Medicare and Medicaid FAST Act

H.R. 8, American Taxpayer Relief Act - Medicare issues, budget offsets, H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger), H.R. 999, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes, H.R. 1063, Strengthening Medicare And Repaying Taxpayers Act (Murphy) - Medicare secondary payer rules, H.R. 1357, Puerto Rico Medicare Part B Equity Act (Pierluisi), H.R. 1580, Medicare Beneficiary Preservation of Choice Act (Gonzalez) - Medicare Advantage enrollment periods, H.R. 2190, Medicare Drug Savings Act (Waxman) - rebates for dual eligibles, H.R. 2248, Medicare Prescription Drug Price Negotiation Act (Welch) - Part D price negotiation, H.R. 2770, Medicare Cost Contract Extension Act (Paulsen) - extension of Medicare cost plans, H.R. 3399, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Roskam/Carney), H.R. 3519 (Towns) - exempting Medicare from sequestration, H.R. 3691, Senior Medicare Fairness Act (Paulsen) - frailty adjuster for certain MA SNPs, H.R. 4254, Medicare Advantage Program Integrity Act (Stark) - MA payment changes, H.R. 5872, Sequestration Transparency Act (Hensarling), H.R. 5979, Medicaid Accountability and Care Act (Cassidy) -- federal financing of state Medicaid programs, H.R. 6232, Medicare Better Health Rewards Program Act (Paulsen) - incentives for wellness and prevention, H.R. 6300, Medicaid Long-Term Care Reform Act (Boustany) - LTC and Medicaid issues, S. 31, Prescription Drug and Health Improvement Act (Franken) - Part D price negotiation, S. 44, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Part D price negotiation, S. 560, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes, S. 1206, Medicare Drug Savings Act (Rockefeller) - rebates for dual eligibles, S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Coburn/Carper), S. 1479, Medicare Beneficiary Preservation of Choice Act (Casey) - Medicare Advantage enrollment periods, S. 1497, Medicare Cost Contract Extension Act (Klobuchar) - extension of Medicare cost plans, S. 1999, Senior Medicare Fairness Act (Klobuchar) - frailty adjuster for certain MA SNPs , S. 2196, Congressional Health Care for Seniors Act (Paul) - reforms affecting Medicare and Medigap, S. 2243, Medicare Better Health Rewards Program Act (Wyden-Portman) - incentives for wellness and prevention, S. 3673, Dollar for Dollar Act (Corker) - Medicare, Medigap, Medicaid reforms.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 8, American Taxpayer Relief Act Medicare issues, budget offsets 16. Specific Lobbying Issues (continued): H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger) H.R. 999, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1063, Strengthening Medicare And Repaying Taxpayers Act (Murphy) Medicare secondary payer rules H.R. 1357, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 1580, Medicare Beneficiary Preservation of Choice Act (Gonzalez) Medicare Advantage enrollment periods H.R. 2190, Medicare Drug Savings Act (Waxman) rebates for dual eligibles H.R. 2248, Medicare Prescription Drug Price Negotiation Act (Welch) Part D price negotiation H.R. 2770, Medicare Cost Contract Extension Act (Paulsen) extension of Medicare cost plans H.R. 3399, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Roskam/Carney) H.R. 3519 (Towns) exempting Medicare from sequestration H.R. 3691, Senior Medicare Fairness Act (Paulsen) frailty adjuster for certain MA SNPs H.R. 4254, Medicare Advantage Program Integrity Act (Stark) MA payment changes H.R. 5872, Sequestration Transparency Act (Hensarling) H.R. 5979, Medicaid Accountability and Care Act (Cassidy) -- federal financing of state Medicaid programs H.R. 6232, Medicare Better Health Rewards Program Act (Paulsen) incentives for wellness and prevention H.R. 6300, Medicaid Long-Term Care Reform Act (Boustany) LTC and Medicaid issues S. 31, Prescription Drug and Health Improvement Act (Franken) Part D price negotiation S. 44, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Part D price negotiation S. 560, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 1206, Medicare Drug Savings Act (Rockefeller) rebates for dual eligibles S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Coburn/Carper) S. 1479, Medicare Beneficiary Preservation of Choice Act (Casey) Medicare Advantage enrollment periods S. 1497, Medicare Cost Contract Extension Act (Klobuchar) extension of Medicare cost plans S. 1999, Senior Medicare Fairness Act (Klobuchar) frailty adjuster for certain MA SNPs S. 2196, Congressional Health Care for Seniors Act (Paul) reforms affecting Medicare and Medigap S. 2243, Medicare Better Health Rewards Program Act (Wyden-Portman) incentives for wellness and prevention S. 3673, Dollar for Dollar Act (Corker) Medicare, Medigap, Medicaid reforms Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues raised by initial implementation in 2014; implications of sequestration in 2013 for Medicare Advantage and Part D plans; implications of the new health insurance plan tax (aka insurer fee) for MA plans starting in 2014; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; implementation of MA and Part D changes made in the Accountable Care Act (ACA), including application of the MA Star Rating system for payment purposes starting 2012 and changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Regulatory Issues (con't): Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the new health insurance plan tax (aka insurer fee) on Medicaid health plans starting in 2014; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation.

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

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, and fraud and abuse. H.R. 1041, Fairness in Medicare Bidding Act--all provisions. H.R. 6490, The Medicare DMEPOS Market Pricing Program Act. H.R. 8, The American Taxpayer Relief Act See continuation on next page. S. 1251 and H.R. 3399, Medicare and Medicaid FAST Act--all provisions. H.R. 452, Medicare Decisions Accountability Act of 2011--all provisions. S. 668, Health Care Bureaucrats Elimination Act--all provisions. S. 3187, The Food and Drug Administration Safety and Innovation Act, all provisions. H.R. 4378, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012, all provisions. H.R. 5652, Sequester Replacement Reconciliation Act of 2012, issues pertaining to Medicare. CMS prior authorization demonstration for power mobility devices. H.R. 6490, Medicare DMEPOS Market Pricing Program Act of 2012, all provisions. H.R. 3630, Middle Class Tax Relief and job Creation Act of 2012, all provisions. H.Con.Res. 112, House Budget Resolution for Fiscal Year 2013, all provisions. H.R. 6575, Medicare Audit Improvement Act of 2012, all provisions.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabeti supplies, negative pressure wound therapy, Medicare audits, and fraud abuse; H.R. 1041 - Fairness in Medicare Bidding Act, all provisions; H.R. 3399/S. 1251 - Medicare and Medicaid FAST Act, all provisions; H.R. 452 - Medicare Decisions Accountability Act of 2011, all provisions; S.668 - Health Care Bureaucrats Elimination Act, all provisions; H.R. 3630 - Middle Class Tax Relief and Job Creation Act of 2012, all provisions; H.Con.Res. 112 - House Budget Resolution for Fiscal Year 2013, all provisions; S.3187 - Food and Drug Administration Safety and Innovation Act, all provisions; H.R. 4378 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012, all provisions; H.R. 5652 - Sequester Replacement Reconciliation Act of 2012, issues pertaining to Medicare; CMS prior authorization demonstration for power mobility devices. H.R. 6490 - Medicare DMEPOS Market Pricing Program Act of 2012, all provisions. H.R. 6575 - Medicare Audit Improvement Act of 2012, all provisions. H.R. 8 - American Taxpayer Relief Act of 2012, all provisions.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

Health IT issues; waste, fraud, and abuse issues. H.R. 3399 / S. 1251, Medicare and Medicaid FAST Act of 2011. H.R. 4053 / S. 1409, Improper Payments Elimination and Recovery Improvement Act of 2012.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Health IT issues; waste, fraud, and abuse issues. H.R. 3399 / S. 1251, Medicare and Medicaid FAST Act of 2011. H.R. 4053 / S. 1409, Improper Payments Elimination and Recovery Improvement Act of 2012.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Changes to Medigap, including first-dollar coverage and imposing a surcharge/tax; Medicare Fraud S1251/H.R.3399 "Medicare and Medicaid FAST Act"; S1789 21 Century Postal Service Act of 2012 sections pertaining to wraparound plan for postal workers with Medicare Part A & B; Delivery system reforms; Physician payment alternatives; Fee for Service Payment Reforms; HR1063 Strengthening Medicare and Repaying Taxpayers Act of 2011

Client expense: $760,000 · Firm income: Not reported

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

H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger). H.R. 999, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1063, Strengthening Medicare And Repaying Taxpayers Act (Murphy) - Medicare secondary payer rules. H.R. 1357, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 1580, Medicare Beneficiary Preservation of Choice Act (Gonzalez) - Medicare Advantage enrollment periods. H.R. 2190, Medicare Drug Savings Act (Waxman) - rebates for dual eligibles. H.R. 2248, Medicare Prescription Drug Price Negotiation Act (Welch) - Part D price negotiation. H.R. 2770, Medicare Cost Contract Extension Act (Paulsen) - extension of Medicare cost plans. H.R. 3399, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Roskam/Carney). H.R. 3519 (Towns) - exempting Medicare from sequestration. H.R. 3691, Senior Medicare Fairness Act (Paulsen) - frailty adjuster for certain MA SNPs. H.R. 4254, Medicare Advantage Program Integrity Act (Stark) - MA payment changes. H.R. 5872, Sequestration Transparency Act (Hensarling). H.R. 5979, Medicaid Accountability and Care Act (Cassidy) -- federal financing of state Medicaid programs. H.R. 6232, Medicare Better Health Rewards Program Act (Paulsen) - incentives for wellness and prevention. H.R. 6300, Medicaid Long-Term Care Reform Act (Boustany) - LTC and Medicaid issues. S. 31, Prescription Drug and Health Improvement Act (Franken) - Part D price negotiation. S. 44, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Part D price negotiation. S. 560, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 1206, Medicare Drug Savings Act (Rockefeller) - rebates for dual eligibles. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Coburn/Carper). S. 1479, Medicare Beneficiary Preservation of Choice Act (Casey) - Medicare Advantage enrollment periods. S. 1497, Medicare Cost Contract Extension Act (Klobuchar) - extension of Medicare cost plans. S. 1999, Senior Medicare Fairness Act (Klobuchar) - frailty adjuster for certain MA SNPs. S. 2196, Congressional Health Care for Seniors Act (Paul) - reforms affecting Medicare and Medigap. S. 2243, Medicare Better Health Rewards Program Act (Wyden-Portman) - incentives for wellness and prevention.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger) 16. Specific Lobbying Issues (continued): H.R. 999, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1063, Strengthening Medicare And Repaying Taxpayers Act (Murphy) Medicare secondary payer rules H.R. 1357, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 1580, Medicare Beneficiary Preservation of Choice Act (Gonzalez) Medicare Advantage enrollment periods H.R. 2190, Medicare Drug Savings Act (Waxman) rebates for dual eligibles H.R. 2248, Medicare Prescription Drug Price Negotiation Act (Welch) Part D price negotiation H.R. 2770, Medicare Cost Contract Extension Act (Paulsen) extension of Medicare cost plans H.R. 3399, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Roskam/Carney) H.R. 3519 (Towns) exempting Medicare from sequestration H.R. 3691, Senior Medicare Fairness Act (Paulsen) frailty adjuster for certain MA SNPs H.R. 4254, Medicare Advantage Program Integrity Act (Stark) MA payment changes H.R. 5872, Sequestration Transparency Act (Hensarling) H.R. 5979, Medicaid Accountability and Care Act (Cassidy) -- federal financing of state Medicaid programs H.R. 6232, Medicare Better Health Rewards Program Act (Paulsen) incentives for wellness and prevention H.R. 6300, Medicaid Long-Term Care Reform Act (Boustany) LTC and Medicaid issues S. 31, Prescription Drug and Health Improvement Act (Franken) Part D price negotiation S. 44, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Part D price negotiation S. 560, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 1206, Medicare Drug Savings Act (Rockefeller) rebates for dual eligibles S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Coburn/Carper) S. 1479, Medicare Beneficiary Preservation of Choice Act (Casey) Medicare Advantage enrollment periods S. 1497, Medicare Cost Contract Extension Act (Klobuchar) extension of Medicare cost plans S. 1999, Senior Medicare Fairness Act (Klobuchar) frailty adjuster for certain MA SNPs S. 2196, Congressional Health Care for Seniors Act (Paul) reforms affecting Medicare and Medigap S. 2243, Medicare Better Health Rewards Program Act (Wyden-Portman) incentives for wellness and prevention Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, data, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues raised by initial implementation in 2014; implications of sequestration in 2013 for Medicare Advantage and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; implementation of MA and Part D changes made in the Accountable Care Act (ACA), including application of the MA Star Rating system for payment purposes starting 2012 and changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital Regulatory Issues (continued): days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation.

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

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

Educated Congressional staff about modernizing the Medicare program. H.R. 3399: Medicare and Medicaid FAST Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including: bidding, power wheelchairs, oxygen, diabeti supplies, negative pressure wound therapy, Medicare audits, and fraud abuse; H.R. 1041 - Fairness in Medicare Bidding Act, all provisions; H.R. 3399/S. 1251 - Medicare and Medicaid FAST Act, all provisions; H.R. 452 - Medicare Decisions Accountability Act of 2011, all provisions; S.668 - Health Care Bureaucrats Elimination Act, all provisions; H.R. 3630 - Middle Class Tax Relief and Job Creation Act of 2012, all provisions; H.Con.Res. 112 - House Budget Resolution for Fiscal Year 2013, all provisions; S.3187 - Food and Drug Administration Safety and Innovation Act, all provisions; H.R. 4378 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012, all provisions; H.R. 5652 - Sequester Replacement Reconciliation Act of 2012, issues pertaining to Medicare; CMS prior authorization demonstration for power mobility devices. H.R. 6490 - Medicare DMEPOS Market Pricing Program Act of 2012, all provisions.

Client expense: $170,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, and fraud and abuse. H.R. 1041, Fairness in Medicare Bidding Act--all provisions. H.R. 6490, The Medicare DMEPOS Market Pricing Program Act. See continuation on next page. S. 1251 and H.R. 3399, Medicare and Medicaid FAST Act--all provisions. H.R. 452, Medicare Decisions Accountability Act of 2011--all provisions. S. 668, Health Care Bureaucrats Elimination Act--all provisions. H.R. 3399, Medicare and Medicaid FAST Act, all provisions. S. 3187, The Food and Drug Administration Safety and Innovation Act, all provisions. H.R. 4378, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012, all provisions. H.R. 5652, Sequester Replacement Reconciliation Act of 2012, all provisions. CMS prior authorization demonstration for power mobility devices. H.R. 6490, Medicare DMEPOS Market Pricing Program Act of 2012, all provisions.

Client expense: Not reported · Firm income: $70,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare Advantage; Medigap first-dollar coverage; Medicare Fraud S1251/H.R.3399 "Medicare and Medicaid FAST Act"; S 1789 "21 Century Postal Service Act of 2012" sections pertaining to wraparound plan for postal workers with medigap Part A & B; Delivery system reforms; Physician payment alternatives; Delivery system reforms

Client expense: $910,000 · Firm income: Not reported

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

Repeal Sustainable Growth Rate formula; H.R. 5707 Medicare Physician Payment Innovation Act; H.R. 3613 Part D Beneficiary Appeals Fairness Act; H.R. 452 Medicare Decisions Accountability Act; S. 1042 / H.R. 1700 Medicare Patient Empowerment Act; H.R. 3399 Medicare and Medicaid FAST Act; S. 1096 / H.R. 2020 Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act; Monitor implementation of P.L. 111-148; Extension of Section 3111 of P.L. 111-148

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

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

Health IT issues; waste, fraud, and abuse issues. H.R. 3399 / S. 1251, Medicare and Medicaid FAST Act of 2011. H.R. 4053 / S. 1409, Improper Payments Elimination and Recovery Improvement Act of 2012.

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

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

H.Con.Res. 112, House budget resolution (Ryan) Medicare, Medicaid, ACA issues H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger) H.R. 999, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes 16. Specific Lobbying Issues (continued): H.R. 1063, Strengthening Medicare And Repaying Taxpayers Act (Murphy) Medicare secondary payer rules H.R. 1357, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 1580, Medicare Beneficiary Preservation of Choice Act (Gonzalez) Medicare Advantage enrollment periods H.R. 2190, Medicare Drug Savings Act (Waxman) rebates for dual eligibles H.R. 2248, Medicare Prescription Drug Price Negotiation Act (Welch) Part D price negotiation H.R. 2770, Medicare Cost Contract Extension Act (Paulsen) extension of Medicare cost plans H.R. 3399, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Roskam/Carney) H.R. 3519 (Towns) exempting Medicare from sequestration H.R. 3691, Senior Medicare Fairness Act (Paulsen) frailty adjuster for certain MA SNPs H.R. 4254, Medicare Advantage Program Integrity Act (Stark) MA payment changes H.R. 5979, Medicaid Accountability and Care Act (Cassidy) -- federal financing of state Medicaid programs S. 31, Prescription Drug and Health Improvement Act (Franken) Part D price negotiation S. 44, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Part D price negotiation S. 560, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 1206, Medicare Drug Savings Act (Rockefeller) rebates for dual eligibles S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Coburn/Carper) S. 1479, Medicare Beneficiary Preservation of Choice Act (Casey) Medicare Advantage enrollment periods S. 1497, Medicare Cost Contract Extension Act (Klobuchar) extension of Medicare cost plans S. 1999, Senior Medicare Fairness Act (Klobuchar) frailty adjuster for certain MA SNPs S. 2196, Congressional Health Care for Seniors Act (Paul) reforms affecting Medicare and Medigap S. 2243, Medicare Better Health Rewards Program Act (Wyden-Portman) incentives for wellness and prevention Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including; risk adjustment methodology, data, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; implementation of MA and Part D changes made in the Accountable Care Act (ACA), including application of the MA Star Rating system for payment purposes starting 2012 and changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to Medigap coverage; and other issues relating to health care reform implementation.

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

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

H.Con.Res. 112, House budget resolution (Ryan) - Medicare, Medicaid, ACA issues H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger) H.R. 999, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1063, Strengthening Medicare And Repaying Taxpayers Act (Murphy) - Medicare secondary payer rules H.R. 1357, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 1580, Medicare Beneficiary Preservation of Choice Act (Gonzalez) - Medicare Advantage enrollment periods H.R. 2190, Medicare Drug Savings Act (Waxman) - rebates for dual eligibles H.R. 2248, Medicare Prescription Drug Price Negotiation Act (Welch) - Part D price negotiation H.R. 2770, Medicare Cost Contract Extension Act (Paulsen) - extension of Medicare cost plans H.R. 3399, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Roskam/Carney) H.R. 3519 (Towns) - exempting Medicare from sequestration H.R. 3691, Senior Medicare Fairness Act (Paulsen) - frailty adjuster for certain MA SNPs H.R. 4254, Medicare Advantage Program Integrity Act (Stark) - MA payment changes H.R. 5979, Medicaid Accountability and Care Act (Cassidy) -- federal financing of state Medicaid programs S. 31, Prescription Drug and Health Improvement Act (Franken) - Part D price negotiation S. 44, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Part D price negotiation S. 560, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 1206, Medicare Drug Savings Act (Rockefeller) - rebates for dual eligibles S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Coburn/Carper) S. 1479, Medicare Beneficiary Preservation of Choice Act (Casey) - Medicare Advantage enrollment periods S. 1497, Medicare Cost Contract Extension Act (Klobuchar) - extension of Medicare cost plans S. 1999, Senior Medicare Fairness Act (Klobuchar) - frailty adjuster for certain MA SNPs S. 2196, Congressional Health Care for Seniors Act (Paul) - reforms affecting Medicare and Medigap S. 2243, Medicare Better Health Rewards Program Act (Wyden-Portman) - incentives for wellness and prevention

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

*Part D price negotiation - S 31, Prescription Drug and Health Improvement Act of 2011; S 44, Medicare Prescription Drug Price Negotiation Act of 2011; HR 2248, Medicare Prescription Drug Price Negotiation Act of 2011. *Medicare Part D changes - HR 999, Medicare Prescription Drug Savings and Choice Act of 2011; S 560, Medicare Prescription Drug Savings and Choice Act of 2011. *Medicare secondary payer rules - HR 1063, Strengthening Medicare And Repaying Taxpayers Act of 2011. *Medicare Advantage enrollment periods - HR 1580, Medicare Beneficiary Preservation of Choice Act of 2011; S 1479, Medicare Beneficiary Preservation of Choice Act of 2011. *Rebates for dual eligibles - HR 2190, Medicare Drug Savings Act of 2011; S 1206, Medicare Drug Savings Act of 2011. *Strengthening Medicare anti-fraud measures - HR 675, Strengthening Medicare Anti-Fraud Measures Act of 2011. *Extension of Medicare cost plans - HR 2770, Medicare Cost Contract Extension Act of 2011; S 1497, Medicare Cost Contract Extension Act of 2011. *Medicare and Medicaid fraud and abuse - S 1251, Medicare and Medicaid FAST Act. *Frailty adjuster for certain MA SNPs - HR 3691, Senior Medicare Fairness Act of 2011; S 1999, Senior Medicare Fairness Act. *MA payment changes - HR 4254, Medicare Advantage Program Integrity Act of 2012. *Reforms affecting Medicare and Medigap - S 2196, Congressional Health Care for Seniors Act of 2012. *Incentives for wellness and prevention - S 2243, Medicare Better Health Rewards Program Act of 2012. *Puerto Rico Medicare Part B - HR 1357, Puerto Rico Medicare Part B Equity Act of 2011. *Medicare and Medicaid - HR 3399, Medicare and Medicaid FAST Act. *Exempting Medicare from sequestration - HR 3519, To amend to exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011. *Medicare, Medicaid, ACA issues - HConRes 112, Establishing the budget for the United States Government for fiscal year 2013 and setting forth appropriate budgetary levels for fiscal years 2014 through 2022. *Federal financing of State Medicaid programs - HR 5979, Medicaid Accountability and Care Act of 2012.

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

Government targets: HOUSE OF REPRESENTATIVES

Educated Congressional staff about modernizing the Medicare program, including providing greater patient and provider incentives. H.R. 3399: Medicare and Medicaid FAST Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health IT issues, issues related to waste, fraud and abuse prevention. HR 3399, Medicare and Medicaid FAST Act, all provisions. S. 1251, Medicare and Medicaid FAST Act, all provisions. HR 4053 / S 1409, Improper Payments Elimination & Recovery Improvement Act, all provisions. HR 2146 / S 1222, Digital Accountability and Transparency Acts, provisions relating to fraud, waste and abuse.

Client expense: $390,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, and fraud and abuse; H.R. 1041 - Fairness in Medicare Bidding Act, all provisions; S.1251 - Medicare and Medicaid FAST Act, all provisions; H.R. 452 - Medicare Decisions Accountability Act of 2011, all provisions; S.668 - Health Care Bureaucrats Elimination Act, all provisions; H.R. 3399 - Medicare and Medicaid FAST Act, all provisions; H.R. 3630 - Middle Class Tax Relief and Job Creation Act of 2012, all provisions; H.Con.Res. 112 - House Budget Resolution for Fiscal Year 2013, all provisions; S.3187 - Food and Drug Administration Safety and Innovation Act, all provisions; H.R. 4378 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012, all provisions; H.R. 5652 - Sequester Replacement Reconciliation Act of 2012, all provisions; CMS prior authorization demonstration for power mobility devices.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, and fraud and abuse. H.R. 1041, Fairness in Medicare Bidding Act--all provisions. See continuation on next page. S. 1251 and H.R. 3399, Medicare and Medicaid FAST Act--all provisions. H.R. 452, Medicare Decisions Accountability Act of 2011--all provisions. S. 668, Health Care Bureaucrats Elimination Act--all provisions. H.R. 3399, Medicare and Medicaid FAST Act, all provisions. S. 3187, The Food and Drug Administration Safety and Innovation Act, all provisions. H.R. 4378, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2012, all provisions. H.R. 5652, Sequester Replacement Reconciliation Act of 2012, all provisions. CMS prior authorization demonstration for power mobility devices.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare Prior Authorization Demonstration Project for Power Mobility Devices (PMDs); PMD Documentation/Prescription/Physician Template Issues; DMEPOS National Competitive Bidding; S.1251 - the Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer Dollars; specifically 100% prepay review of power wheelchairs provision; HR3399 - Fighting Fraud and Abuse to Save Tax Payer Dollars Act; specifically 100% prepay review of power provision.

Client expense: $124,500 · Firm income: Not reported

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

Repeal Sustainable Growth Rate Formula; S. 1042 / H.R. 1700 Medicare Patient Empowerment Act; H.R. 3613 Part D Beneficiary Appeals Fairness Act; H.R. 3399 Medicare and Medicaid FAST Act; S. 1096 / H.R. 2020 Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act; Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111 - 148); Extension of Section 3111 of P.L. 111-148

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

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

Sustainable growth rate and impact on other Medicare programs, Medicare physician payment, budget offsets - HR 3630, Middle Class Tax Relief and Job Creation Act of 2012. Impact of House budget resolution on Medicare provisions - H Con Res 112, Establishing the budget for the United States Government for fiscal year 2013 and setting forth appropriate budgetary levels for fiscal years 2014 through 2022. *Part D price negotiation - S 31, Prescription Drug and Health Improvement Act of 2011; S 44, Medicare Prescription Drug Price Negotiation Act of 2011; HR 2248, Medicare Prescription Drug Price Negotiation Act of 2011. *Medicare Part D changes - HR 999, Medicare Prescription Drug Savings and Choice Act of 2011; S 560, Medicare Prescription Drug Savings and Choice Act of 2011. *Medicare secondary payer rules - HR 1063, Strengthening Medicare And Repaying Taxpayers Act of 2011. *Medicare Advantage enrollment periods - HR 1580, Medicare Beneficiary Preservation of Choice Act of 2011; S 1479, Medicare Beneficiary Preservation of Choice Act of 2011. *Rebates for dual eligibles - HR 2190, Medicare Drug Savings Act of 2011; S 1206, Medicare Drug Savings Act of 2011. *Strengthening Medicare anti-fraud measures - HR 675, Strengthening Medicare Anti-Fraud Measures Act of 2011. *Extension of Medicare cost plans - HR 2770, Medicare Cost Contract Extension Act of 2011; S 1497, Medicare Cost Contract Extension Act of 2011. *Medicare and Medicaid fraud and abuse - S 1251, Medicare and Medicaid FAST Act. *Budget offsets - S 1944, Middle Class Tax Cut Act of 2011; S 1931, Temporary Tax Holiday and Government Reduction Act. *Frailty adjuster for certain MA SNPs - HR 3691, Senior Medicare Fairness Act of 2011; S 1999, Senior Medicare Fairness Act. *Medicare physician payment, extension of QI and TMA programs, budget offsets - HR 3765, Temporary Payroll Tax Cut Continuation Act of 2011. *MA payment changes - HR 4254, Medicare Advantage Program Integrity Act of 2012. *Reforms affecting Medicare and Medigap - S 2196, Congressional Health Care for Seniors Act of 2012. *Incentives for wellness and prevention - S 2243, Medicare Better Health Rewards Program Act of 2012. *Puerto Rico Medicare Part B - HR 1357, Puerto Rico Medicare Part B Equity Act of 2011. *Medicare and Medicaid - HR 3399, Medicare and Medicaid FAST Act. *Exempting Medicare from sequestration - HR 3519, To amend to exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Federal Trade Commission and the role of state medical boards in state-based health professional regulation; Prescriber / patient education and responsible opioid prescribing policies to combat prescription drug abuse The Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (HR 3399/S 1251); Sec. 301; License portability enablers and licensure models that facilitate multi-state practice and telemedicine while preserving the state-based licensure system; The Online Pharmacy Safety Act (HR 4095/S 2002); all provisions Submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the Physician Payment Sunshine Act proposed rule; Sought to promote and strengthen physician credentials verification processes pursuant to expansion of state licensure exceptions provision (Sec. 713) in the National Defense Authorization Act for FY 2012; Participated on policy work group to support the expanded use of prescription drug monitoring programs (PDMP)

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

CMS 100% Prepay Review for Power Mobility Devices Demonstration Project; S.1251 - the Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer Dollars; specifically 100% prepay review of power wheelchair provision; HR3399 - Fighting Fraud and Abuse to Save Taxpayer Dollars Act; specifically 100% prepay review of power wheelchair provision;

Client expense: $123,000 · Firm income: Not reported

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

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148) S. 660, PATIENTS Act of 2011. S. 668, Health Care Bureaucrats Elimination Act. S. 1031, Medicaid Improvement and State Empowerment Act. H.R. 2013, Medicaid Improvement and State Empowerment Act. S. 2069, Spending Reductions through Innovations in Therapies Agenda Act of 2012. H.R. 3891, Spending Reductions through Innovations in Therapies Agenda Act of 2012. S. 2113, Transforming the Regulatory Environment to Accelerate Access to Treatments. S. 2196, Congressional Health Care for Seniors Act of 2012. H.R. 5, Protecting Access to Healthcare Act. H.R. 452, Medicare Decisions Accountability Act of 2011. H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011. H.R. 3399, Medicare and Medicaid FAST Act. H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011. (P.L. 112-96) H.R. 3839, Drug Shortage Prevention Act of 2012. H.R. 4209, Patients' Access to Treatments Act of 2012. Ryans Fy2013 Budget: A Path to Prosperity: A Blueprint for American Renewal Monitor federal issues and legislation associated with health care policy.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage; Medigap first-dollar coverage; Medicare Fraud S1251/H.R.3399 "Medicare and Medicaid FAST Act"

Client expense: $1,150,000 · Firm income: Not reported

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

H.Con.Res. 112, House budget resolution (Ryan) - Medicare, Medicaid, ACA issues. H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger). H.R. 1063, Strengthening Medicare And Repaying Taxpayers Act (Murphy) - Medicare secondary payer rules. H.R. 1580, Medicare Beneficiary Preservation of Choice Act (Gonzalez) - Medicare Advantage enrollment periods. H.R. 2190, Medicare Drug Savings Act (Waxman) - rebates for dual eligibles. H.R. 2248, Medicare Prescription Drug Price Negotiation Act (Welch) - Part D price negotiation. H.R. 2770, Medicare Cost Contract Extension Act (Paulsen) - extension of Medicare cost plans. H.R. 3399, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Roskam/Carney). H.R. 3519 (Towns) - exempting Medicare from sequestration. H.R. 3630, Temporary Payroll Tax Cut Continuation Act (Camp) - Medicare physician payment, extension of QI and TMA programs, budget offsets. H.R. 3691, Senior Medicare Fairness Act (Paulsen) - frailty adjuster for certain MA SNPs. H.R. 3765, Temporary Payroll Tax Cut Continuation Act (Camp) - Medicare physician payment, extension of QI and TMA programs, budget offsets.H.R. 4254, Medicare Advantage Program Integrity Act (Stark) - MA payment changes. S. 31, Prescription Drug and Health Improvement Act (Franken) - Part D price negotiation. S. 44, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Part D price negotiation. S. 560, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 1206, Medicare Drug Savings Act (Rockefeller) - rebates for dual eligibles. S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Coburn/Carper). S. 1479, Medicare Beneficiary Preservation of Choice Act (Casey) - Medicare Advantage enrollment periods S. 1497, Medicare Cost Contract Extension Act (Klobuchar) - extension of Medicare cost plans. S. 1931, Temporary Tax Holiday and Government Reduction Act (Heller) -budget offsets. S. 1944, Middle Class Tax Cut Act (Casey) - budget offsets. S. 1999, Senior Medicare Fairness Act (Klobuchar) - frailty adjuster for certain MA SNPs. S. 2196, Congressional Health Care for Seniors Act (Paul) - reforms affecting Medicare and Medigap. S. 2243, Medicare Better Health Rewards Program Act (Wyden-Portman) - incentives for wellness and prevention.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health IT issues, issues related to waste, fraud and abuse prevention. HR 3399, Medicare and Medicaid FAST Act, all provisions. S. 1251, Medicare and Medicaid FAST Act, all provisions. HR 4053 / S 1409, Improper Payments Elimination & Recovery Improvement Act, all provisions. HR 173, Medicare Fraud Prevention Act of 2011, all provisions.

Client expense: $360,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, and fraud and abuse. H.R. 1041, Fairness in Medicare Bidding Act--all provisions. See continuation on next page. S. 1251 and H.R. 3399, Medicare and Medicaid FAST Act--all provisions. H.R. 452, Medicare Decisions Accountability Act of 2011--all provisions. S. 668, Health Care Bureaucrats Elimination Act--all provisions. H.R. 3399, Medicare and Medicaid FAST Act, all provisions. H.R. 3630, The Middle Class Tax Relief and Job Creation Act of 2012 (Became PL 112-96 on 2/22/12).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, and fraud and abuse; H.R. 1041- Fairness in Medicare Bidding Act, all provisions; S.1251 - Medicare and Medicaid FAST Act, all provisions; H.R. 452 - Medicare Decisions Accountability Act of 2011, all provisions; S.668 - Health Care Bureaucrats Elimination Act, all provisions; H.R. 3399 - Medicare and Medicaid FAST Act, all provisions; H.R. 3630 - Middle Class Tax Relief and Job Creation Act of 2012, all provisions; H.Con.Res. 112-House Budget Resloution for Fiscal Year 2013, all provisions.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), Office of Management & Budget (OMB), SENATE, White House Office

S.1251 - the Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer Dollars; specifically 100% prepay review of power wheelchair provision; HR 3399 - Fighting Fraud and Abuse to Save Taxpayer Dollars Act; specifically 100% prepay review of power wheelchair provision; Power mobility device documentation standards that are regulated by the Centers for Medicare and Medicaid Services (CMS).

Client expense: $151,000 · Firm income: Not reported

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

Issues related to USDA licensed exhibitors; HR 3399 - transport of animals; Animal enterprise Terrorism Act (AETA)

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

Government targets: Agriculture, Dept of (USDA), HOUSE OF REPRESENTATIVES, Interior, Dept of (DOI), SENATE

Medicare Advantage; Medigap first-dollar coverage; Medicare Fraud S1251/H.R.3399 "Medicare and Medicaid FAST Act"

Client expense: $780,000 · Firm income: Not reported

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

H.R. 3399 Medicare & Medicaid Fraud Protections

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 452, Medicare Decisions Accountability Act of 2011, all provisions S. 668, Health Care Bureaucrats Elimination Act, all provisions H.R. 1700, Medicare Patient Empowerment Act, all provisions S. 1042, Medicare Patient Empowerment Act, all provisions S. 818, Improving Access to Medicare Coverage Act of 2011, all provisions H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011, provisions on the sustainable growth rate (SGR) H.R. 3765, Temporary Payroll Tax Cut Continuation Act of 2011, provisions on the SGR H.R. 674, To amend the Internal Revenue Code of 1986 to repeal the imposition of 3 percent withholding on certain payments made to vendors by government entities, to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs, and for other purposes, provision on 3 percent withholding H.R. 3399, Medicare and Medicaid FAST Act, all provisions Medicare Physician Payment Innovation Act of 2011, provisions on SGR repeal Medicare program - SGR permanent repeal Medicare program - Self-referral/anatomic pathology Medicare program - Private contracting Medicare program - Repeal of the Independent Payment Advisory Board (IPAB) Medicare program - Graduate Medical Education (GME) Medicare program - Performance measurement Medicare program - Physician Quality Reporting System (PQRS) Medicare program - eRx incentive and penalty program Medicare program - Value-based modifier Medicare program - Enrollment Medicare program - Extenders Medicare program - Program Integrity Medicare program - CPT and use of Z codes Medicare program - FY 2012 Physician Fee Schedule Medicare program - FY 2012 Physician Fee Schedule/End-of-life Issues Medicare program - Accountable Care Organizations/Shared Savings Medicare program - Preventive services Medicare program - Off-cycle Revalidation Medicare program - Durable Medical Equipment Medicare program - RUC/CPT chronic care payment Medicare program - Imaging services Medicare program - Enhanced use of prepayment review and preauthorization Medicare and Medicaid programs - Physician identity theft Medicare and Medicaid programs - Meaningful Use/Electronic Health Records (EHR's) Medicare and Medicaid programs - Delivery and payment reform Medicare and Medicaid programs - Recovery Audit Contractors Medicare and Medicaid programs - Administrative burden Medicare and Medicaid programs - Medical Liability Reform Medicare and Medicaid programs - Health Information Technology Medicare and Medicaid programs - HIPAA (5010, ICD-10, National Payer ID, EFT) Medicare and Medicaid programs - Conditions of Participation

Client expense: $5,210,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Defense, Dept of (DOD), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

Impact of deficit reduction issues and actions of the Joint Committee on Deficit Reduction on Medicare and Medicare Part D - Proposed legislation re these issues. Sustainable growth rate and impact on other Medicare programs; *Medicare physician payment, extension of QI and TMA programs; *budget offsets - HR 3630, Temporary Payroll Tax Cut Continuation Act of 2011; HR 3765, Temporary Payroll Tax Cut Continuation Act of 2011. Potential changes to Medicare Advantage - Proposed legislation re this issue. *Part D price negotiation - S 31, Prescription Drug and Health Improvement Act of 2011; S 44, Medicare Prescription Drug Price Negotiation Act of 2011; HR 2248, Medicare Prescription Drug Price Negotiation Act of 2011; HR 3399, Medicare and Medicaid FAST Act; HR 3519, To amend to exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011; HR 3630, Temporary Payroll Tax Cut Continuation Act of 2011; HR 3691, Senior Medicare Fairness Act of 2011; HR 3765, Temporary Payroll Tax Cut Continuation Act of 2011. *Medicare Part D changes - HR 999, Medicare Prescription Drug Savings and Choice Act of 2011; S 560, Medicare Prescription Drug Savings and Choice Act of 2011. *Medicare secondary payer rules - HR 1063, Strengthening Medicare And Repaying Taxpayers Act of 2011. *Medicare Advantage enrollment periods - HR 1580, Medicare Beneficiary Preservation of Choice Act of 2011; S 1479, Medicare Beneficiary Preservation of Choice Act of 2011; HR 1357, Puerto Rico Medicare Part B Equity Act of 2011. *Rebates for dual eligibles - HR 2190, Medicare Drug Savings Act of 2011; S 1206, Medicare Drug Savings Act of 2011. *Strengthening Medicare anti-fraud measures - HR 675, Strengthening Medicare Anti-Fraud Measures Act of 2011. *Extension of Medicare cost plans - HR 2770, Medicare Cost Contract Extension Act of 2011; S 1497, Medicare Cost Contract Extension Act of 2011. *Medicare and Medicaid fraud and abuse - S 1251, Medicare and Medicaid FAST Act. *Budget offsets - S 1944, Middle Class Tax Cut Act of 2011; S 1931, Temporary Tax Holiday and Government Reduction Act. *Frailty adjuster for certain MA SNPs - S 1999, Senior Medicare Fairness Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health IT issues, issues related to waste, fraud and abuse prevention. HR 675, Strengthening Medicare Anti-Fraud Measures Act, all provisions. HR 3399, Medicare and Medicaid FAST Act, all provisions. S. 1251, Medicare and Medicaid FAST Act, all provisions. HR 173, Medicare Fraud Prevention Act of 2011, all provisions.

Client expense: $430,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger), H.R. 999, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes, H.R. 1063, Strengthening Medicare And Repaying Taxpayers Act (Murphy) - Medicare secondary payer rules, H.R. 1357, Puerto Rico Medicare Part B Equity Act (Pierluisi), H.R. 1580, Medicare Beneficiary Preservation of Choice Act (Gonzalez) Medicare Advantage enrollment periods, H.R. 2190, Medicare Drug Savings Act, 16. Specific Lobbying Issues (con't): (Waxman) rebates for dual eligibles, H.R. 2248, Medicare Prescription Drug Price Negotiation Act (Welch) Part D price negotiation, H.R. 2770, Medicare Cost Contract Extension Act (Paulsen) extension of Medicare cost plans, H.R. 3399, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Roskam/Carney), H.R. 3519 (Towns) exempting Medicare from sequestration, H.R. 3630, Temporary Payroll Tax Cut Continuation Act (Camp) Medicare physician payment, extension of QI and TMA programs, budget offsets, H.R. 3691, Senior Medicare Fairness Act (Paulsen) frailty adjuster for certain MA SNPs, H.R. 3765, Temporary Payroll Tax Cut Continuation Act (Camp) Medicare physician payment, extension of QI and TMA programs, budget offsets, S. 31, Prescription Drug and Health Improvement Act (Franken) Part D price negotiation, S. 44, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Part D price negotiation, S. 560, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes, S. 1206, Medicare Drug Savings Act (Rockefeller) rebates for dual eligibles, S. 1251, Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (Coburn/Carper), S. 1479, Medicare Beneficiary Preservation of Choice Act (Casey) Medicare Advantage enrollment periods, S. 1497, Medicare Cost Contract Extension Act (Klobuchar) extension of Medicare cost plans, S. 1931, Temporary Tax Holiday and Government Reduction Act (Heller) budget offsets, S. 1944, Middle Class Tax Cut Act (Casey) budget offsets, S. 1999, Senior Medicare Fairness Act (Klobuchar) frailty adjuster for certain MA SNPs MMM (Regulatory Issues): Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including; risk adjustment methodology, data, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; implementation of MA and Part D changes made in the Accountable Care Act (ACA), including application of the MA Star Rating system for payment purposes starting 2012 and changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to data warehouses including the Office of Personnel Management and Office of the Inspector General proposals related to the Federal Employee Health Benefits Program and all-payer comparative effectiveness research and health information technology standards and policies.

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

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

The National Defense Authorization Act for Fiscal Year 2012; Federal Trade Commission and State-based Medical Licensure; Medicare/Medicaid Fraud and Abuse (S. 1251/H.R. 3399, Medicare and Medicaid FAST Act); Graduate Medical Education (GME); Responsible Opioid Prescribing/Provider Education; Physician Credentials Verification; Health Care Workforce; Telemedicine; Physician License Portability; Patient Safety; Prescription Drug Abuse; NASPER (HR 866)

Client expense: $170,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, and fraud and abuse. H.R. 1041, Fairness in Medicare Bidding Act--all provisions. See continuation on next page. S. 1251 and H.R. 3399, Medicare and Medicaid FAST Act--all provisions. H.R. 452, Medicare Decisions Accountability Act of 2011--all provisions. S. 668, Health Care Bureaucrats Elimination Act--all provisions. Budget Control Act of 2011 Implementation (Became PL 112-25 on August 2, 2011) H.R. 3630, Temporary Payroll Tax Cut Continuation Act of 2011 H.R. 3765, Temporary Payroll Tax Cut Continuation Act of 2011 (Became PL 112-78 on 12/23/11)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 3399; Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer Dollars (FAST) Act; all sections Supporting legislative action that would revise a Medicare Part B policy that is causing the government to squander millions of dollars annually

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, diabetic supplies, negative pressure wound therapy, Medicare audits, and fraud and abuse; H.R. 1041- Fairness in Medicare Bidding Act, all provisions; H.R. 1 - Full-Year Continuing Appropriations Act, 2011, provisions related to HHS; S.1251 - Medicare and Medicaid FAST Act, all provisions; H.R. 452 - Medicare Decisions Accountability Act of 2011, all provisions; S.668 - Health Care Bureaucrats Elimination Act, all provisions; H.R. 3399 - Medicare and Medicaid FAST Act, all provisions; H.R. 3630 - Temporary Payroll Tax Cut Continuation Act of 2011, House and Senate versions, all provisions.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE