Psoriasis and Psoriatic Arthritis Research, Cure, and Care Act of 2011. H.R. 2033, Psoriasis and Psoriatic Arthritis Research, Cure, and Care Act of 2011. S. 1599, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2012. H.R. 3070, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2012. S. 1699, Prescription Drug Cost Reduction Act. S. 1720, Jobs Through Growth Act. H.R. 3400, Jobs Through Growth Act. H.J. Res 79, Continuing Appropriations Resolution, 2012. H.R. 452, Medicare Decisions Accountability Act of 2011. H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011. H.R. 1744, American Job Protection Act. H.R. 2112, Consolidated and Further Continuing Appropriations Act, 2012 H.R. 2363, Health Care OverUse Reform Today Act (HealthCOURT Act) of 2011. H.R. 2576, To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011. Monitor federal issues and legislation associated with health care policy.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of Patient Protection and Affordable Care Act PL 111-148 and PL 111-152 - Executive Branch actions re this issues. *Funding for HHS programs and agencies - HR 2055, Consolidated Appropriations Act, 2012; S 1599, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2012. *Medical Liability reform - HR 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; S 197, MCAP Act; S 218, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; S 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011. *Data Security - HR 611, BEST PRACTICES Act; HR 1707, Data Accountability and Trust Act; HR 1841, Data Accountability and Trust Act (DATA) of 2011; HR 2577, SAFE Data Act; S 1207, Data Security and Breach Notification Act of 2011; S 1408, Data Breach Notification Act of 2011; S 1535, Personal Data Protection and Breach Accountability Act of 2011. *Antitrust exemption for physicians - HR 1409, Quality Health Care Coalition Act of 2011; HR 1173, Fiscal Responsibility and Retirement Security Act of 2011. *Repeal of premium tax and other ACA provisions - HR 2676, Small Business Health Relief Act of 2011; S 1049, Small Business Health Relief Act of 2011. *Repeal of 3 percent withholding rate - HR 674, To amend the Internal Revenue Code of 1986 to repeal the imposition of 3 percent withholding on certain payments made to vendors by government entities. *Privacy, data security - S 1151, Personal Data Privacy and Security Act of 2011. *Eligibility for healthcare assistance - HR 2576, To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs; HR 2055, Consolidated Appropriations Act, 2012.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5, HEALTH Act (Gingrey) medical liability reform, H.R.611 -- BEST PRACTICES Act (Rush) data security, H.R. 674, (Herger) repeal of 3 percent withholding rule, eligibility for health care assistance, H.R. 1173, Fiscal Responsibility 16. Specific Lobbying Issues (con't): and Retirement Security Act (Boustany) National Clearinghouse for LTC Information H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2055, Consolidated Appropriations Act funding for HHS programs and agencies H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions S. 197, Medical Care Access Protection Act (Ensign) medical liability reform S. 218, HEALTH Act (Ensign) medical liability reform S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1599, Labor-HHS-Education Appropriations Act (Harkin) funding for HHS programs and agencies HCR (Regulatory Issues): HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers and enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements ; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues related to genetics and genetic nondiscrimination; issues relating to mental health parity; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues relating to Form 5500 reporting requirements, including the application of service provider contract rules; medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; internal claims and appeals and external review processes; coverage of preventive services; pre-existing condition exclusions; lifetime and annual dollar limits on benefits rescissions; patient protections; grandfathered health plan provisions; issues related to privacy, security, and other regulation of the Internet and electronic commerce; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; dependent coverage; and other issues relating to health care reform implementation. 18. Name of each individual who acted as a lobbyist in this issue area (con't): J. Miller, Legislative Counsel, Washington, D.C. Assistant Legislative Counsel, August 1992 December 1995.

Client expense: $2,750,000 · Firm income: Not reported

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

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace (no bill). Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed transitional care demonstration program. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148) Lobbied in support of draft legislation that would grant individuals whose COBRA has expired the same Medicare Part B enrollment rights as those who have group coverage. (no bill) S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services. Consolidated Appropriations Act, FY 2012, H.R. 2055, H.R. 3671, H.R. 2017, Consolidated and Further Appropriations Continuing Appropriations Act, H.R. 2112, Continuing Resolution, FY 2012, H.R. 2608 and H.J. Res. 79, 94 and 95 - Lobbied for funding for agencies and programs within jurisdiction of the Labor-HHS Appropriations bill (H.R. 3055/S. 1599), including Social Security Administration operations, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs, high risk pool subsidies to states and Medicaid. Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed implementation of Anti-Fraud Measures of Affordable Care Act (PL. 111-148), including coordination between HHS, DOJ and state Attorneys General. Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed medicare physician payment issues. (no bill) Discussed durable medical equipment bidding. (no bill) H.R. 1654, Medicare Enrollment Protection Act - Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B. H.R. 978, To amend Title II of the Social Security Act - Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. H.R. 1683, State Flexibility Act - Lobbied against H.R. 1683, a bill that would eliminate the Medicaid Maintenance of Effort (MOE) requirement included as a part of the Affordable Care Act. S. 1206/H.R. 2190, The Medicare Drug Savings Act of 2011 - Discussed legislation to require prescription drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act - Discussed support to curb waste and fraud from the Medicare and Medicaid programs. S. 1275, The Medicare and Medicaid FAST Act - Lobbied on legislation to prevent fraud and abuse within the federal health programs. S. 1206/H.R. 2190, The Medicare Drug Savings Act - Discussed legislation that would establish Medicaid drug rebates for the duals. Medicare physician reimbursement issues. (no bill) S. 365, Budget Control Act - Lobbied Congress against cuts to Medicare and Medicaid in the Super Committee debate and where savings could be found without harming beneficiaries. Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Medicare Physician Payment Reform. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed Senior Navigation and Planning Act. (no bill) Discussed no entitlement cuts press event. (no bill) Discussed focus groups on dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, invited staff to speak at meetings on Medicaid home and community-based services (HCBS), Medicaid managed long-term services and supports, and state oversight of Medicaid managed care, discussed opposition to Florida medicaid waivers (including letter), inquired on status of a Medicaid waiver and questions regarding implementation of some Medicaid HCBS provisions, discussed workforce issues in relation to Innovation Center work, inquired re: status of 1115 waiver transparency regulations, shared information on family caregiver makeover events (education), discussed home and community setting issue in Medicaid, discussed focus groups on dual eligibles; comment letter on Medicaid Program Eligibility Changes under the Affordable Care Act (PL 111-148). Discussed Medicaid managed care and long-term services and supports broadly, discussed CLASS Program. Discussed Fair Labor Standards Act and companionship exemption. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed inviting FTC to participate in a webinar on how they are and can be engaged on state scope of practice issues. Also sent follow-up items for their review. (no bill)

Client expense: $2,740,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Energy, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), Federal Energy Regulatory Commission (FERC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, White House Office

H.R. 2576: To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. S. 1680: Rural Hospital and Provider Equity Act of 2011. H.R.3519: To amend to exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011. H.R.3516: To amend title XVIII of the Social Security Act with respect to Medicare payment for long-term care hospital services. H.R.3587: To amend title XIX of the Social Security Act to provide for the application of Medicaid prompt pay requirement to claims for payment for covered items and services furnished by any Medicaid health care entity. H.R.3630: Temporary Payroll Tax Cut Continuation Act of 2011; and, H.R.3765: Temporary Payroll Tax Cut Continuation Act of 2011. Pub.L. 112-25: Budget Control Act of 2011. Joint Select Committee on Deficit Reduction negotiations (Super committee created by Budget Control Act). H.R.2112: Consolidated and Further Continuing Appropriations Act, 2012.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA)

H.R. 674 - To amend the Internal Revenue Code of 1986 to repeal the imposition of 3 percent withholding on certain payments made to vendors by government entities H.R. 1726 - Child Care Protection Act of 2011 H.R. 2112 - Consolidated and Further Continuing Appropriations Act, 2012 H.R. 2576 To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs H.R. 3091 To make permanent the individual income tax rates for capital gains and dividends H.R. 3307 American Renewable Energy Production Tax Credit Extension Act of 2011 S. 89 Withholding Tax Relief Act of 2011 S. 164 Withholding Tax Relief Act of 2011 S. 166 Good Samaritan Hunger Relief Tax Incentive Extension Act of 2011 S. 700 A bill to amend the Internal Revenue Code of 1986 to permanently extend the treatment of certain farming business machinery and equipment as 5-year property for purposes of depreciation S. 1647 A bill to repeal the sunset on the reduction of capital gains rates for individuals and on the taxation of dividends of individuals at capital gain rates S. 1747 Computer Professionals Update Act S. 1880 Jobs and Premium Protection Act Agricultural Equipment Depreciation 3 Percent Withholding Tax Estate Tax Health Insurance Tax (HIT) Capital Gains Dividends Biodiesel and Renewable Diesel Tax Credit Small Agri-Biodiesel Producer Credit Diesel Fuel Created from Biomass Tax Credit Volumetric Ethanol Excise Tax Credit (VEETC) Small Producer Ethanol Tax Credit Excise Tax Credits for Alternative Fuel Alternative Refueling Property Tax Credit Alternative Minimum Tax Exemption Bonus Depreciation for Investments for Businesses Section 179 Small Business Expensing Deduction of state and local general sales taxes in lieu of the itemized deduction Provision Encouraging Donations of Conservations Easements Above-the-Line Deduction for Education Expenses Fifty Percent Railroad Track Maintenance Credit for Short Line Railroads Enhanced Deduction for Donated Food Unrelated Business Income Tax (UBIT)

Client expense: $520,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)

H.R. 5, HEALTH Act (Gingrey) medical liability reform H.R.611 -- BEST PRACTICES Act (Rush) data security H.R. 674, (Herger) repeal of 3 percent withholding rule H.R. 1409, Quality Health Care Coalition Act (Conyers) antitrust exemption for physicians H.R. 1707, Data Accountability and Trust Act (Rush) data security H.R. 1841, Data Accountability and Trust Act (Stearns) data security H.R. 2576, (Black) eligibility for health care assistance H.R. 2577, Secure and Fortify Electronic Data Act (Bono Mack) data security H.R. 2676, Small Business Health Relief Act (Schweikert) repeal of premium tax and other ACA provisions H.R. 3070, Labor-HHS-Education Appropriations Act (Rehburg) funding for HHS programs and agencies S. 197, Medical Care Access Protection Act (Ensign) medical liability reform S. 218, HEALTH Act (Ensign) medical liability reform S. 365, Budget Control Act of 2011 Medicare, Medigap, Medicaid, ACA issues S. 1049, Small Business Health Relief Act (Kyl) repeal of premium tax and other ACA provisions S. 1099, HEALTH Act (Blunt) medical liability reform S. 1151, Personal Data Privacy and Security Act (Leahy) privacy, data security S. 1207, Data Security and Breach Notification Act (Pryor) data security S. 1408, Data Breach Notification Act (Feinstein) data security S. 1535, Personal Data Protection and Breach Accountability Act (Blumenthal) data security S. 1599, Labor-HHS-Education Appropriations Act (Harkin) funding for HHS programs and agencies HCR (Regulatory Issues): HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers and enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements ; transition from the similarly sized subscriber group (SSSG) requirement to an MLR; OPM data warehouse; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues related to genetics and genetic nondiscrimination; issues relating to mental health parity; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues relating to Form 5500 reporting requirements, including the application of service provider contract rules; medical loss ratios; review of rates for reasonableness; health insurance exchanges; preexisting condition insurance plans; accountable care organizations; internal claims and appeals and external review processes; coverage of preventive services; pre-existing condition exclusions; lifetime and annual dollar limits on benefits rescissions; patient protections; grandfathered health plan provisions; issues related to privacy, security, and other regulation of the Internet and electronic commerce; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; dependent coverage; and other issues relating to health care reform implementation.

Client expense: $2,350,000 · Firm income: Not reported

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

*Funding for HHS programs and agencies - HR 3070, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2012, and for other purposes; S 1599, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2012. *Medical Liability reform - HR 5, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; S 197, MCAP Act; S 218, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; S 1099, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011. *Data Security - HR 611, BEST PRACTICES Act; HR 1707, Data Accountability and Trust Act; HR 1841, Data Accountability and Trust Act (DATA) of 2011; HR 2577, SAFE Data Act; S 1207, Data Security and Breach Notification Act of 2011; S 1408, Data Breach Notification Act of 2011; S 1535, Personal Data Protection and Breach Accountability Act of 2011. *Antitrust exemption for physicians - HR 1409, Quality Health Care Coalition Act of 2011. *Repeal of premium tax and other ACA provisions - HR 2676, Small Business Health Relief Act of 2011; S 1049, Small Business Health Relief Act of 2011. *Repeal of 3 percent withholding rate - HR 674, To amend the Internal Revenue Code of 1986 to repeal the imposition of 3 percent withholding on certain payments made to vendors by government entities. *Privacy, data security - S 1151, Personal Data Privacy and Security Act of 2011. *Eligibility for healthcare assistance - HR 2576, To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. *Medicare, Medigap, Medicaid, ACA issues - S 365, Budget Control Act of 2011.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5 Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act H.R. 2500 Equal Access and Parity for Multi-campus Hospitals Act S. 1404 Medical Flexible Spending Account Improvement Act S. 1395 WAIVE Act H.R. 1206 Access to Professional Health Insurance Advisors Act of 2011 H.R. 2576 To amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs S. 1376 A bill to conform income calculations for purposes of eligibility for the refundable credit for coverage under a qualified health plan and for Medicaid to existing Federal low-income assistance programs H.R. 2363 Health Care OverUse Reform Today Act H.R. 2577 SAFE Data Act S. 1207 Data Security and Breach Notification Act of 2011 H.R. 2795 FIT For Life Act H.R. 2649 Personal Health Invest Today Act of 2011 S. 1370 Afterschool for Americas Children Act S. Res 256 National Nurse Managed Care Week H.R. 2729 Health IT Modernization for Underserved Communities Act of 2011 H.R. 1852 Childrens Hospital GME Support Reauthorization Act of 2011 H.R. 2832 Trade Adjustment Assistance Extension Act of 2011 S. 1535 Personal data Protection and Breach Accountability Act of 2011

Client expense: $22,000 · Firm income: Not reported

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