Medigap Medical Loss Ratio Improvement Act

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed support for H.R. 2181, Safe Foods for Seniors Act of 2013. Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm Bill. S. 562, Seniors Mental Health Access Improvement Act - Discussed the bill for eventual endorsement. Discussed Care Corps. (no bill) Discussed grandparents raising grandchildren and ACA provision extending coverage to those under age 26. (no bill) Discussed need to suport family caregivers and long-term services and supports. (no bill) Discussed repeal of medical device tax. (no bill) Discussed consumer directed care. (no bill) Discussed policy related to dementia. (no bill) Discussed no wrong door system. (no bill) Discussed data on LTSS and women. (no bill)Discussed FTC participation in state scope of practice issues. Also sent follow-up items for their review. (no bill) Discussed Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, payroll tax holiday extension, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) PL 112-240 of 2012, American Taxpayer Relief Act - Discussed the Commission on Long-Term Care and and service delivery workforce and caregiving, financing and related long-term care issues and data. Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. 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/ 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. H.R. 1549, Helping Sick Americans Now Act - Discussed cuts to the health care prevention fund. S. 1284, The Labor, Health and Human Services Appropriations Act, 2014 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid, Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed perspectives on proposed ideas for legislation to address health disparities with HHS and CMS officials. H.J.R. 59/H.R. 2775, Continuing Appropriations Act, 2014 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance.

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

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) Discussed support for H.R. 2181, Safe Foods for Seniors Act of 2013. Discussed S.1119, Positive Aging Act of 2013. H.R. 2641, Farm Program bill-Discussed the severed nutrition programs from Farm 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 Medicare and Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, payroll tax holiday extension, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid flexibility and Medicaid structural reforms to. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations and other CMS demonstration initiatives. (no bill) PL 112-240 of 2012, American Taxpayer Relief Act - Discussed the Commission on Long-Term Care and and service delivery workforce and caregiving, financing and related long-term care issues and data. Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. 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/ 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. H.R. 1549, Helping Sick Americans Now Act - Discussed cuts to the health care prevention fund. S. 1284, The Labor, Health and Human Services Appropriations Act, 2014 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) H.R. 1263, Excellence in Mental Health Act - Discussed the bill for eventual endorsement. Discussed Affordable Care Act Medicaid expansion issues, including AARP comments on state 1115 waiver proposals to use premium assistance authority to expand Medicaid. (no bill)

S.452, Medicare Diabetes Prevention Act - Discussed bill with Senate. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform (no bill) Discussed Age Rating in the ACA and rate shock. (no bill)Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund, is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (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 Medicare and Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, payroll tax holiday extension, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicaid including concerns over cuts to Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations and other CMS demonstration initiatives. (no bill) H.R. 8/PL 112-240 of 2012, American Taxpayer Relief Act - Discussed the establishment of the Commission on Long-Term Care and process related to the Commission. Discussed Senate amendment 99 to H.R. 933, the Consolidated and Further Continuing Appropriations Act (PL 113-6). Also made changes to Commission on Long-Term Care. Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. 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/ 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. H.R. 1549, Helping Sick Americans Now Act - Discussed cuts to the health care prevention fund. The Labor, Health and Human Services Appropriations Act, 2014 - Lobbied to protect employment, health and human services and energy assistance programs for seniors, disabled and low income assistance. (no bill) Discussed Affordable Care Act Medicaid expansion issues, including questions related to the use of premium assistance authority to expand Medicaid. (no bill) Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill)

S.452, Medicare Diabetes Prevention Act - Discussed bill with Sen. Franken's staff. Discussed draft language on senior mental health with Senate HELP Committee staff. (no bill) Discussed Medicare Reform in meeting with House Energy and Commerce minority staff. (no bill) Discussed Age Rating in the ACA and rate shock in meeting with House Energy and Commerce minority staff. (no bill)Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) H.R. 1099, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645 (112th Congress), Medigap Medical Loss Ratio Improvement Act of 2011. Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) S.3295, the Labor-HHS Appropriations bill for FY 2013 - Lobbied to protect/increase funding for the Social Security Administration, Older Americans Act nutrition, family caregiver & supportive services programs, low income home energy assistance (LIHEAP), and to protect funding for program authorized under the Affordable Care Act, including CMS State Health insurance exchanges, state survey & demonstrations and preventive Care Act, including CMS State Health insurance exchanges, state survey and demonstrations and preventive health. 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. H.R. 963, Discussed, Coordination of Pro Bono Medically Recommended Dental Care Act of 2013.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 Medicare and Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed deficit reduction issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, payroll tax holiday extension, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140). Discussed Medicare and Medicaid including concerns over increasing Medicare's age of eligibility and cuts to Medicaid. (no bill) Discussed Affordable Care Act Medicaid expansion issues. Discussed Medicare-Medicaid integration efforts and financial alignment demonstrations and other CMS demonstration initiatives. (no bill) H.R. 8/PL 112-240 of 2012, American Taxpayer Relief Act - Discussed repeal of CLASS Program and the establishment of the Commission on Long-Term Care. H.R. 8/PL 112-240 of 2012, American Taxpayer Relief Act - Discussed a nomination for appointment to the Commission on Long-Term Care and process related to the Commission. Discussed Senate amendment 99 to H.R. 933, the Consolidated and Further Continuing Appropriations Act (PL 113-6). Also made changes to Commission on Long-Term Care. Discussed implementation of the Affordable Care Act, its provisions and H.R. 95 to repeal the Patient Protection and Affordable Care Act. 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. Discussed evaluation of the Independence at Home Demonstration and it's implementation (CMS). (no bill)

House FY 13 Budget (H.Con.Res. 112) Mental Health in Schools Act (H.R. 751) Labor, Health and Human Services, and Education, and Related Agencies FY 12 Appropriations Act (S.1599/H.R.3070) Behavioral Health Information Technology Act of 2011 (S. 539/H.R. 6043)Healthy Lifestyles and Prevention America Act (S.174) Medicare Mental Health Access Act (S.483) Seniors Mental Health Access Improvement Act of 2011 (S.604) Medicare Mental Health Inpatient Equity Act (S.374) A Bill To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges (HR 1213) A Bill To repeal mandatory funding for school-based health center construction (HR 1214) A Bill To repeal the Prevention and Public Health Fund (HR 1217) Patients Rights Repeal Act (H.R. 2) Medicaid Maintenance-Of-Effort Repeal (H.R.1683/S. 868) The Garrett Lee Smith Memorial Act (GLSMA) Reauthorization of 2011 (S. 740) The Sergeant Coleman S. Bean Reserve Component Suicide Prevention Act (H.R. 1089/S. 579) The Keeping All Students Safe Act (H.R. 1381/S.2020) The Ryan Creedon Act of 2011 (H.R. 2119) Mental Health on Campus Improvement Act, H.R. 1833 Constitutional Balanced Budget Amendment (H.J.Res. 1/S.J.Res. 23) Agriculture FY12 Appropriations (HR 2112) Military/Veterans FY12 Appropriations (HR 2055) Medicare Decisions Accountability Act of 2011 (IPAB; HR 452/S. 668) Cap, Cut and Balance Bill (HR 2560/S. 1340) CAMPUS Safety Act of 2011 (HR 2342) Health Equity and Accountability Act of 2011 (H.R.2954) Continuing Appropriations Act, 2012 (HR 2608) Medigap Medical Loss Ratio Improvement Act (S.1416/H.R.2645) Improving Access to Medicare Coverage Act of 2011 (S.818) Stop Child Abuse in Residential Programs for Teens Act of 2011 (H.R.3126) Commerce/Justice/State FY12 Appropriations Act (HR.2596/S.1572) Promoting Accountability and Excellence in Child Welfare Act (S. 1509) Lifespan Respite Reauthorization Act (HR 3266) Consolidated FY2012 Appropriations Act (was Military/Veterans; HR 2055) Children's Budget Act (S.1396) Middle Class Tax Cut Act of 2011 (H.R. 3630) Speak Up Act Letter of Support (S. 1877) Reauthorization of Drug-Free Communities Support Program (S. 2159) WIPA and PABSS Continuation of Services Act of 2012 (H.R.6061) The Childrens Mental Health Accessibility Act (S. 3289) Departments of Labor, Health and Human Services, and Education Appropriations Act, 2013 (S.3295) Military/Veterans FY13 Appropriations (H.R. 5854/S. 3215) Excellence in Mental Health (S. 2257/H.R. 5989) Mental Health First Aid Higher Education Act (S. 3325/H.R. 5996) Health Equity and Accountability Act (HEAA) of 2012 (S. 2474) Pharmaceutical Stewardship Act of 2011 (H.R. 2939) Food and Drug Administration Reform Act of 2012 (H.R. 5651/S. 3187) Mental Health ACCESS Act of 2012 (S. 3340) Medicaid Information Technology to Enhance Community Health Act of 2012 (S.3539) Recidivism Reduction Act (H.R.6256) To provide payment for patient navigator services under title XIX of the Social Security Act (H.R.6521) 21st Century Language Act of 2012 (S. 2367) Continuing Appropriations Act (through 3/27/2013), HJRes117 Averting the Fiscal Cliff Act/American Taxpayer Relief Act of 2012 (H.R. 8/H.R. 6688) To establish and operate a National Center for Campus Public Safety (H.R.6691) CAMPUS Safety Act of 2012 (S.3682) A bill to provide grants to establish veteran's treatment courts (S.3702)Training of mental health counselors for members of the Armed Forces, veterans, and their families. (S.3254) To improve mental health care programs and activities for members of the Armed Forces and veterans. ( S.3254) Servicemember Mental Health Review Act (H.R.6574)

House FY 13 Budget (H.Con.Res. 112) Mental Health in Schools Act (H.R. 751) Medicaid Maintenance-Of-Effort Repeal (H.R.1683/S. 868) Behavioral Health Information Technology Act of 2011 (S. 539/H.R. 6043)Healthy Lifestyles and Prevention America Act (S.174) Medicare Mental Health Access Act (S.483) Seniors Mental Health Access Improvement Act of 2011 (S.604) Medicare Mental Health Inpatient Equity Act of 2011 (S.374/H.R.2783) CAP Act of 2011 (H.R. 1605/S. 245) Constitutional Balanced Budget Amendment (H.J.Res. 1/S.J.Res. 23) Mental Health on Campus Improvement Act, H.R. 1833 Medicare Decisions Accountability Act of 2011 (HR 452/S 668) Cap, Cut and Balance Bill (HR 2560/S. 1340) Health Equity and Accountability Act of 2011 (H.R.2954) Continuing Appropriations Act, 2012 (HR 2608) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2012 (S.1599/H.R.3070) Medigap Medical Loss Ratio Improvement Act (S.1416/H.R.2645) Improving Access to Medicare Coverage Act of 2011 (S.818) Consolidated FY2012 Appropriations Act (was Military/Veterans; HR 2055) Excellence in Mental Health Act (S.2257) Children's Budget Act (S.1396) Middle Class Tax Cut Act of 2011 (H.R.3630) Speak Up Act Letter of Support (S. 1877) WIPA and PABSS Continuation of Services Act of 2012 (H.R. 6061) The Childrens Mental Health Accessibility Act (S.3289) Departments of Labor, Health and Human Services, and Education Appropriations Act, 2013 (S.3295) Excellence in Mental Health (S. 2257/H.R.5989) Mental Health First Aid Higher Education Act (S. 3325/H.R.5996) Health Equity and Accountability Act (HEAA) of 2012 (S.2474) Mental Health ACCESS Act of 2012 (S.3340) Medicaid Information Technology to Enhance Community Health Act of 2012 (S.3539) Recidivism Reduction Act (H.R.6256) To provide payment for patient navigator services under title XIX of the Social Security Act (H.R.6521) Continuing Appropriations Act (through 3/27/2013), HJRes117 Averting the Fiscal Cliff Act/American Taxpayer Relief Act of 2012 (H.R. 8/H.R. 6688)

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) - LTC insurance reforms, H.R. 111, Breast Cancer Patient Protection Act (DeLauro) - minimum hospital stays for mastectomy patients, H.R. 346, Health Care Choice Act (Pearce ) - national marketplace for individual coverage, H.R.371, Health Care Choice Act (Blackburn) - national marketplace for individual coverage, H.R. 416, Health Insurance Rate Review Act (Schakowsky) - rate review, H.R. 1050, Small Business Health Fairness Act (Johnson) - association health plans, H.R. 1150, Competitive Health Insurance Reform Act (Gosar) - antitrust policy, H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) - agent commissions, medical loss ratios, H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) - changes to McCarran-Ferguson Act, H.R. 2077, MLR Repeal Act (Price) - medical loss ratios, H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) - MLRs for Medigap policies, H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) - disability program for federal employees, H.R. 5838, Health Insurance Industry Antitrust Enforcement Act (Conyers) - changes to McCarran-Ferguson Act, H.R.6283, Guaranteed Access to Health Insurance Act (Burgess) - reinsurance, high risk pools, S. 137, Health Insurance Rate Review Act (Feinstein) - rate review, S. 159, Confidence in Long-Term Care Insurance Act (Kohl) - LTC insurance reforms S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) - MLRs for Medigap policies, S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) - enrollment period for child-only policies, S. 2068, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) - agent commissions, medical loss ratios, S. 2288, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) - agent commissions, medical loss ratios, S. 3229, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) -- model disclosure form for marketing long-term care insurance policies, S. 3230, Long-Term Care Integrity Act (Klobuchar) -- claims dispute resolution procedures, S. 3271, Equal Access to Medicare Options Act (Kerry) - Medigap provisions, MA enrollment provisions.

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) LTC insurance reforms 16. Specific Lobbying Issues (continued): H.R. 111, Breast Cancer Patient Protection Act (DeLauro) minimum hospital stays for mastectomy patients H.R. 346, Health Care Choice Act (Pearce ) national marketplace for individual coverage H.R.371, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 416, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1050, Small Business Health Fairness Act (Johnson) association health plans H.R. 1150, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) agent commissions, medical loss ratios H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) changes to McCarran-Ferguson Act H.R. 2077, MLR Repeal Act (Price) medical loss ratios H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) MLRs for Medigap policies H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) disability program for federal employees H.R. 5838, Health Insurance Industry Antitrust Enforcement Act (Conyers) changes to McCarran-Ferguson Act H.R.6283, Guaranteed Access to Health Insurance Act (Burgess) reinsurance, high risk pools S. 137, Health Insurance Rate Review Act (Feinstein) rate review S. 159, Confidence in Long-Term Care Insurance Act (Kohl) LTC insurance reforms S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) MLRs for Medigap policies S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) enrollment period for child-only policies S. 2068, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) agent commissions, medical loss ratios S. 2288, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) agent commissions, medical loss ratios S. 3229, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) -- model disclosure form for marketing long-term care insurance policies S. 3230, Long-Term Care Integrity Act (Klobuchar) -- claims dispute resolution procedures S. 3271, Equal Access to Medicare Options Act (Kerry) Medigap provisions, MA enrollment provisions Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; and other issues relating to health care reform implementation.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Lobbied on preserving funding for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles. (no bill) S.3295, the Labor-HHS Appropriations bill for FY 2013 - Lobbied to protect/increase funding for the Social Security Administration, Older Americans Act nutrition, family caregiver & supportive services programs, low income home energy assistance (LIHEAP), and to protect funding for program authorized under the Affordable Care Act, including CMS State Health insurance exchanges, state survey & demonstrations and preventive Care Act, including CMS State Health insurance exchanges, state survey and demonstrations and preventive health. 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 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 Medicare GNE demonstration design problems. 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 Medicare and Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill) Discussed fiscal cliff issues dealing with Medicare and Medicaid including concerns over increasing Medicare's age of eligibility, chained CPI, payroll tax holiday extension, and cuts to Medicaid. (no bill) Discussed Affordable Care Medicaid expansion issues. Centers for Medicare and Medicaid Services, Center for Medicaid and CHIP Services. Discussed Medicaid reform, Medicare-Medicaid integration efforts and financial alignment demonstrations, other CMS demonstration initiatives. (no bill) Discussed Medicaid expansion implementation, as included in the ACA (P.L. 111-140).

House FY 13 Budget (H.Con.Res. 112) Mental Health in Schools Act (H.R. 751) Labor, Health and Human Services, and Education, and Related Agencies FY 12 Appropriations Act (S.1599/H.R.3070) Behavioral Health Information Technology Act of 2011 (S. 539/H.R. 6043) Healthy Lifestyles and Prevention America Act (S.174) Medicare Mental Health Access Act (S.483) Seniors Mental Health Access Improvement Act of 2011 (S.604) Medicare Mental Health Inpatient Equity Act (S.374) A Bill To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges (HR 1213) A Bill To repeal mandatory funding for school-based health center construction (HR 1214) A Bill To repeal the Prevention and Public Health Fund (HR 1217) Patients Rights Repeal Act (H.R. 2) Medicaid Maintenance-Of-Effort Repeal (H.R.1683/S. 868) The Garrett Lee Smith Memorial Act (GLSMA) Reauthorization of 2011 (S. 740) The Sergeant Coleman S. Bean Reserve Component Suicide Prevention Act (H.R. 1089/S. 579) The Keeping All Students Safe Act (H.R. 1381/S.2020) The Ryan Creedon Act of 2011 (H.R. 2119) Mental Health on Campus Improvement Act, H.R. 1833 Constitutional Balanced Budget Amendment (H.J.Res. 1/S.J.Res. 23) Agriculture FY12 Appropriations (HR 2112) Military/Veterans FY12 Appropriations (HR 2055) Medicare Decisions Accountability Act of 2011 (IPAB; HR 452/S. 668) Cap, Cut and Balance Bill (HR 2560/S. 1340) CAMPUS Safety Act of 2011 (HR 2342) Health Equity and Accountability Act of 2011 (H.R.2954) Continuing Appropriations Act, 2012 (HR 2608) Medigap Medical Loss Ratio Improvement Act (S.1416/H.R.2645) Improving Access to Medicare Coverage Act of 2011 (S.818) Stop Child Abuse in Residential Programs for Teens Act of 2011 (H.R.3126) Commerce/Justice/State FY12 Appropriations Act (HR.2596/S.1572) Promoting Accountability and Excellence in Child Welfare Act (S. 1509) Lifespan Respite Reauthorization Act (HR 3266) Consolidated FY2012 Appropriations Act (was Military/Veterans; HR 2055) Children's Budget Act (S.1396) Middle Class Tax Cut Act of 2011 (H.R. 3630) Speak Up Act Letter of Support (S. 1877) Reauthorization of Drug-Free Communities Support Program (S. 2159) WIPA and PABSS Continuation of Services Act of 2012 (H.R.6061) The Childrens Mental Health Accessibility Act (S. 3289) Departments of Labor, Health and Human Services, and Education Appropriations Act, 2013 (S.3295) Military/Veterans FY13 Appropriations (H.R. 5854/S. 3215) Excellence in Mental Health (S. 2257/H.R. 5989) Mental Health First Aid Higher Education Act (S. 3325/H.R. 5996) Health Equity and Accountability Act (HEAA) of 2012 (S. 2474) Pharmaceutical Stewardship Act of 2011 (H.R. 2939) Food and Drug Administration Reform Act of 2012 (H.R. 5651/S. 3187) Mental Health ACCESS Act of 2012 (S. 3340) Medicaid Information Technology to Enhance Community Health Act of 2012 (S.3539) Recidivism Reduction Act (H.R.6256) To provide payment for patient navigator services under title XIX of the Social Security Act (H.R.6521)

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) - LTC insurance reforms. H.R. 111, Breast Cancer Patient Protection Act (DeLauro) - minimum hospital stays for mastectomy patients. H.R. 346, Health Care Choice Act (Pearce ) - national marketplace for individual coverage. H.R.371, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 416, Health insurance Rate Review Act (Schakowsky) - rate review. H.R. 1050, Small Business Health Fairness Act (Johnson) - association health plans. H.R. 1150, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) - agent commissions, medical loss ratios. H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) - changes to McCarran-Ferguson Act. H.R. 2077, MLR Repeal Act (Price) - medical loss ratios. H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) - MLRs for Medigap policies. H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) - disability program for federal employees. H.R. 5838, Health Insurance Industry Antitrust Enforcement Act (Conyers) - changes to McCarran-Ferguson Act. H.R.6283, Guaranteed Access to Health Insurance Act (Burgess) - reinsurance, high risk pools. S. 137, Health Insurance Rate Review Act (Feinstein) - rate review. S. 159, Confidence in Long-Term Care Insurance Act (Kohl) - LTC insurance reforms. S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) - MLRs for Medigap policies. S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) - enrollment period for child-only policies. S. 2068, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) - agent commissions, medical loss ratios. S. 2288, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) - agent commissions, medical loss ratios. S. 3229, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) -- model disclosure form for marketing long-term care insurance policies. S. 3230, Long-Term Care Integrity Act (Klobuchar) -- claims dispute resolution procedures. S. 3271, Equal Access to Medicare Options Act (Kerry) - Medigap provisions, MA enrollment provisions.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Lobbied on preserving fund for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed dual eligibles with Medpac. (no bill) S.3295, the Labor-HHS Appropriations bill for FY 2013 - Lobbied to protect/increase funding for the Social Security Administration, Older Americans Act nutrition, family caregiver & supportive services programs, low income home energy assistance (LIHEAP), and to protect funding for program authorized under the Affordable Care Act, including CMS State Health insurance exchanges, state survey & demonstrations and preventive Care Act, including CMS State Health insurance exchanges, state survey and demonstrations and preventive health. 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 Medicare GNE demonstration design problems. 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 Medicare and Social Security programs. (no bill) Lobbied against cuts to the health care prevention fund. (no bill)

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) LTC insurance reforms 16. Specific Lobbying Issues (continued): H.R. 111, Breast Cancer Patient Protection Act (DeLauro) minimum hospital stays for mastectomy patients H.R. 346, Health Care Choice Act (Pearce ) national marketplace for individual coverage H.R.371, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 416, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1050, Small Business Health Fairness Act (Johnson) association health plans H.R. 1150, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) agent commissions, medical loss ratios H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) changes to McCarran-Ferguson Act H.R. 2077, MLR Repeal Act (Price) medical loss ratios H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) MLRs for Medigap policies H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) disability program for federal employees H.R. 5838, Health Insurance Industry Antitrust Enforcement Act (Conyers) changes to McCarran-Ferguson Act H.R.6283, Guaranteed Access to Health Insurance Act (Burgess) reinsurance, high risk pools S. 137, Health Insurance Rate Review Act (Feinstein) rate review S. 159, Confidence in Long-Term Care Insurance Act (Kohl) LTC insurance reforms S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) MLRs for Medigap policies S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) enrollment period for child-only policies S. 2068, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) agent commissions, medical loss ratios S. 2288, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) agent commissions, medical loss ratios S. 3229, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) -- model disclosure form for marketing long-term care insurance policies S. 3230, Long-Term Care Integrity Act (Klobuchar) -- claims dispute resolution procedures S. 3271, Equal Access to Medicare Options Act (Kerry) Medigap provisions, MA enrollment provisions Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; and other issues relating to health care reform implementation.

Health insurance taxes included in Patient Protection and Affordable Care Act - HR 1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act; proposed legislation re this issue. Repeal IAPB provisions sof PL 111-148, PL 111-152 - HR 5, Protecting Access to Healthcare Act; HR 452, Medicare Decisions Accountability Act of 2011; S 2118, Health Care Bureaucrats Elimination Act. Funding for HHS programs and agencies - HJRes 17, Continuing Appropriations Resolution, 2013; S 3295, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013; proposed legislation re this issue. Proposed changes to PPACA, PL 111-148, PL 111-152, involving medical loss ratio - HR 1206, Access to Professional Health Insurance Advisors Act of 2011; HR 2077, MLR Repeal Act of 2011; HR 2645, Medigap Medical Loss Ratio Improvement Act.

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

Government targets: HOUSE OF REPRESENTATIVES

House FY 13 Budget (H.Con.Res. 112) Mental Health in Schools Act (H.R. 751) Labor, Health and Human Services, and Education, and Related Agencies FY 12 Appropriations Act (S.1599/H.R.3070) Behavioral Health Information Technology Act of 2011 (S. 539/H.R. 6043) Healthy Lifestyles and Prevention America Act (S.174) Medicare Mental Health Access Act (S.483) Seniors Mental Health Access Improvement Act of 2011 (S.604) Medicare Mental Health Inpatient Equity Act (S.374) A Bill To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges (HR 1213) A Bill To repeal mandatory funding for school-based health center construction (HR 1214) A Bill To repeal the Prevention and Public Health Fund (HR 1217) Patients Rights Repeal Act (H.R. 2) Medicaid Maintenance-Of-Effort Repeal (H.R.1683/S. 868) The Garrett Lee Smith Memorial Act (GLSMA) Reauthorization of 2011 (S. 740) The Sergeant Coleman S. Bean Reserve Component Suicide Prevention Act (H.R. 1089/S. 579) The Keeping All Students Safe Act (H.R. 1381/S.2020) The Ryan Creedon Act of 2011 (H.R. 2119) Mental Health on Campus Improvement Act, H.R. 1833 Constitutional Balanced Budget Amendment (H.J.Res. 1/S.J.Res. 23) Agriculture FY12 Appropriations (HR 2112) Military/Veterans FY12 Appropriations (HR 2055) Medicare Decisions Accountability Act of 2011 (IPAB; HR 452/S. 668) Cap, Cut and Balance Bill (HR 2560/S. 1340) CAMPUS Safety Act of 2011 (HR 2342) Health Equity and Accountability Act of 2011 (H.R.2954) Continuing Appropriations Act, 2012 (HR 2608) Medigap Medical Loss Ratio Improvement Act (S.1416/H.R.2645) Improving Access to Medicare Coverage Act of 2011 (S.818) Stop Child Abuse in Residential Programs for Teens Act of 2011 (H.R.3126) Commerce/Justice/State FY12 Appropriations Act (HR.2596/S.1572) Promoting Accountability and Excellence in Child Welfare Act (S. 1509) Lifespan Respite Reauthorization Act (HR 3266) Consolidated FY2012 Appropriations Act (was Military/Veterans; HR 2055) Children's Budget Act (S.1396) Middle Class Tax Cut Act of 2011 (H.R. 3630) Speak Up Act Letter of Support (S. 1877) Reauthorization of Drug-Free Communities Support Program (S. 2159) WIPA and PABSS Continuation of Services Act of 2012 (H.R.6061) The Childrens Mental Health Accessibility Act (S. 3289) Departments of Labor, Health and Human Services, and Education Appropriations Act, 2013 (S.3295) Military/Veterans FY13 Appropriations (H.R. 5854/S. 3215) Excellence in Mental Health (S. 2257/H.R. 5989) Mental Health First Aid Higher Education Act (S. 3325/H.R. 5996) Health Equity and Accountability Act (HEAA) of 2012 (S. 2474) Pharmaceutical Stewardship Act of 2011 (H.R. 2939) Food and Drug Administration Reform Act of 2012 (H.R. 5651/S. 3187) Mental Health ACCESS Act of 2012 (S. 3340)

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) LTC insurance reforms H.R. 111, Breast Cancer Patient Protection Act (DeLauro) minimum hospital stays for mastectomy patients H.R. 346, Health Care Choice Act (Pearce ) national marketplace for individual coverage 16. Specific Lobbying Issues (continued): H.R.371, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 416, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1050, Small Business Health Fairness Act (Johnson) association health plans H.R. 1150, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) agent commissions, medical loss ratios H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) changes to McCarran-Ferguson Act H.R. 2077, MLR Repeal Act (Price) medical loss ratios H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) MLRs for Medigap policies H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) disability program for federal employees H.R. 5838, Health Insurance Industry Antitrust Enforcement Act (Conyers) changes to McCarran-Ferguson Act S. 137, Health Insurance Rate Review Act (Feinstein) rate review S. 159, Confidence in Long-Term Care Insurance Act (Kohl) LTC insurance reforms S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) MLRs for Medigap policies S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) enrollment period for child-only policies S. 2068, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) agent commissions, medical loss ratios S. 2288, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) agent commissions, medical loss ratios S. 3229, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) -- model disclosure form for marketing long-term care insurance policies S. 3230, Long-Term Care Integrity Act (Klobuchar) -- claims dispute resolution procedures S. 3271, Equal Access to Medicare Options Act (Kerry) Medigap provisions, MA enrollment provisions Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; issues related to genetic nondiscrimination; summary of benefits and coverage disclosures; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; and other issues relating to health care reform implementation.

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) - LTC insurance reforms H.R. 111, Breast Cancer Patient Protection Act (DeLauro) - minimum hospital stays for mastectomy patients H.R. 346, Health Care Choice Act (Pearce ) - national marketplace for individual coverage H.R.371, Health Care Choice Act (Blackburn) - national marketplace for individual coverage H.R. 416, Health Insurance Rate Review Act (Schakowsky) - rate review H.R. 1050, Small Business Health Fairness Act (Johnson) - association health plans H.R. 1150, Competitive Health Insurance Reform Act (Gosar) - antitrust policy H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) - agent commissions, medical loss ratios H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) - changes to McCarran-Ferguson Act H.R. 2077, MLR Repeal Act (Price) - medical loss ratios H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) - MLRs for Medigap policies H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) - disability program for federal employees H.R. 5838, Health Insurance Industry Antitrust Enforcement Act (Conyers) - changes to McCarran-Ferguson Act S. 137, Health Insurance Rate Review Act (Feinstein) - rate review S. 159, Confidence in Long-Term Care Insurance Act (Kohl) - LTC insurance reforms S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) - MLRs for Medigap policies S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) - enrollment period for child-only policies S. 2068, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) - agent commissions, medical loss ratios S. 2288, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) - agent commissions, medical loss ratios S. 3229, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) -- model disclosure form for marketing long-term care insurance policies S. 3230, Long-Term Care Integrity Act (Klobuchar) -- claims dispute resolution procedures S. 3271, Equal Access to Medicare Options Act (Kerry) - Medigap provisions, MA enrollment provisions

*LTC insurance reforms - HR 63, Long-Term Care Insurance Reform Act of 2011; S 159, Confidence in Long-Term Care Insurance Act of 2011. *Minimum hospital stays for matectomy patients - HR 111, Breast Cancer Patient Protection Act of 2011. *National marketplace for individual coverage - HR 346, Health Care Choice Act of 2011; HR 371, Health Care Choice Act of 2011. *Rate review - HR 416, Health Insurance Rate Review Act; S 137, Health Insurance Rate Review Act. *Association health plans - HR 1050, Small Business Health Fairness Act of 2011. *Antitrust policy - HR 1150, Competitive Health Insurance Reform Act of 2011. *Changes to McCarran-Ferguson Act - HR 1943, Health Insurance Industry Fair Competition Act; HR 5838, Health Insurance Industry Antitrust Enforcement Act of 2012. *Medical loss ratios - HR 2077, MLR Repeal Act of 2011. *MLRs for Medigap policies - HR 2645, Medigap Medical Loss Ratio Improvement Act; S 1416, Medigap Medical Loss Ratio Improvement Act of 2011. *Disability program for Federal employees - HR 2958, Federal Employee Short-Term Disability Insurance Act of 2011. *Enrollment period for child-only policies - S 1500, Ensure Children Have Health Care Act. *Agent commissions, medical loss ratios - HR 1206, Access to Professional Health Insurance Advisors Act of 2011; S 2068, Access to Independent Health Insurance Advisors Act of 2012; S 2288, Access to Independent Health Insurance Advisors Act of 2012. *Model disclosure form for marketing long-term care insurance policies - S 3229, Long-Term Care Insurance Consumer Right-to-Know Act of 2012. *Claims dispute resolution procedures - S 3230, Long Term Care Insurance Integrity Act of 2012. *Medigap provisions, MA enrollment provisions - S 3271, Equal Access to Medicare Options Act of 2012.

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

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Lobbied on preserving fund for the ACA; defended meaningful use of the ACA. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, Discussed the Confidence in Long-Term Care Insurance Act/Long-Term Insurance Reform Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed status of the CLASS Program. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act. Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program and shared stories and information related to long-term services and supports. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) Discussed cost effectiveness of home and community-based services. (no bill) Discussed dual eligibles with Medpac. (no bill) S.3295, the Labor-HHS Appropriations bill for FY 2013 - Lobbied to protect/increase funding for the Social Security Administration, Older Americans Act nutrition, family caregiver & supportive services programs, low income home energy assistance (LIHEAP), and to protect funding for program authorized under the Affordable Care Act, including CMS State Health insurance exchanges, state survey & demonstrations and preventive Care Act, including CMS State Health insurance exchanges, state survey and demonstrations and preventive health. 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 Medicare GNE demonstration design problems. 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 legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill) Discussed Medicare and Social Security programs. (no bill)

House FY 13 Budget (H.Con.Res. 112) Mental Health in Schools Act (H.R. 751) Labor, Health and Human Services, and Education, and Related Agencies FY 12 Appropriations Act (S.1599/H.R.3070) Behavioral Health Information Technology Act of 2011 (S. 539) Healthy Lifestyles and Prevention America Act (S.174) Medicare Mental Health Access Act (S.483) Seniors Mental Health Access Improvement Act of 2011 (S.604) Medicare Mental Health Inpatient Equity Act (S.374) A Bill To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges (HR 1213) A Bill To repeal mandatory funding for school-based health center construction (HR 1214) A Bill To repeal the Prevention and Public Health Fund (HR 1217) Patients Rights Repeal Act (H.R. 2) Medicaid Maintenance-Of-Effort Repeal (H.R.1683/S. 868) The Garrett Lee Smith Memorial Act (GLSMA) Reauthorization of 2011 (S. 740) The Sergeant Coleman S. Bean Reserve Component Suicide Prevention Act (H.R. 1089/S. 579) The Keeping All Students Safe Act (H.R. 1381/S.2020) The Ryan Creedon Act of 2011 (H.R. 2119) Mental Health on Campus Improvement Act, H.R. 1833 Constitutional Balanced Budget Amendment (H.J.Res. 1/S.J.Res. 23) Agriculture FY12 Appropriations (HR 2112) Military/Veterans FY12 Appropriations (HR 2055) Medicare Decisions Accountability Act of 2011 (IPAB; HR 452/S. 668) Cap, Cut and Balance Bill (HR 2560/S. 1340) CAMPUS Safety Act of 2011 (HR 2342) Health Equity and Accountability Act of 2011 (H.R.2954) Continuing Appropriations Act, 2012 (HR 2608) Medigap Medical Loss Ratio Improvement Act (S.1416/H.R.2645) Improving Access to Medicare Coverage Act of 2011 (S.818) Stop Child Abuse in Residential Programs for Teens Act of 2011 (H.R.3126) Commerce/Justice/State FY12 Appropriations Act (HR.2596/S.1572) Promoting Accountability and Excellence in Child Welfare Act (S. 1509) Lifespan Respite Reauthorization Act (HR 3266) Consolidated FY2012 Appropriations Act (was Military/Veterans; HR 2055) Children's Budget Act (S.1396) Middle Class Tax Cut Act of 2011 (H.R. 3630) Speak Up Act Letter of Support (S. 1877) Reauthorization of Drug-Free Communities Support Program (S. 2159)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, Discussed the Confidence in Long-Term Care Insurance Act/Long-Term Insurance Reform Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed status of the CLASS Program. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act. Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program and shared stories and information related to long-term services and supports. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) 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 Medicare GNE demonstration design problems. 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 legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) LTC insurance reforms H.R. 111, Breast Cancer Patient Protection Act (DeLauro) minimum hospital stays for mastectomy patients H.R. 346, Health Care Choice Act (Pearce ) national marketplace for individual coverage 16. Specific Lobbying Issues (continued): H.R.371, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 416, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1050, Small Business Health Fairness Act (Johnson) association health plans H.R. 1150, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) agent commissions, medical loss ratios H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) changes to McCarran-Ferguson Act H.R. 2077, MLR Repeal Act (Price) medical loss ratios H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) MLRs for Medigap policies H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) disability program for federal employees S. 137, Health Insurance Rate Review Act (Feinstein) rate review S. 159, Confidence in Long-Term Care Insurance Act (Kohl) LTC insurance reforms S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) MLRs for Medigap policies S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) enrollment period for child-only policies S. 2068, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) agent commissions, medical loss ratios Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; issues related to genetic nondiscrimination; summary of benefits and coverage disclosures; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; 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).

*LTC insurance reforms - HR 63, Long-Term Care Insurance Reform Act of 2011; S 159, Confidence in Long-Term Care Insurance Act of 2011. *Minimum hospital stays for matectomy patients - HR 111, Breast Cancer Patient Protection Act of 2011. *National marketplace for individual coverage - HR 346, Health Care Choice Act of 2011; HR 371, Health Care Choice Act of 2011. *Rate review - HR 416, Health Insurance Rate Review Act; S 137, Health Insurance Rate Review Act. *Association health plans - HR 1050, Small Business Health Fairness Act of 2011. *Antitrust policy - HR 1150, Competitive Health Insurance Reform Act of 2011. *Agent commissions, medical loss ratios - HR 1206, Access to Professional Health Insurance Advisors Act of 2011. *Changes to McCarran-Ferguson Act - HR 1943, Health Insurance Industry Fair Competition Act. *Medical loss ratios - HR 2077, MLR Repeal Act of 2011. *MLRs for Medigap policies - HR 2645, Medigap Medical Loss Ratio Improvement Act; S 1416, Medigap Medical Loss Ratio Improvement Act of 2011. *Disability program for Federal employees - HR 2958, Federal Employee Short-Term Disability Insurance Act of 2011. *Enrollment period for child-only policies - S 1500, Ensure Children Have Health Care Act. *Agent commissions, medical loss ratios - S 2068, Access to Independent Health Insurance Advisors Act of 2012.

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

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) - LTC insurance reforms. H.R. 111, Breast Cancer Patient Protection Act (DeLauro) - minimum hospital stays for mastectomy patients. H.R. 346, Health Care Choice Act (Pearce ) - national marketplace for individual coverage. H.R.371, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 416, Health Insurance Rate Review Act (Schakowsky) - rate review. H.R. 1050, Small Business Health Fairness Act (Johnson) - association health plans. H.R. 1150, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) - agent commissions, medical loss ratios. H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) - changes to McCarran-Ferguson Act. H.R. 2077, MLR Repeal Act (Price) - medical loss ratios. H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) - MLRs for Medigap policies. H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) - disability program for federal employees. S. 137, Health Insurance Rate Review Act (Feinstein) - rate review. S. 159, Confidence in Long-Term Care Insurance Act (Kohl) - LTC insurance reforms. S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) - MLRs for Medigap policies. S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) - enrollment period for child-only policies. S. 2068, Access to Independent Health Insurance Advisors Act (Landrieu/Isakson) - agent commissions, medical loss ratios.

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

House FY 12 Budget (H.Con.Res. 34) Mental Health in Schools Act (H.R. 751) Labor, Health and Human Services, and Education, and Related Agencies FY 12 Appropriations Act (S.1599/H.R.3070) Behavioral Health Information Technology Act of 2011 (S. 539) Healthy Lifestyles and Prevention America Act (S.174) Medicare Mental Health Access Act (S.483) Seniors Mental Health Access Improvement Act of 2011 (S.604) Medicare Mental Health Inpatient Equity Act (S.374) A Bill To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges (HR 1213) A Bill To repeal mandatory funding for school-based health center construction (HR 1214) A Bill To repeal the Prevention and Public Health Fund (HR 1217) Patients Rights Repeal Act (H.R. 2) Medicaid Maintenance-Of-Effort Repeal (H.R.1683/S. 868) The Garrett Lee Smith Memorial Act (GLSMA) Reauthorization of 2011 (S. 740) The Sergeant Coleman S. Bean Reserve Component Suicide Prevention Act (H.R. 1089/S. 579) The Keeping All Students Safe Act (H.R. 1381/S.2020) The Ryan Creedon Act of 2011 (H.R. 2119) Mental Health on Campus Improvement Act, H.R. 1833 Constitutional Balanced Budget Amendment (H.J.Res. 1/S.J.Res. 23) Agriculture FY12 Appropriations (HR 2112) Military/Veterans FY12 Appropriations (HR 2055) Medicare Decisions Accountability Act of 2011 (IPAB; HR 452/S. 668) Cap, Cut and Balance Bill (HR 2560/S. 1340) CAMPUS Safety Act of 2011 (HR 2342) Health Equity and Accountability Act of 2011 (H.R.2954) Continuing Appropriations Act, 2012 (HR 2608) Medigap Medical Loss Ratio Improvement Act (S.1416/H.R.2645) Improving Access to Medicare Coverage Act of 2011 (S.818) Stop Child Abuse in Residential Programs for Teens Act of 2011 (H.R.3126) Commerce/Justice/State FY12 Appropriations Act (HR.2596/S.1572) Promoting Accountability and Excellence in Child Welfare Act (S. 1509) Lifespan Respite Reauthorization Act (HR 3266) Consolidated FY2012 Appropriations Act (was Military/Veterans; HR 2055)

House FY 12 Budget (H.Con.Res. 34) Mental Health in Schools Act (H.R. 751) Medicaid Maintenance-Of-Effort Repeal (H.R.1683/S. 868) Behavioral Health Information Technology Act of 2011 (S. 539) Healthy Lifestyles and Prevention America Act (S.174) Medicare Mental Health Access Act (S.483) Seniors Mental Health Access Improvement Act of 2011 (S.604) Medicare Mental Health Inpatient Equity Act of 2011 (S.374/H.R.2783) CAP Act of 2011 (H.R. 1605/S. 245) Constitutional Balanced Budget Amendment (H.J.Res. 1/S.J.Res. 23) Mental Health on Campus Improvement Act, H.R. 1833 Medicare Decisions Accountability Act of 2011 (HR 452/S 668) Cap, Cut and Balance Bill (HR 2560/S. 1340) Health Equity and Accountability Act of 2011 (H.R.2954) Continuing Appropriations Act, 2012 (HR 2608) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2012 (S.1599/H.R.3070) Medigap Medical Loss Ratio Improvement Act (S.1416/H.R.2645) Improving Access to Medicare Coverage Act of 2011 (S.818) Consolidated FY2012 Appropriations Act (was Military/Veterans; HR 2055)

Client expense: Not reported · Firm income: Not reported

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

*LTC insurance reforms - HR 63, Long-Term Care Insurance Reform Act of 2011; S 159, Confidence in Long-Term Care Insurance Act of 2011. *Minimum hospital stays for matectomy patients - HR 111, Breast Cancer Patient Protection Act of 2011. *National marketplace for individual coverage - HR 346, Health Care Choice Act of 2011; HR 371, Health Care Choice Act of 2011. *Rate review - HR 416, Health Insurance Rate Review Act; S 137, Health Insurance Rate Review Act. *Association health plans - HR 1050, Small Business Health Fairness Act of 2011. *Antitrust policy - HR 1150, Competitive Health Insurance Reform Act of 2011. *Agent commissions, medical loss ratios - HR 1206, Access to Professional Health Insurance Advisors Act of 2011. *Changes to McCarran-Ferguson Act - HR 1943, Health Insurance Industry Fair Competition Act. *Medical loss ratios - HR 2077, MLR Repeal Act of 2011. *MLRs for Medigap policies - HR 2645, Medigap Medical Loss Ratio Improvement Act; S 1416, Medigap Medical Loss Ratio Improvement Act of 2011. *Disability program for Federal employees - HR 2958, Federal Employee Short-Term Disability Insurance Act of 2011. *Enrollment period for child-only policies - S 1500, Ensure Children Have Health Care Act.

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

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) LTC insurance reforms, H.R. 111, Breast Cancer Patient Protection Act (DeLauro) minimum hospital stays for mastectomy patients, H.R. 346, Health Care Choice Act (Pearce ) national marketplace for individual coverage, H.R.371, Health Care Choice Act (Blackburn) national marketplace for individual coverage, H.R. 416, 16. Specific Lobbying Issues (con't): Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1050, Small Business Health Fairness Act (Johnson) association health plans H.R. 1150, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) agent commissions, medical loss ratios H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) changes to McCarran-Ferguson Act H.R. 2077, MLR Repeal Act (Price) medical loss ratios H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) MLRs for Medigap policies H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) disability program for federal employees S. 137, Health Insurance Rate Review Act (Feinstein) rate review S. 159, Confidence in Long-Term Care Insurance Act (Kohl) LTC insurance reforms S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) MLRs for Medigap policies S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) enrollment period for child-only policies INS (Regulatory Issues): Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; internal claims and appeals and external review processes; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits rescissions; patient protections; grandfathered health plan provisions; 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.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) 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. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal of the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159/H.R. 63, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill) Discussed Essential Health Benefits with HHS. (no bill) Discussed employer affordability safe harbor. (no bill) Discussed health insurance exchanges - eligibility, enrollment, premium tax credits. (no bill) Discussed Basic Health Plans. (no bill) Discussed Medigap reform. (no bill) Discussed Pre-existing Condition Insurance Program. (no bill) Discussed role of grandfathered plans. (no bill) Discussed implementation of the CLASS Porgram. (no bill) Discussed opposition to repeal of the CLASS Program (no bill, but also as S. 720, the Repeal the CLASS Entitlement Act/ this was also filed as multiple amendments). Discussed opposition to H.R. 1173, the Fiscal Responsibility and Retirement Security Act, to repeal the CLASS Program. Discussed reauthorization of the Older Americans Act and other amendments to the OAA. (no bill) S. 1750 -Discussed Home Care Consumer Bill of Rights Act. Discussed cost effectiveness of home and community-based services. (no bill) Discussed invitation to solutions forum on family caregiving and webinar on elder care and employment. (no bill) Discussed reports on family caregiving and Long-Term Services and Supports State Scorecard. (no bill) 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 Medicare GNE demonstration design problems. 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 legislation to make long-term care insurance available under cafeteria plans and flexible spending arrangements and to improve consumer protections. (no bill)

Supported all provisions: S. 31, Prescription Drug and Health Improvement Act of 2011 S. 227, H.R. 2267, Home Health Care Planning Improvement Act of 2011 S. 1206, H.R. 2190, Medicare Drug Savings Act of 2011 Continuation of supported all provisions: S.1356, H.R. 3342, The Affordable Medicines Utilization Act of 2011 S. 1416, H.R. 2645, Medigap Medical Loss Ratio Improvement Act of 2011 H.R. 999, Medicare Prescription Drug Savings Choice Act of 2011 Opposed all provisions: S. 868, H.R. 1683, State Flexibility Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

House FY 12 Budget (H.Con.Res. 34) Mental Health in Schools Act (H.R. 751) Labor-HHS-Education FY 11 and Full-Year Continuing Appropriations Act (HR 1473) Behavioral Health Information Technology Act of 2011 (S. 539) Healthy Lifestyles and Prevention America Act (S.174) Medicare Mental Health Access Act (S.483) Seniors Mental Health Access Improvement Act of 2011 (S.604) Medicare Mental Health Inpatient Equity Act (S.374) A Bill To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges (HR 1213) A Bill To repeal mandatory funding for school-based health center construction (HR 1214) A Bill To repeal the Prevention and Public Health Fund (HR 1217) Patients Rights Repeal Act (H.R. 2) Medicaid Maintenance-Of-Effort Repeal (H.R.1683/S. 868) The Garrett Lee Smith Memorial Act (GLSMA) Reauthorization of 2011 (S. 740) The Sergeant Coleman S. Bean Reserve Component Suicide Prevention Act (H.R. 1089/S. 579) The Keeping All Students Safe Act (H.R. 1381) The Ryan Creedon Act of 2011 (H.R. 2119) Mental Health on Campus Improvement Act, H.R. 1833 Constitutional Balanced Budget Amendment (H.J.Res. 1/S.J.Res. 23) Agriculture FY12 Appropriations (HR 2112) Military/Veterans FY12 Appropriations (HR 2055) Medicare Decisions Accountability Act of 2011 (IPAB; HR 452/S. 668) Cap, Cut and Balance Bill (HR 2560/S. 1340) CAMPUS Safety Act of 2011 (HR 2342) Health Equity and Accountability Act of 2011 (H.R.2954) Continuing Appropriations Act, 2012 (HR 2608) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2012 (S.1599/H.R.3070) Medigap Medical Loss Ratio Improvement Act (S.1416/H.R.2645) Improving Access to Medicare Coverage Act of 2011 (S.818) Stop Child Abuse in Residential Programs for Teens Act of 2011 (H.R.3126) The legislative vehicle for the Agriculture, Commerce, Justice and Science, and Transportation/HUD appropriations bills (H.R.2112) Promoting Accountability and Excellence in Child Welfare Act (S. 1509) Lifespan Respite Reauthorization Act (HR 3266)

H.R. 63, Long-Term Care Insurance Reform Act (Doggett) LTC insurance reforms H.R. 111, Breast Cancer Patient Protection Act (DeLauro) minimum hospital stays for mastectomy patients H.R. 346, Health Care Choice Act (Pearce ) national marketplace for individual coverage H.R.371, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 416, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1050, Small Business Health Fairness Act (Johnson) association health plans H.R. 1150, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R.1206, Access to Professional Health Insurance Advisors Act (Rogers) agent commissions, medical loss ratios H.R. 1943, Health Insurance Industry Fair Competition Act (DeFazio) changes to McCarran-Ferguson Act H.R. 2077, MLR Repeal Act (Price) medical loss ratios H.R. 2645, Medigap Medical Loss Ratio Improvement Act (Stark) MLRs for Medigap policies H.R. 2958, Federal Employee Short-Term Disability Insurance Act (Holmes Norton) disability program for federal employees S. 137, Health Insurance Rate Review Act (Feinstein) rate review S. 159, Confidence in Long-Term Care Insurance Act (Kohl) LTC insurance reforms S. 1416, Medigap Medical Loss Ratio Improvement Act (Kerry) MLRs for Medigap policies S. 1500, Ensure Children Have Health Care Act (Murkowski/Enzi) enrollment period for child-only policies INS (Regulatory): Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; implementation of the Mental Health Parity Act requirements; issues related to genetic nondiscrimination; summary of benefits and coverage disclosures; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; internal claims and appeals and external review processes; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits rescissions; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; and other issues relating to health care reform implementation.

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

Provided information on the need for nursing education capacity and the retention of newer and older nurses in the workplace. (no bill) Discussed barriers to care that can result from language differences between providers and patients and/or lack of translation services. (no bill) H.J.Res 44, H.R. 1599, H.J. Res.79, H.R. 2068, H.R. 2017Labor-Health & Human Services, Education and Related Agencies Appropriations bill for FY2012 - Lobbied for funding for LIHEAP. Sent letters to House and Senate LHHS Subcommittees on funding for SSA Administration, Older Americans Act nutrition, health care delivery reform, CLASS, LIHEAP, Older Americans Act caregiver programs and Medicaid. Pub. Law 111-148 & 111-152 - Discussed implementation of health disparities data collection provisions of the Affordable Care Act. Pub. Law 111-148 & 111-152 - Discussed implementation of health care legislation that would reform the health care system to provide affordable quality health care and expand access to long term care services. Lobbied in support of comparative effectiveness research. (no bill) Discussed need to increase health information technology quality measurements and access to qualified systems. (no bill) S. 1019, Hearing Aid Assistance Tax Credit Act - Discussed Hearing Aid Assistance Tax Credit Act which would provide a $500 credit to people of all ages. H.R. 217, To repeal the Prevention and Public Health Fund - Lobbied against the repeal the Prevention and Public Health Trust Fund. This fund is an important component in state and community efforts to prevent illness and promote health. Discussed Pre-existing Condition Insurance Program. (no bill) Discussed Accountable Care Organization and Medical Shared savings. (no bill) Discussed Rate Review. (no bill) Discussed Internal Appeals and External Review Process. (no bill) Discussed Medicare reimbursement issues. Lobbied in support of Medicare physician payment reform. Discussed legislation to make prescription drugs more affordable to older Americans. S. 159, The Confidence in Long-Term Care Insurance Act - Discussed the Long-Term Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. H.R. 63, The Long-Term Care Insurance Reform Act - Discussed the Long Term Care Insurance Act which improves the consumer protections of LTC insurance policies and make more and better information available to consumers to help them make informed decisions about such policies. S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act - Lobbied for bill introduction and helped with crafting. Discussed Internal Claims, Appeals and external Review Process. (no bill) Discussed HIPAA Privacy Rule Accounting under HITECH Act. (no bill) Discussed coverage for screening depression and screening and counseling for alcohol misuse. (no bill) Discussed consumer operated and oriented plan programs. (no bill) Discussed standards related to risk adjustment, reinsurance, and risk mitigation as they relate to exchanges. (no bill) H.R.2077, MLR Repeal Act of 2011 - Expressed opposition to the elimination of provision in the Affordable Care Act (P.L. 111-148)Discussed opposition to draft legislation regarding the elimination of grandfathered status. (no bill) Discussed association health plans with DOL, HHS and DOT. (no bill) Discussed quality and care coordination with HHS. (no bill)

*LTC insurance reforms - HR 63, Long-Term Care Insurance Reform Act of 2011; S 159, Confidence in Long-Term Care Insurance Act of 2011. *Minimum hospital stays for matectomy patients - HR 111, Breast Cancer Patient Protection Act of 2011. *National marketplace for individual coverage - HR 346, Health Care Choice Act of 2011; HR 371, Health Care Choice Act of 2011. *Rate review - HR 416, Health Insurance Rate Review Act; S 137, Health Insurance Rate Review Act. *Association health plans - HR 1050, Small Business Health Fairness Act of 2011. *Antitrust policy - HR 1150, Competitive Health Insurance Reform Act of 2011. *Agent commissions, medical loss ratios - HR 1206, Access to Professional Health Insurance Advisors Act of 2011. *Changes to McCarran-Ferguson Act - HR 1943, Health Insurance Industry Fair Competition Act. *Medical loss ratios - HR 2077, MLR Repeal Act of 2011. *MLRs for Medigap policies - HR 2645, Medigap Medical Loss Ratio Improvement Act; S 1416, Medigap Medical Loss Ratio Improvement Act of 2011. *Disability program for Federal employees - HR 2958, Federal Employee Short-Term Disability Insurance Act of 2011. *Enrollment period for child-only policies - S 1500, Ensure Children Have Health Care Act.

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

Supported all provisions: S. 1206/H.R. 2190, Medicare Drug Savings Act of 2011 S. 1416/H.R. 2645, Medigap Medical Loss Ratio Improvement Act Opposed all provisions: S. 868/H.R. 1683, State Flexibility Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3590 & HR 4872 -Patient Protection and Affordable Care Act & Reconciliation Act of 2010 - Long-term care requirements as a result of a national, voluntary long-term care insurance program and effect on home office procedures and self-insured plan, executive compensation and 1099 reporting requirements. S 668/HR 452-Medicare Decisions Accountability Act of 2011 - Repeal the creation of IPAB. S 1416/HR2645 - Medigap Medical Loss Ratio Improvement Act of 2011 - Health Reform medical loss ratio requirements to Medigap. S 159/ HR 63 - Confidence in Long-Term Care Insurance Act of 2011 - LTC model disclosures and consumer protections. HR 2958 - Federal Employee Short-Term Disability Insurance Act of 2011 - Federal Short-Term Disability Program.

Client expense: $136,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE