Medicare Decisions Accountability Act of 2011

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

Client expense: $316,855 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Sustainable Growth Rate Formula Reform (general); H.R. 452, Medicare Decisions Accountability Act; S. 688, Health Care Bureaucrats Elimination Act; Imaging (general); Medicaid (general); H.R. 2020/ S.1096, Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act; Strong Start Initiative; Primary care payment bonuses.

Client expense: $316,855 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Medicare: H.R 831/S. 483: Medicare Mental Health Access Act S. 374/H.R 2783: Medicare Mental Health Inpatient Equity Act H.R 452/S. 668: Medicare Decisions Accountability Act H.R 3630: Middle Class Tax Relief and Job Creation Act of 2012

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page 5 for specific lobbying issues. H.R. 2 - Repealing the Job-Killing Health Care Law Act H.R. 5/S. 218/S.1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 8 American Taxpayer Relief Act of 2012 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R.1172 - Medicare Lung Cancer Early Detection Promotion Act of 2011 H.R. 1256 - Medicare Physician Payment Transparency and Assessment Act of 2011 H.R. 3475 - Keeping IDs Safe Act - Provisions related to Pediatric Subspecialty Loan Repayment Program H.R. 3630/3743/3765 - Temporary Payroll Tax Cut Continuation Act of 2011 - Provisions related to Medicare physician payment only H.Res. 9 - Instructing certain committees to report legislation replacing the job-killing health care law H.J. Res. 48 - Additional Continuing Appropriations Amendments, 2011 S. 668 - Health Care Bureaucrats Elimination Act S. 756 Medicare Data Access for Transparency and Accountability Act Health care reform, health care quality improvement; physician workforce; comparative effectiveness research; health information technology; HIT Meaningful Use; Sustainable Growth Rate; Independent Payment Advisory Board; accountable care organizations; resident work hours; Patient Centered Outcomes Research Institute; Center for Medicare and Medicaid Innovation; MEDCAC; Coverage with Evidence Development

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE

Issues surrounding the enactment or repeal of the Affordable Care Act, including IPAB and ACOs. Medicare reimbursement for providers. FDA Reauthorization. Issues surrounding the tissue bank industry. HR 452: Medicare Decisions Accountability Act (IPAB repeal). S 668: Health Care Bureaucrats Elimination Act (IPAB repeal) HR 1845, S 960: Medicare IVIG Access Act. HR 5: Protecting Access to Healthcare Act (Medical Liability Reform) HR 1955, S. 1045: Children's Access to Reconstructive Evaluation and Surgery Act. HR 6155: Palliative Care and Hospice Education and Training Act. HR 5937: The Breast Cancer Patient Education Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 668, Health Care Bureaucrats Elimination Act - Lobbied for passage of bill to eliminate the Independent Payment Advisory Board. H.R. 452, Medicare Decisions Accountability Act - Lobbied for passage of bill to eliminate the Independent Payment Advisory Board.Bill not yet introduced, The Medicare Home Infusion Therapy Coverage Act - Lobbied for expanded coverage of home infusion therapy. S. 1454 and H.R. 2969, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act - Lobbied for extended coverage of immunosuppresive drugs in Medicare. H.R. 2190 and S. 1206, Medicare Drug Savings Act of 2011 - Lobbied to oppose extending Medicaid rebates to Medicare Part D. No Bill, Health care reform implementation. Lobbied CMS on new definition of the Average Manufacturer's Price calculation in Medicaid.

Client expense: $560,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE, Treasury, Dept of

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)

Client expense: $8,158 · Firm income: Not reported

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

Regarding coverage of medications for mental health and substance use disorders in health care reform law (ACA) Medicare Decisions Accountability Act of 2011 (HR 452/S. 668) S.A.F.E. Compounded Drugs Act of 2012 (H.R.6638)

Client expense: $8,158 · Firm income: Not reported

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

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)

Client expense: $8,158 · Firm income: Not reported

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

HR452, Medicare Decisions Accountability Act, Revamping the Independent Payment Advisory Board. HR2055, Military Construction and Veterans Affairs and Related Appropriations Act, Promoting AAFP federal budget priorities - Title VII Sec 747, NHSC, AHRQ, Rural Health and Workforce Commission.HR3630, Welfare Integrity and Data Improvement Act, Prevent Medicare physician pay cut effective March 1, 2012. HR3667, Primary Care Workforce Access Improvement Act of 2011, GME modernization pilot program authorization, Direct GME funding for non-hospital training sites. HR3671, Judiciary Appropriations Act, 2012, Promoting AAFP federal budget priorities - Title VII Sec 747, NHSC, AHRQ, Rural Health and Workforce Commission. HR4013, Temporary Payroll Tax Cut Continuation Act, Ten month extension of the Medicare physician fee schedule. PL112-25, Impact of the Budget Control Act on FY13 HHS appropriations process and Medicare payment, AAFP budget priorities funding and Medicare physician payment. S407, Prescription Drug Abuse Prevention and Treatment Act of 2011, Ensure that Senator Rockefeller's bill is not burdensome to family physicians but increases communication among states to allow them to identify prescription drug abusers. No Bill Number, Title VII Sec 747 primary care grants stakeholders conference call, Supporting Title VII training to family medicine grants, NHSC, AHRQ, Workforce Commission, Rural Health. No Bill Number, Medicare physician payment reform of the Sustainable Growth Rate, Medicare physician pay cuts scheduled for 2013. No Bill Number, Budget allocation for the discretionary spending on health programs and agencies, Ensure adequate federal funds for AAFP budget priorities. No Bill Number, HHS FY2013 budget briefing, AAFP budget priorities. No Bill Number, AAFP Board Officers meeting to present FY2013 Appropriations priorities, AAFP budget priorities. No Bill Number, HHS FY2013 conference call, AAFP budget priorities. No Bill Number, SGR, Medicare payment, Include a repeal of the SGR within super-committee deliberations and include a primary care differential. No Bill Number, Rural Hospital Residency development meeting and discussions, Increasing the number of slots for family physicians to train in community settings. No Bill Number, AAFP Board Officers meeting to present FY2013 Appropriations priorities, AAFP budget priorities. HR2119, Ryan Creedon Act of 2011, Opposing a requirement that physicians be specially trained on the dangers of addictive drugs. No Bill Number, Valuation of Primary Care, Strategies for improving primary care payment in the physician fee schedule. No Bill Number, Primary Care Incentive Payment (PCIP), Requesting CMS release data on PCIP use. No Bill Number, Innovative quality and efficiency recognition reward programs that might be adopted by Medicare, Family physicians are focusing on quality, HIT and the PCMH model to transform practices. No Bill Number, Adequacy and accuracy of Medicare physician payment, Positive payment differential for Primary Care Physicians. No Bill Number, Legislation to repeal Independent Payment Advisory Board (IPAB), AAFP is dissatisfied with IPAB's composition and process but have not called for IPAB repeal. No Bill Number, Increasing physician awareness of TBI and PTSD, Promoting family physician pay cuts scheduled for 2013 No Bill Number, Task force on primary care valuation meeting, Medical home and health care reform No Bill Number, PCPCC Center for Consumer Engagement, Medical Home and Health Care Reform. No Bill Number, Tobacco cessation, Health of the public No Bill Number, Primary care meeting, Medical home and health care reform. No Bill Number, Meaningful use meetings, Medical home and health care reform. No Bill Number, Adequacy and accuracy of Medicare physician payment, Positive payment differential for primary care physicians. No Bill Number, Invitation to judge the 2013 Family Physician of the Year competition, competition.

Client expense: $747,230 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, White House Office

HR5, Protecting Access to Health Are Act, Capping medical liability. HR452, Medicare Decisions Accountability Act, Revamping the independent payment advisory board.HR3630, Welfare Integrity and Data Improvement Act, Prevent Medicare physician pay cut effective March 1, 2012. HR3667, Primary Care Workforce Access Improvement Act of 2011, GME modernization pilot program authorization, Direct GME funding for non-hospital training sites. HR 4013, Temporary Payroll Tax Cut Continuation Act, ten month extension of the Medicare physician fee schedule. PL112-25, Impact of the Budget Control Act on FY13 HHS appropriations process and Medicare payment, AAFP budget priorities funding and Medicare physician payment. No Bill Number, Innovative quality and efficiency recognition reward programs that might be adopted by Medicare, Family physicians are focusing on quality, HIT and the PCMH model to transform practices. No Bill Number, HHS FY2013 budget briefing, AAFP budget priorities. No Bill Number, AAFP Board Officers meeting to present FY2013 Appropriations priorities, AAFP budget priorities. No Bill Number, Conference call on FY2013 HHS spending request, AAFP budget priorities. No Bill Number, Medicare physician payment reform of the Sustainable Growth Rate, Medicare physician pay cuts scheduled for 2013. No Bill Number, Increasing physician awareness of TBI and PTSD, Promoting family physician pay cuts scheduled for 2013 No Bill Number, Task force on primary care valuation meeting, Medical home and health care reform No Bill Number, PCPCC Center for Consumer Engagement, Medical Home and Health Care Reform. No Bill Number, Tobacco cessation, Health of the public No Bill Number, Primary care meeting, Medical home and health care reform. No Bill Number, Meaningful use meetings, Medical home and health care reform. No Bill Number, Valuation of Primary Care, Strategies for improving primary care payment in the physician fee schedule. No Bill Number, Primary Care Incentive Payment (PCIP), Requesting CMS release data on PCIP use. No Bill Number, Adequacy and accuracy of Medicare physician payment, Positive payment differential for primary care physicians. No Bill Number, SGR, Medicare payment, Include a repeal of the SGR within super-committee deliberations and include a primary care differential. No Bill Number, Medicare Part D, Ensure that CMS continues to hear from practicing physicians on drug issues, including Part D. No Bill Number, GME, Advocate for GME pilot project.

Client expense: $747,230 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, White House Office

HR452, Medicare Decisions Accountability Act, Revamping the Independent Payment Advisory Board. HR2055, Military Construction and Veterans Affairs and Related Appropriations Act, Promoting AAFP federal budget priorities - Title VII Sec 747, NHSC, AHRQ, Rural Health and Workforce Commission.HR3630, Welfare Integrity and Data Improvement Act, Prevent Medicare physician pay cut effective March 1, 2012. HR3667, Primary Care Workforce Access Improvement Act of 2011, GME modernization pilot program authorization, Direct GME funding for non-hospital training sites. HR3671, Judiciary Appropriations Act, 2012, Promoting AAFP federal budget priorities - Title VII Sec 747, NHSC, AHRQ, Rural Health and Workforce Commission. HR4013, Temporary Payroll Tax Cut Continuation Act, Ten month extension of the Medicare physician fee schedule. PL112-25, Impact of the Budget Control Act on FY13 HHS appropriations process and Medicare payment, AAFP budget priorities funding and Medicare physician payment. S407, Prescription Drug Abuse Prevention and Treatment Act of 2011, Ensure that Senator Rockefeller's bill is not burdensome to family physicians but increases communication among states to allow them to identify prescription drug abusers. No Bill Number, Title VII Sec 747 primary care grants stakeholders conference call, Supporting Title VII training to family medicine grants, NHSC, AHRQ, Workforce Commission, Rural Health. No Bill Number, Medicare physician payment reform of the Sustainable Growth Rate, Medicare physician pay cuts scheduled for 2013. No Bill Number, Budget allocation for the discretionary spending on health programs and agencies, Ensure adequate federal funds for AAFP budget priorities. No Bill Number, HHS FY2013 budget briefing, AAFP budget priorities. No Bill Number, AAFP Board Officers meeting to present FY2013 Appropriations priorities, AAFP budget priorities. No Bill Number, HHS FY2013 conference call, AAFP budget priorities. No Bill Number, SGR, Medicare payment, Include a repeal of the SGR within super-committee deliberations and include a primary care differential. No Bill Number, Rural Hospital Residency development meeting and discussions, Increasing the number of slots for family physicians to train in community settings. No Bill Number, AAFP Board Officers meeting to present FY2013 Appropriations priorities, AAFP budget priorities. HR2119, Ryan Creedon Act of 2011, Opposing a requirement that physicians be specially trained on the dangers of addictive drugs. No Bill Number, Valuation of Primary Care, Strategies for improving primary care payment in the physician fee schedule. No Bill Number, Primary Care Incentive Payment (PCIP), Requesting CMS release data on PCIP use. No Bill Number, Innovative quality and efficiency recognition reward programs that might be adopted by Medicare, Family physicians are focusing on quality, HIT and the PCMH model to transform practices. No Bill Number, Adequacy and accuracy of Medicare physician payment, Positive payment differential for Primary Care Physicians. No Bill Number, Legislation to repeal Independent Payment Advisory Board (IPAB), AAFP is dissatisfied with IPAB's composition and process but have not called for IPAB repeal. No Bill Number, Increasing physician awareness of TBI and PTSD, Promoting family physician pay cuts scheduled for 2013 No Bill Number, Task force on primary care valuation meeting, Medical home and health care reform No Bill Number, PCPCC Center for Consumer Engagement, Medical Home and Health Care Reform. No Bill Number, Tobacco cessation, Health of the public No Bill Number, Primary care meeting, Medical home and health care reform. No Bill Number, Meaningful use meetings, Medical home and health care reform. No Bill Number, Adequacy and accuracy of Medicare physician payment, Positive payment differential for primary care physicians. No Bill Number, Invitation to judge the 2013 Family Physician of the Year competition, competition.

Client expense: $747,230 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, White House Office

HR5, Protecting Access to Health Are Act, Capping medical liability. HR452, Medicare Decisions Accountability Act, Revamping the independent payment advisory board.HR3630, Welfare Integrity and Data Improvement Act, Prevent Medicare physician pay cut effective March 1, 2012. HR3667, Primary Care Workforce Access Improvement Act of 2011, GME modernization pilot program authorization, Direct GME funding for non-hospital training sites. HR 4013, Temporary Payroll Tax Cut Continuation Act, ten month extension of the Medicare physician fee schedule. PL112-25, Impact of the Budget Control Act on FY13 HHS appropriations process and Medicare payment, AAFP budget priorities funding and Medicare physician payment. No Bill Number, Innovative quality and efficiency recognition reward programs that might be adopted by Medicare, Family physicians are focusing on quality, HIT and the PCMH model to transform practices. No Bill Number, HHS FY2013 budget briefing, AAFP budget priorities. No Bill Number, AAFP Board Officers meeting to present FY2013 Appropriations priorities, AAFP budget priorities. No Bill Number, Conference call on FY2013 HHS spending request, AAFP budget priorities. No Bill Number, Medicare physician payment reform of the Sustainable Growth Rate, Medicare physician pay cuts scheduled for 2013. No Bill Number, Increasing physician awareness of TBI and PTSD, Promoting family physician pay cuts scheduled for 2013 No Bill Number, Task force on primary care valuation meeting, Medical home and health care reform No Bill Number, PCPCC Center for Consumer Engagement, Medical Home and Health Care Reform. No Bill Number, Tobacco cessation, Health of the public No Bill Number, Primary care meeting, Medical home and health care reform. No Bill Number, Meaningful use meetings, Medical home and health care reform. No Bill Number, Valuation of Primary Care, Strategies for improving primary care payment in the physician fee schedule. No Bill Number, Primary Care Incentive Payment (PCIP), Requesting CMS release data on PCIP use. No Bill Number, Adequacy and accuracy of Medicare physician payment, Positive payment differential for primary care physicians. No Bill Number, SGR, Medicare payment, Include a repeal of the SGR within super-committee deliberations and include a primary care differential. No Bill Number, Medicare Part D, Ensure that CMS continues to hear from practicing physicians on drug issues, including Part D. No Bill Number, GME, Advocate for GME pilot project.

Client expense: $747,230 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, White House Office

Repeal of the Independent Payment Advisory Board (H.R. 452/H.R. 5; S. 668/S. 2118); 2012 final Medicare physician fee schedule, implementation of Medicare pre and post-payment audits (OMB review for CMS-10417); Sunshine Act (ACA section 6002) implementation; and Transcather Aortic Valve Replacement Medicare coverage policy; implementation of appropriate use criteria; repeal of the Independent Payment Advisory Board; advocacy for year-end issues including the sustainable growth rate ("doc fix")

Client expense: Not reported · Firm income: $7,200

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

Repeal of the Independent Payment Advisory Board (H.R. 452/H.R. 5; S. 668/S. 2118); 2012 final Medicare physician fee schedule, implementation of Medicare pre and post-payment audits (OMB review for CMS-10417); Sunshine Act (ACA section 6002) implementation; and Transcather Aortic Valve Replacement Medicare coverage policy; implementation of appropriate use criteria; repeal of the Independent Payment Advisory Board; advocacy for year-end issues including the sustainable growth rate ("doc fix")

Client expense: Not reported · Firm income: $7,200

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

Repeal of the Independent Payment Advisory Board (H.R. 452/H.R. 5; S. 668/S. 2118); 2012 final Medicare physician fee schedule, implementation of Medicare pre and post-payment audits (OMB review for CMS-10417); Sunshine Act (ACA section 6002) implementation; and Transcather Aortic Valve Replacement Medicare coverage policy; implementation of appropriate use criteria; repeal of the Independent Payment Advisory Board; advocacy for year-end issues including the sustainable growth rate ("doc fix")

Client expense: Not reported · Firm income: $7,200

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

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148) S. 2113, Transforming the Regulatory Environment to Accelerate Access to Treatments. S. 2196, Congressional Health Care for Seniors Act of 2012. S. 2236, Advancing Breakthrough Therapies for Patients Act of 2012. S. 3295, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013. Draft, House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013. H.R. 5, Protecting Access to Healthcare Act. H.R. 452, Medicare Decisions Accountability Act of 2011. H.R. 3839, Drug Shortage Prevention Act of 2012. H.R. 4209, Patients' Access to Treatments Act of 2012. H.R. 451, Healthcare Truth and Transparency Act of 2011. H.R. 5707, Medicare Physician Payment Innovation Act of 2012. H.R. 6142, Assuring Medicare Stability and Access for Seniors Act of 2012. H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act. H.R. 6482, To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. H.R. 6562, Resident Physician Shortage Reduction Act of 2012. HJRes 117, Continuing Appropriations Resolution, 2013. (P.L. 112-175) 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

Legislation and issues related to: Physician/nurse reimbursement; Medicare Medical Home; Medicaid Health Home; Medicare-Medicaid Advanced Primary Care demonstration; Accountable Care Organizations; Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148); Repeal/retention of Medicaid maintenance of effort requirements; Graduate Nurse Education demonstration; Home health face-to-face examination requirements; Medicare-Medicaid Program Integrity policies; Independent Payment Advisory Board (IPAB); Medicare-Medicaid hospital conditions of participation; Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges; Medicaid waiver application procedures; State of Florida Section 1115 Medicaid waiver application on managed medical assistance program; Medicare-Medicaid dual eligibles coverage and demonstration; Ordering of Medicare portable x-ray services; Provisions of the 2013 Medicare physician payment proposed rule; Medicaid per capita cap policy options; Medicaid payment for primary care services; Medicaid eligibility expansion and state options; Social Security Administration policies on primary medical evidence of disability; H.R. 2 - Repealing the Job-Killing Health Care Law Act; S. 16 - Patient Choice Restoration Act; S. 56/H.R. 2134 - Medicaid Advanced Practice Nurses and Physician Assistants Access Act; S. 58/H.R. 876 - Registered Nurse Safe Staffing Act; S. 227/H.R. 2267 - Home Health Care Planning Improvement Act; S. 244/H.R. 782 - State Health Care Flexibility Act; H.R. 560 - Rural Representation and Transparency Improvement Act; H.R. 452 - Medicare Decisions Accountability Act; S. 668 - Health Care Bureaucrats Elimination Act; S. 1680 - Craig Thomas Rural Hospital and Provider Equity Act; H.R. 3859 - Rural Hospital and Provider Equity Act; H.R. 3630/H.R. 3743/H.R. 3765 - Temporary Payroll Tax Cut Continuation Act; H.R. 3326/S. 1587 - Medicaid Flexibility for States Act; H.R. 4160 - State Health Flexibility Act; S. 2057 - To amend Title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. H.R. 5979 - Medicaid Accountability and Care (MAC) Act; H.R. 436 - Health Care Cost Reduction Act; H.R. 5707 - Medicare Physician Payment Innovation Act; H.R. 4348 - MAP-21 and offsets for student loan interest rate provisions; H.R. 6079 - Repeal of Obamacare Act; H.R. 6684 - Spending Reduction Act; H.R. 8 - American Taxpayer Relief Act.

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Legislation and issues related to: Physician/nurse reimbursement; Medicare Medical Home; Medicaid Health Home; Medicare-Medicaid Advanced Primary Care demonstration; Accountable Care Organizations; Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148); Repeal/retention of Medicaid maintenance of effort requirements; Graduate Nurse Education demonstration; Home health face-to-face examination requirements; Coverage and payment for CPT code 96110; Medicare-Medicaid Program Integrity policies; Independent Payment Advisory Board (IPAB); Medicare-Medicaid hospital conditions of participation; Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges; Medicaid waiver application procedures; State of Florida Section 1115 Medicaid waiver application on managed medical assistance program; Medicare-Medicaid dual eligibles coverage and demonstration; Ordering of Medicare portable x-ray services; Provisions of the 2013 Medicare physician payment proposed rule; Medicaid per capita cap policy options; Medicaid payment for primary care services; Medicaid eligibility expansion and state options; Social Security Administration policies on primary medical evidence of disability; H.R. 2 - Repealing the Job-Killing Health Care Law Act; S. 16 - Patient Choice Restoration Act; S. 56/H.R. 2134 - Medicaid Advanced Practice Nurses and Physician Assistants Access Act; S. 58/H.R. 876 - Registered Nurse Safe Staffing Act; S. 227/H.R. 2267 - Home Health Care Planning Improvement Act; S. 244/H.R. 782 - State Health Care Flexibility Act; H.R. 560 - Rural Representation and Transparency Improvement Act; H.R. 452 - Medicare Decisions Accountability Act; S. 668 - Health Care Bureaucrats Elimination Act; S. 1680 - Craig Thomas Rural Hospital and Provider Equity Act; H.R. 3859 - Rural Hospital and Provider Equity Act; H.R. 3630/H.R. 3743/H.R. 3765 - Temporary Payroll Tax Cut Continuation Act; H.R. 3326/S. 1587 - Medicaid Flexibility for States Act; H.R. 4160 - State Health Flexibility Act; S. 2057 - To amend Title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs; H.R. 340 - Amending title XIX (Medicaid) of the Social Security Act to repeal the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases; H.R. 669 - Ensuring Continuous Medicaid Coverage for Children Act; H.R. 671 - Ensuring Continuous Coverage under SCHIP Act H.R. 5979 - Medicaid Accountability and Care (MAC) Act; H.R. 436 - Health Care Cost Reduction Act; H.R. 5707 - Medicare Physician Payment Innovation Act; H.R. 4348 - MAP-21 and offsets for student loan interest rate provisions; H.R. 6079 - Repeal of Obamacare Act; H.R. 6684 - Spending Reduction Act; H.R. 8 - American Taxpayer Relief Act.

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Support American Society of Consultant Pharmacists and "Short Cycle Dispensing Coalition" recommendations regarding the delay and study of new long-term care pharmacy dispensing rules and the impact of those rules on Medicare and Medicaid patients. Support H.R. 1055, the Part D Off-Label Prescription Drug Parity Act. Continue to oppose cuts to Medicare benefits, and continue to oppose the Independent Payment Advisory Board (IPAB). Support Medicare Access for Patients Rx (MAPRx) recommendations to Centers for Medicare and Medicaid Services (CMS) all regarding Medicare Part D. Those MAPRx recommendations are in regard to: Improved beneficiary protections; Better, more transparent Specialty Tier guidance including the threshold for inclusion on this tier and the inclusion of data for newly approved drugs; New, more realistic co-pay thresholds; Automatic disenrollment from Special Needs Plans; Proposed plan rating criteria; and Approval of six-tier formularies. These are in addition to MAPRx concerns regarding: The Part D Medicare appeals process and the handling of enrollee complaints; Drug dispensing rules for Part D beneficiaries in long-term care facilities; the Authority to deny bids and potential additional restrictions; and Compound Drug Policy. Support repeal of IPAB (H.R. 452). Support changes to the Medicare Shared Savings Program: Accountable Care Organization (ACO) proposed regulations, to provide additional safeguards to guarantee patient access to needed care, and to ensure that ACO's support the adoption of new treatments and cures for patients. Also support the addition of new Alzheimer's disease focused ACO quality measures, new ACO measures of provider evidence of competency in Geriatrics and Dementia, as well as a guarantee that Alzheimer's and Dementia patients under ACO care will have access to the newest pharmaceutical and biological treatments. Support repeal of Section 6001 of the PPACA and remove all restrictions on physician-owned hospitals. (Support H.R. 1159 and H.R. 1186) Oppose federal budget cuts that would increase co-payments for home health care services under Medicare and/or Medicaid Support the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (S. 1096 and H.R. 2020) Support MAPRx suggestions to CMS on Medicare Part D Prescription Drug Program regarding new beneficiary-friendly point-of-sale notices that address problems in filling prescriptions and clear, instructive remedies for beneficiaries. Oppose proposals that would reduce payments to providers of drugs and biologics under Medicare Part B. Oppose proposals to increase Medicare Part D cost-sharing, raise Part D coinsurance, and/or freeze income thresholds. Oppose efforts to require Medicaid-type drug rebates from any Medicare Part D providers and all other kinds of mandated or negotiated Part D price controls that will harm beneficiaries and increase costs in other areas of Medicare. Support efforts to focus Medicare cost-saving efforts on eliminating improper payments, waste, fraud, and abuse first -- before cutting benefits, cutting payments to providers, or raising premium and coinsurance costs for beneficiaries. Support H.R. 3613 - Medicare Part D Beneficiary Appeals Fairness Act. Urged the "Super Committee" to resist proposals to erode beneficiary protections in Part D that ensure broad and accessible prescription drug formularies. Supported an extension of legislation to preserve access to osteoporosis testing for Medicare beneficiaries in the the final conference report on the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3630). Joined other patient advocate organizations to urge the National Government Services to to reconsider its policy regarding blanket denials under the Current Procedural Terminology (CPT) health and behavioral assessment and intervention codes (96150-96155) which restrict those medically appropriate services to Medicare beneficiaries with Alzheimer's disease. Support the MAPRx comments regarding the Draft 2013 Medicare Call Letter regarding proposed actions related to the Part D Prescription Drug Program. These included improved comments on beneficiary protections; Specialty Tiers; Co-pay Thresholds; Tier Labeling; Plan Rating Criteria; Medicare Therapy Management; and Drug Utilization Review Controls in Part D. Oppose Centers for Medicare and Medicaid Services (CMS) regulation that subjects dual-eligible Medicare/Medicaid beneficiaries to new state programs that may well diminish their Medicare protections and lessen their access to quality health care services. This includes passive enrollment into a managed care plan and disruptions to the continuity of care. Support "unique naming" requirements for all biologic drugs, especially biosimilar drugs, as a matter of patient safety. Support full Medicare funding for dual energy x-ray absorptiometry (DXA) test reimbursement to fight osteoporosis. Support new extended funding (as under the expired Medicare Improvements for Patients and Providers Act or MIPPA) for Medicare low-income outreach and enrollment activities. Support the Medicare Part D prescription drug benefit program and the needed improvements to correct its limitations; including gaps in coverage, onerous cost-shifting created by specialty tiers, and restrictive utilization management tools. Robust formularies, coverage of the six protected drug classes, strong oversight, and transparency for consumers are also critical, as is a process for notice of non-coverage, and an appeals and exceptions process that is patient and provider friendly. Support all measures making Alzheimer's disease a continued top priority at the U.S. Food and Drug Administration (FDA).

Client expense: $42,249 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

-- Seek corrections to Medicare coverage for abdominal aortic aneurysms screening to allow for screening without a referral during a Welcome to Medicare Physical Exam. -- H.R. 8 - American Taxpayer Relief Act of 2012: Examine solutions for Medicare system of reimbursement for physicians for 2013. -- Examine elimination of cuts to Medicare coverage for medical imaging, particularly regarding ultrasound services. -- H.R. 452 - Medicare Decisions Accountability Act of 2011 / S. 668 - Health Care Bureaucrats Elimination Act: Examine repeal of Independent Payment Advisory Board.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-- H.R. 8 - American Taxpayer Relief Act of 2012: Examine solutions to the Medicare system of reimbursement for physicians. -- H.R. 452 - Medicare Decisions Accountability Act of 2011 / S. 668 - Health Care Bureaucrats Elimination Act: Examine repeal of Independent Payment Advisory Board.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose home health and hospice payment cuts and co-pays. Legislative and regulatory proposals affecting home care and hospice. S. 659/H.R. 6059, Home Health Care Access Protection Act of 2012. S. 501, Fostering Independence Through Technology Act of 2011. S. 227/H.R. 2267, Home Health Care Planning Improvement Act of 2011. H.R. 3859, Rural Hospital and Provider Equity Act of 2012, sections 11, 13, and 16. Implementation of P.L. 111-5, American Recovery and Reinvestment Act of 2009, provisions relating to technology. S. 722/H.R. 3506, Hospice Evaluation and Legitimate Payment Act. H.R. 452, Medicare Decisions Accountability Act of 2011. S. 668, Health Care Bureaucrats Elimination Act. Skilled Home Health Integrity and Program Savings Act of 2011 (SHHIPS) (draft legislation). S. 1680, Craig Thomas Rural Hospital and Provider Equity Act of 2011, sections 12, 13, 15, and 19. H.R. 5, Protecting Access to Healthcare Act, sections 201 and 202. H.R. 8, American Taxpayer Relief Act of 2012, opposing home care and hospice cuts.

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 452 Medicare Decisions Accountability Act of 2011, to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; HR 541 Pay for all your Undocumented Procedures (PAY UP!) Act of 2011, amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to make permanent the program of federal reimbursement of emergency health services furnished to undocumented aliens. Requires a re-allotment of unspent program funds in a fiscal year among eligible providers in full expenditure states according to a specified ratio. Requires addition of such funds to the aggregate amount available for allotment for the succeeding fiscal year in the event there is no full expenditure state; HR 876 and S 58 The Registered Nurse Safe Staffing Act of 2011, to amend title XVIII of the Social Security Act to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers; HR 1159, to repeal certain provisions of the Patient Protection and Affordable Care Act relating to the limitation on the Medicare exception to the prohibition on certain physician referrals for hospitals and to transparency reports and reporting of physician ownership or investment interests; HR 1186, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; S 374 and HR 2783 Medicare Mental Health Inpatient Equity Act, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare program; HR 1398 Rural Hospital Protection Act, legislation which would amend the Social Security Act to ensure that the full cost of certain provider taxes are considered allowable costs for purposes of Medicare reimbursements to CAHs; S 1486 Long-Term Care Hospital Improvement Act of 201, a bill to amend title XVIII of the Social Security Act to clarify and expand on criteria applicable to patient admission to and care furnished in long-term care hospitals participating in the Medicare program; Raising concerns about CMS flawed methodology that overstates the effect of the documentation and coding changes to PPS payments, ensuring that CMS does not go beyond its charge of ensuring budget-neutral implementation of MS-DRGs; Working with CMS to clarify requirements and ensure that the systems to register for the meaningful use incentives and attest to meeting the requirements are useable, including ensuring that hospitals can, with permission, help their physicians sign up for the program and attest to meeting the requirements; Worked with ONC to modify the certification requirements for EHRs to allow the flexibility promised in the rules for meaningful use; Worked to get legislative fix introduced for ACA provision related to readmission policy to eliminate a computation error and ensure that unrelated and planned readmissions are excluded from the policy; Worked to improve the regulation to implement ACOs; Urging CMS to update, streamline, and modernize the Medicare conditions of participation; HR 1852/ S 950 Children's Hospital GME Support Reauthorization Act of 2011, the current CHGME authorization expired in September 2011, and the bills would reauthorize the CHGME program for an additional five years, through fiscal year (FY) 2016, at the current authorization level of up to $330 million a year; HR 1683/ S 868 Medicaid MOE, strikes provisions of ACA related to maintaining Medicaid eligibility levels; HR 1543 Improving Access to Medicare Coverage Act of 2011, to amend title XVIII of the Social Security Act to count a period of receipt of outpatient observation services in a hospital toward satisfying the 3-day inpatient hospital requirement for coverage of skilled nursing facility services under Medicare; S 1251Medicare and Medicaid FAST Act, a bill to amend titles XVIII and XIX of the Social Security Act to curb waste, fraud, and abuse in the Medicare and Medicaid programs; HR 2500 Equal Access and Parity for Multi-Campus Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to clarify the application of EHR payment incentives in cases of multi-campus hospitals; HR 2674 340B Program Improvement Act, a bill to amend section 340B of the Public Health Service Act to improve the provision of discounts on drug purchases for certain safety net providers; HR 3630 Temporary Payroll Tax Cut Continuation Act of 2011 or Middle Class Tax Relief and Job Creation Act of 2011, a bill that cuts hospitals to pay for the doc fix, it contains the Social Security payroll tax cut and the Unemployment Insurance extension; HR 3519 a bill to amend and exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011; S. 1680 Craig Thomas Rural Hospital and Provider Equity (R-HoPE) Act of 2011, a bill to amend title XVIII of the Social Security Act to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; Letter to Rehberg and DeLauro in support of the CHGME program that was circulated by Reps. Capps and Bilbray; Wyden/Crapo letter to CMS to actively oppose a Senate Dear Colleague letter to CMS in support of updating Medicare payments to ambulatory surgery centers (ASCs). The letter did not request a payment update for ASCs. Rather, the letter advocated against the Medicare payment rate for services provided in hospital outpatient department settings; HR 2954 and S 2474 Health Equity and Accountability Act of 2011, Comprehensive bill focused on eliminating racial and ethnic disparities in health care through improved data collection and reporting, culturally and linguistically-appropriate health care, workforce diversity, health information technology, and other actions; Discussions with the Administration (CMS) on applying the therapy cap to hospital outpatient departments; Worked to change CMS definition of allowed EHR costs for CAH Meaningful Use incentive payments to include capital lease purchases of EHRs; HR 3859 Rural Hospital and Provider Equity (R-HOPE) Act of 2012, to amend title XVIII of the SSA to protect and preserve access of Medicare beneficiaries in rural areas to health care providers under the Medicare program; HR 4245 Veterans Co-Pay Fairness Act, to amend title 38, United States Code, to require the Secretary of Veterans Affairs to reimburse eligible veterans who are entitled to Medicare benefits for Medicare deductibles and other expenses that are owed by the veterans for emergency medical treatment provided in non-Department of Veterans affairs facilities; S 2620 and HR 5943 Rural Hospital Access Act of 2012, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; S 3187 and HR 5651Prescription Drug User Fee Amendments of 2012, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs and medical devices, to establish user-fee programs for generic drugs and biosimilars; H.R.6575 Medicare Audit Improvement Act of 2012 to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Urging HHS and OIG to examine error rates of RAC as part of its Workplan for 2013 studies of RAC effectiveness.

Client expense: $5,350,000 · Firm income: Not reported

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

PL 111-148 - The Patient Protection and Affordable Care Act; HR 452 - A bill to repeal IPAB; PL 112-96 - Middle Class Tax Relief and Job Creation Act of 2012; S. 818 - Improving Access to Medicare Coverage Act of 2011; HR 1543 - Improving Access to Medicare Coverage Act of 2011; S. 2037 - To reauthorize and improve the Older Americans Act of 1965, and for other purposes; Continued monitoring of Post Acute Care Payments and reform issues; monitoring the reduction of Hospital Readmission for Skilled Nursing Facilities; HR 5979 - Medicaid Accountability and Care Act; HR 6413 - the Medicare Transitional Care Act of 2012; S. 3604 - Improving Dementia Care Treatment for Older Adults act of 2012; HR 8 - American Taxpayer Relief Act of 2012; HR 6884 - Spending Reduction Act of 2012, Sec. 211; and PL 112-25 - Budget Control Act of 2011.

Client expense: Not reported · Firm income: $80,000

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

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

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

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

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 452: A bill to repeal IPAB. H.R. 1543: Improving Access to Medicare Coverage Act of 2011. S. 818: Improving Access to Medicare Coverage Act of 2011. P.L. 112-96: Middle Class Tax Relief and Job Creation Act of 2012. S. 2037: To reauthorize and improve the Older Americans Act of 1965, and for other purposes. Continued monitoring Post Acute Care Payment and reform issues. Continued monitoring to reducing Hospital Readmission from Skilled Nursing Facility. H.R. 5979: Medicaid Accountability and Care Act. H.R. 6413: the Medicare Transitional Care Act of 2012. S. 3604: Improving Dementia Care Treatment for Older Adults Act of 2012. H.R. 8: American Taxpayer Relief Act of 2012. H.R. 6884: Spending Reduction Act of 2012, Sec. 211. P.L.112-25: Budget Control Act of 2011.

Client expense: $470,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE

S. 668, Health Care Bureaucrats Elimination Act - Lobbied for passage of bill to eliminate the Independent Payment Advisory Board. H.R. 452, Medicare Decisions Accountability Act - Lobbied for passage of bill to eliminate the Independent Payment Advisory Board. Bill not yet introduced, The Medicare Home Infusion Therapy Coverage Act - Lobbied for expanded coverage of home infusion therapy. S. 1454 and H.R. 2969, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act - Lobbied for extended coverage of immunosuppresive drugs in Medicare. H.R. 2190 and S. 1206, Medicare Drug Savings Act of 2011 - Lobbied to oppose extending Medicaid rebates to Medicare Part D. No Bill, Health care reform implementation. Lobbied CMS on new definition of the Average Manufacturer's Price calculation in Medicaid.

Client expense: $1,280,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE, Treasury, Dept of

H.R. 5, Protecting Access to Healthcare Act: Provisions related to Independent Payment Advisory Board (IPAB) H.R. 8, American Taxpayer Relief Act of 2012: Medicare and tax related provisions H.R. 452, Medicare Decisions Accountability Act of 2011: Provisions related to Independent Payment Advisory Board (IPAB) H.R. 999, Medicare Prescription Drug Savings and Choice Act of 2011: Provisions related to Part D issues H.R. 2190 Medicare Drug Savings Act of 2011: Provisions related to Part D issues H.R. 4209, Patients Access to Treatments Act of 2012: Provisions related to capping specialty tier drugs and no cost-sharing above the non-preferred brand tier S. 365, Budget Control Act of 2011: Deficit reduction issues related to Medicare/Medicaid S. 668, Health Care Bureaucrats Elimination Act: Provisions related to Independent Payment Advisory Board (IPAB) S. 1206, Medicare Prescription Drug Savings Act of 2011: Provisions related to Part D issues S. 1699, Prescription Drug Cost Reduction Act: Provisions related to Medicare Part B, 340B, least costly alternative, and other provisions Deficit reduction policy issues Medicaid Program, Covered Outpatient Drugs rulemaking Dual eligibles coordination policy issues Implementation issues relating to the Physician Payment Sunshine Act, including Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking

Client expense: $4,120,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Security Council (NSC), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR), White House Office

Support for legislation to rebase the Medicare physician payment formula to stabilize physician payments. Support for legislation to insure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services. Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act (HR 2104). Support for repealing the establishment of an Independent Payment Advisory Board that would develop and submit detailed proposals to reduce the per capita rate of growth in Medicare spending, specifically the Medicare Decisions Accountability Act of 2011 (H.R. 452) (S 2118). Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Research of legislation to exempt certain requests by physicians for consultations by radiation oncologists (HR 4127). Support for preserving access to radiation therapy services under the Medicare Physician Fee Schedule Support for repeal of Medicare sequestration cuts under the Budget Control Act of 2011

Client expense: $172,077 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Energy, Dept of, Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Nuclear Regulatory Commission (NRC), SENATE, Veterans Affairs, Dept of (VA)

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $70,254 · Firm income: Not reported

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

See page five for specific HCR issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Proposed Rule Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Trauma Appropriations

Client expense: $70,254 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. MMM Medicare/Medicaid Issues H.R. 5 - Protecting Access to Healthcare Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 3474 - PRIME Act of 2011 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 Accountable Care Organizations Final Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Medicare SGR and Overseas Contingency Operations funds Inspiring Quality Campaign IPAB CMS RUC Refinement Ambulatory Surgical Centers Medicare Liability Reform Trauma center designation Trauma GAO study Imaging Pediatric subspecialty loan repayment program Rx Drug shortages Cancer programs appropriations Trauma Appropriations Children's Hospitals Graduate Medical Education Payment Program funding RUC Refinement panel valuation problem HHS ASPR/MSET Program Medical Device User Fee and Modernization Act (MDUFMA) Health Information Technology (45 CFR Part 170) NIH Appropriations Electronic Health Record Meaningful Use Stage 2 Proposed Rule Surgical workforce issues Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Medicare audit programs

Client expense: $88,958 · Firm income: Not reported

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

See page five for specific Health Care Issues. HCR Health Care Issues H.R. 5 - Protecting Access to Healthcare Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 1409 - Quality Health Care Coalition Act of 2011 H.R. 3474 - PRIME Act of 2011 S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 Accountable Care Organizations Final Rule Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Medicare SGR and Overseas Contingency Operations funds Inspiring Quality Campaign IPAB CMS RUC Refinement Ambulatory Surgical Centers Medicare Liability Reform Trauma center designation Trauma GAO study Imaging Pediatric subspecialty loan repayment program Rx Drug shortages Cancer programs appropriations Trauma Appropriations Children's Hospitals Graduate Medical Education Payment Program funding RUC Refinement panel valuation problem HHS ASPR/MSET Program Medical Device User Fee and Modernization Act (MDUFMA) Health Information Technology (45 CFR Part 170) NIH Appropriations Electronic Health Record Meaningful Use Stage 2 Proposed Rule Surgical workforce issues Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Medicare audit programs

Client expense: $88,958 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (MMM Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $16,647 · Firm income: Not reported

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

See page six for specific Health Care Issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (HCR Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $16,647 · Firm income: Not reported

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

See page three for specific Medicare/Medicaid issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (MMM Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $87,126 · Firm income: Not reported

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

See page six for specific Health Care Issues. H.R. 1409 - Quality Health Care Coalition Act of 2011 H. R. 1700 The Medicare Patient Empowerment Act H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 2104 - Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2011 H.R. 2119 - Ryan Creedon Act of 2011 H.R. 2405 - Pandemic and All-Hazards Preparedness Reauthorization Act of 2011 H.R. 2600 - National Pediatric Acquired Brain Injury Plan Act of 2011 H.R. 3239 - Safeguarding Access For Every Medicare Patient Act H.R. 3474 - PRIME Act of 2011 H.R. 3586 - Good Samaritan Health Professionals Act of 2011 H.R. 4310 - National Defense Authorization Act for Fiscal Year 2013 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 5 - Protecting Access to Healthcare Act H.R. 5651 - Food and Drug Administration Reform Act of 2012 H.R. 5707 - Medicare Physician Payment Innovation Act of 2012 H.R. 5888 - Physician Reentry Demonstration Program Act H.R. 5937 Breast Cancer Patient Education Act of 2012 H.R. 5998 - USPSTF Transparency and Accountability Act of 2012 H. R. 6043 - Behavioral Health Information Technology Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability & Transparency Act H. R. 6598 - Electronic Health Records Improvement Act S. 1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 S. 1855 - Pandemic and All-Hazards Preparedness Act Reauthorization of 2011 S. 2516 - Food and Drug Administration Safety and Innovation Act S. 3201 - Graduate Medical Education Reform Act of 2012 Accountable Care Organizations Final Rule ACS VBU (Value Based-Update) proposal Ambulatory Surgical Centers Cancer programs appropriations Children's Hospitals Graduate Medical Education Payment Program funding CMS EHR Stage 2 Proposed Rule CMS RUC Refinement Electronic Health Record Meaningful Use Stage 2 Issues Federal Privacy laws Health Information Technology (45 CFR Part 170) HHS ASPR/MSET Program HAI prevention Imaging Inspiring Quality Campaign IPAB Medical Device User Fee and Modernization Act (MDUFMA) Medicare audit programs Medicare fraud identification efforts Medicare Inpatient Prospective Payment System Proposed Rule Medicare Liability Reform Medicare SGR and Overseas Contingency Operations funds NIH Appropriations Nominations for the Committee on Governance and Financing of Graduate Medical Education Nominations for the Medicare Payment Advisory Commission Pediatric subspecialty loan repayment program Prescription Drug User Fee Act (PDUFA) reauthorization (HCR Continued) Physician Fee Schedule and OPPS/ASC CY 2012 Proposed Rule Physician Quality Reporting System (PQRS) Quality and Value Based Purchasing Provisions of Medicare Physician Fee Schedule Final Rule Risk pool legislation RUC Refinement panel valuation problem Rx Drug and Surgical Workforce shortages Sequestration Surgical Consumer Assessment of Healthcare Providers and Systems (S-CAHPS) Trauma Appropriations Value-Based Update (VBU) Proposal

Client expense: $87,126 · Firm income: Not reported

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

H.R. 452, Medicare Decisions Accountability Act of 2011. H.R. 866, National All Schedules Prescription Electronic Reporting Reauthorization Act of 2011. H.R. 3827, To repeal the Patient-Centered Outcomes Research program and comparative effectiveness research funding. H.R. 8, American Taxpayer Relief Act of 2012. Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER), (P.L. 109-60).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 452, Medicare Decisions Accountability Act of 2011. H.R. 866, National All Schedules Prescription Electronic Reporting Reauthorization Act of 2011. H.R. 3827, To repeal the Patient-Centered Outcomes Research program and comparative effectiveness research funding. H.R. 8, American Taxpayer Relief Act of 2012. Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER), (P.L. 109-60).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 452, Medicare Decisions Accountability Act of 2011. H.R. 866, National All Schedules Prescription Electronic Reporting Reauthorization Act of 2011. H.R. 3827, To repeal the Patient-Centered Outcomes Research program and comparative effectiveness research funding. H.R. 8, American Taxpayer Relief Act of 2012. Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER), (P.L. 109-60).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 452, Medicare Decisions Accountability Act of 2011. H.R. 866, National All Schedules Prescription Electronic Reporting Reauthorization Act of 2011. H.R. 3827, To repeal the Patient-Centered Outcomes Research program and comparative effectiveness research funding. H.R. 8, American Taxpayer Relief Act of 2012. Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER), (P.L. 109-60).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See page 3 for specific lobbying issues H.R. 2 - Repealing the Job-Killing Health Care Law Act H.R. 5/S. 218/S.1099 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H.R. 8 American Taxpayer Relief Act of 2012 H.R. 157 - Health Care Safety Net Enhancement Act of 2011 H.R. 451 - Healthcare Truth and Transparency Act of 2011 H.R. 452 - Medicare Decisions Accountability Act of 2011 H.R. 733 - Recalcitrant Cancer Research Act of 2012 H.R.1172 - Medicare Lung Cancer Early Detection Promotion Act of 2011 H.R. 1256 - Medicare Physician Payment Transparency and Assessment Act of 2011 H.R. 1394/S.752 - Lung Cancer Mortality Reduction Act H.R. 2219 - Department of Defense Appropriations Act - Provisions related to funding for Lung Cancer research only H.R. 3475 - Keeping IDs Safe Act - Provisions related to Pediatric Subspecialty Loan Repayment Program H.R. 3526/S. 438 - Heart Disease Education, Analysis, Research, and Treatment for Women (HEART for Women) Act H.R. 3630/3743/3765 - Temporary Payroll Tax Cut Continuation Act of 2011 - Provisions related to Medicare physician payment only H.R. 4310 - National Defense Authorization Act - Provisions related to recalcitrant cancer only H.Res. 9 - Instructing certain committees to report legislation replacing the job-killing health care law H.J. Res. 48 - Additional Continuing Appropriations Amendments, 2011 S. 362 - Pancreatic Cancer Research and Education Act (companion to HR 733) S. 668 - Health Care Bureaucrats Elimination Act S. 756 Medicare Data Access for Transparency and Accountability Act Section 5203 of the Affordable Care Act (P.L. 111-148) - Provisions on Health Care Workforce Loan Repayment Programs S. 1534 - Identify Theft and Tax Fraud Prevention Act - Provisions on Social Security Death Master File Health care reform, health care quality improvement; physician workforce; comparative effectiveness research; health information technology; HIT Meaningful Use; Sustainable Growth Rate; Independent Payment Advisory Board; accountable care organizations; resident work hours; Patient Centered Outcomes Research Institute; Center for Medicare and Medicaid Innovation; MEDCAC; Joint Select Committee on Deficit Reduction; Social Security Death Master File; Coverage with Evidence Development; ICD-10 Implementation; health care-associated infections; Physician Payment Sunshine Act; Physician Fee Schedule; Inpatient Prospective Payment System; Value Based Update (VBU) Proposal; Sequestration

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE