Medicaid Accountability and Care Act of 2012

Legislation and issues related to: Physician/nurse reimbursement; Accountable Care Organizations; Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148); Graduate Nurse Education demonstration; Home health face-to-face examination requirements; Medicare-Medicaid Program Integrity policies; Ordering of Medicare portable x-ray services; Provisions of the 2013 Medicare physician payment proposed rule; Medicaid payment for primary care services; S. 227/H.R. 2267 - Home Health Care Planning Improvement Act; S. 1680 - Craig Thomas Rural Hospital and Provider Equity Act; H.R. 3859 - Rural Hospital and Provider Equity Act; H.R. 5979 - Medicaid Accountability and Care (MAC) Act; H.R. 6079 - Repeal of Obamacare Act; H.R. 8 - American Taxpayer Relief Act.

Client expense: Not reported · Firm income: $15,000

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; 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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- Legislative ideas for addressing health care costs, financing & dual eligible demonstration programs. - H.R. 1370, "A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - H.R. 5979, "Medicaid Accountability and Care Act", regarding all provisions - H.R. 8, "American Taxpayer Relief Act of 2012", provisions affecting Medicare/Medicaid.

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

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

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

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

(1) Issues related to Public Law 111-148- The Patient Protection and Affordable Care Act (provisions related to Medicaid and Medicare); (2) Issues related to Public Law 111-152- Health Care and Education Reconciliation Act of2010 (provisions related to Medicaid and Medicare); (3) Issues raised by H.R. 5979 - Medicaid Accountability and Care Act of2012 (capping the federal government's share of every state's Medicaid expenditures); (4) Issues raised by H.R. 6498 - Medicaid Integrity Act (require independent audits and actuarial services under Medicaid managed care programs); (5) Issues raised by H.R. 6482- The Preventative Health Savings Act of20l2 (wellness programs and population health); (6) Issues pertaining to entitlement reform, Medicare Advantage, premium support models, reimbursement and enrollment; and (7) Issues related to the reauthorization of special needs plans (SNPs).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Treasury, Dept of

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

H.R. 1370, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act; H.R. 5979, Medicaid Accountability and Care Act of 2012; Managed care services, including state Medicaid programs; Implementation of the Patient Protection and Affordable Care Act (PL 111-148), insurer fees, issues relating to managed care organizations, managed care for dual eligible individuals, issues relating to health insurance market provisions, issues related to Medicaid.

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

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

Issues pertaining to Medicaid reform, block grant proposals, Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments and maintenance of effort provisions in the thealth reform law, Medicaid Waivers, Extension of Medicare Sustainable Growth Rate Medicare Evaluation and Management Reimbursement Reduction Proposal Medicaid Disproportionate Share Hospital Payments H.R. 5979 Medicaid Accountability and Care Act of 2012, all provisions Issues related to waste, fraud, and abuse in Medicaid Medicare Disproportionate Share Hospital Payments H.R. 5979 Medicaid Accountability and Care Act H.R. 8 American Taxpayer Relief Act of 2012, all provisions relating to hospitals, Medicare, and Medicaid

Client expense: $180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

HR3667, GME Modernization pilot program authorization. HR5707, Repeal Medicare SGR; implement primary care centric payment and care system; offset with Overseas Operations Fund, Prevent Medicare physician pay cut effective January 1, 2013. HR5, Protecting Access to Healthcare Act, Medical liability reform, support extension of current payment rate for Medicare. HR5979 Medicaid Accountability and Care Act of 2012, Prevent per capita cap reform of the Medicaid program. HR6688, Averting the Fiscal Cliff Act, American Tax Payer Relief Act, Prevent SGR sequester Medicare payment cuts, protect Medicaid parity primary care rates. Avoid sequester cuts to title VII primary care training grants, GME, AHRQ, NHSC, Prevention and public health trust funds, stop the 2% cut due January 2, 2013. No Bill Number, Medicaid parity for primary care, Ensuring payments for true primary care physicians. No Bill Number, Medicare physician payment reform of the Sustainable Growth Rate, Medicare physician pay cuts scheduled for 2013. No Bill Number, Meaningful use meetings, Medical Home and Health Care Reform. No Bill Number, Electronic Health Records, Meaningful use funds and quality improvement. No Bill Number, Medicaid parity for primary care, Ensuring payments for true primary care physicians. No Bill Number, Primary Care meetings. Medical Home and Health Care Reform. No Bill Number, Medicaid payment for primary care, Support for Medicaid payment for primary care services. No Bill Number, Medicaid Expansion, Expansion of access to health care coverage for uninsured and underinsured individuals. No Bill Number, Patient Centered Medical Homes, Increase support for the model.

Client expense: $633,350 · 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), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR6688, Averting the Fiscal Cliff Act, American Tax Payer Relief Act, Prevent SGR sequester Medicare payment cuts, protect Medicaid parity primary care rates. Avoid sequester cuts to title VII primary care training grants, GME, AHRQ, NHSC, Prevention and public health trust funds, stop the 2% cut due January 2, 2013 and medical liability reform. HR3667, GME Modernization pilot program authorization. HR5, Protecting Access to Healthcare Act, Medical liability reform. HR5707, Repeal Medicare SGR; implement primary care centric payment and care system; offset with Overseas Operations Fund, Prevent Medicare physician pay cut effective January 1, 2013. HR5979 Medicaid Accountability and Care Act of 2012, Prevent per capita cap reform of the Medicaid program. HR6400, Restoring the Doctors of our Country through scholarships RDOCS Act, Support medical student debt relief, increase family physician workforce. S3295, Department of Labor Appropriations Act, 2013, Support increased FY13 spending on Title VII Sec 747 primary care training grants and AHRQ funding. No Bill Number, Meeting with OMB Public Health Program Examiner, Supporting AAFP federal budgetary priorities. No Bill Number, Coalition for Health Funding Townhall, Supporting AAFP federal budgetary priorities. No Bill Number, Medicare physician payment reform of the Sustainable Growth Rate, Medicare physician pay cuts scheduled for 2013. No Bill Number, Patient Centered Medical Homes, Increase support for the model. No Bill Number, SGR Fix, Stop the 27% cut due to go into effect January 1st, 2013. No Bill Number, Briefing on ONDCP/NIDA e-Learning tools on opioid prescribing, monitor federal activities on tools for prescribers, support policies which do not burden family physicians. No Bill Number, Meeting with ONDCP director to eliminate CME mandates from National Drug Control strategy. No Bill Number, Meeting with AHRQ director on primary care research HIT promotion and work to support family physicians. No Bill Number, Promote expanding primary care physician workforce, Increase family physician workforce. No Bill Number, Adequacy and accuracy of Medicare physician payment, Positive payment differential for primary care physicians. No Bill Number, Health Insurance Exchanges, Expansion of access to health care coverage for uninsured and underinsured individuals. No Bill Number, Essential Health Benefits, Expansion of access to health care coverage for uninsured and underinsured individuals. No Bill Number, Center for Medicare and Medicaid Innovation, Comprehensive Primary Care Initiative. No Bill Number, Medicaid Expansion, Expansion of access to health care coverage for uninsured and underinsured individuals. No Bill Number, Meaningful use meetings, Medical Home and Health Care Reform. No Bill Number, Electronic Health Records, Meaningful use funds and quality improvement. No Bill Number, Medicaid parity for primary care, Ensuring payments for true primary care physicians. No Bill Number, Primary Care meetings. Medical Home and Health Care Reform. No Bill Number, Veterans health, Access of veterans to community physicians. No Bill Number, Health research, Primary care research agenda. No Bill Number, Medicare physician payment system, Support for transition care provision of the payment schedule. No Bill Number, Medicaid payment for primary care, Support for Medicaid payment for primary care services. No Bill Number, Health labels for smokeless tobacco products, Opposition to changes in health safety warning for smokeless tobacco products.

Client expense: $633,350 · 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), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Veterans Affairs, Dept of (VA), White House Office

Medicare Access to Community Health Centers Act/MATCH Act; Medicare Payment to Health Centers; The FIX-HIT Act(H.R.1187/S.643); Prompt Payment for FQHCs under Medicaid; House Budget Committee Concurrent Resolution-Medicaid; State Medicaid Budget issues; Medicaid Prospective Payment System for FQHCs; Middle Class Tax Relief and Job Creation Act of 2011 (H.R.3630); Temporary Payroll Tax Cut Continuation of 2011 (H.R.3765); Medicaid Accountability and Care (MAC) Act (H.R.5979); Fair Pay to Medicaid Providers Act (H.R.3587); FQHC and QHP payment rules per final rule on Establishment of Exchanges and Qualified Health Plans; Fiscal cliff negotiations/The American Taxpayer Relief Act of 2012 (H.R.8); Provider tax reduction proposals; 340B and drug shortage issues.

Client expense: $300,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

Issues relating to oral-health and dental practice in the following bills: H.R. 2/S. 192, 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. 38, A bill to rescind funds appropriated to the Health Insurance Reform Implementation Fund under the Health Care and Education Reconciliation Act of 2010; HR105, Empowering Patients First Act; HR157, Health Care Safety Net Enhancement Act of 2011; HR165, Informed Choice Act; H.R. 969, the Medical Practice Freedom Act of 2011; H.R. 314, Medical Liability Procedural Reform Act of 2011; H.R. 570, Dental Emergency Responder Act; H.R. 1578/S. 1765, Violence Against Women Health Initiative Act of 2011; H.R. 2119, Ryan Creedon Act of 2011; H.R. 2405/S. 1855, Pandemic and All Hazards Preparedness Act of 2011; H.R. 3586, Good Samaritan Health Professionals Act of 2011; S. 197, Medical Care Access Protection (MCAP) Act of 2011; S. 312/H.R. 605, Patients Freedom to Choose Act; S. 966, Bone Health Promotion and Research Act of 2011; S. 296/H.R. 2245, Preserving Access to Life-Saving Medications Act; S. 1878/H.R. 4091, Coordination of Pro Bono Medically Recommended Dental Care Act; S. 1925, Violence Against Women Reauthorization Act of 2011; H.R. 3765, Temporary Payroll Tax Cut Continuation Act of 2011; H.R. 3839, Drug Shortage Prevention Act of 2012; S. 296/H.R. 2245, Preserving Access to Life-Saving Medications Act; S. 3187 [H.R. 5651] - Prescription Drug User Fee Act. H.R. 5909 - Comprehensive Dental Reform Act of 2012 H.R. 5979 - Medicaid Accountability and Care Act of 2012 S. 3272 - Comprehensive Dental Reform Act of 2012 Community water fluoridation Medicaid and CHIP Payment and Access Commission: -Center for Consumer Information and Insurance Oversight; -Center for Medicaid, CHIP and Survey and Certification; Implementation of P.L. 111-148; 111-152, Patient Protection and Affordable Care Act; Oral-health issues within Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020, Healthy People 2020; Comments on planning and establishment of state level exchanges; Office of the Assistant Secretary for Preparedness and Response, National Health Security Strategy (biennial implementation plan), National Disaster Medical System (disaster medical assistance team) regarding issues related to utlization of dental professionals in the event of a disaster; Office of Global Health (United Nations high-level meeting on non-communicable diseases); Division of Oral Health Reorganization; CMS Limited English Proficiency Guidelines; Advisory Committee on Training in Primary Care Medicine and Dentistry Nominations, Ninth Report to Congress; National Advisory Dental and Craniofacial Research Council Nominations; Center for Substance Abuse Treatment, National Recovery Month; United Nations Summit on Non-Communicable Diseases; National Drug Control Strategy / Prescription Drug Abuse Prevention Plan; DEA National Prescription Drug Take Back Campaign; FDA Center for Drug Evaluation and Research regarding dry mouth labeling; Medical/Dental Coding Issues; Comparative Effectiveness regarding Dental Quality Alliance; Health Information Technology (HIT) Regulations; Health care issues before the Joint Select Committee on Deficit Reduction. United Nations General Assembly's High-level Meeting on Non-communicable Diseases CMS proposed rule on reporting and returning Medicare overpayments Food and Drug Administration Sedation Product Guidance Centers for Disease Control and Prevention recommendations for identification of persons with Hepatitis C (HCV) chronic infection H.R. 5711 - Access to Substance Abuse Treatment Act of 2012 Department of Health and Human Services media campaign to educate the public about the dangers of tobacco use SAMHSA National Recovery Month Food and Drug Administration clinical development and use of sedation products Surgeon General report on sugar-sweetened beverages S. 3562, Older Americans Act Amendments of 2012 HR 436, Protect Medical Innovation Act of 2011 (Medical Device Tax) HR 488, Save Our Medical Devices Act of 2011 (Medical Device Tax) S 17, Medical Device Access and Innovation Protection Act (Medical Device Tax) S 262, To repeal the excise tax on medical device manufacturers (Medical Device Tax)

Client expense: $620,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), Office of Natl Drug Control Policy (NDCP), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

H.R. 5979 Medicaid Accountability & Care Act

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

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

H.R. 8 American Taxpayer Relief Act of 2012 H.R. 5979 Medicaid Accountabilty and Care Act H.R. 6433 FDA User Fee Corrections Act of 2012 S.3684 - Senior Navigation and Planning Act H.R.6626 - Health Care Innovation and the Marketplace Technologies Act of 2012 H.R. 6482 Preventive Health Savings Act of 2012 S. 3414 Cybersecurity Act of 2012

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

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

HR 3590, S 1790 (as enacted into PL 111-148 and PL 111-152) issues related to Medicare and Medicaid reform, including possible changes to Part D and changes to Medicaid price reporting requirements. HR 2190, S 1206 and related legislative proposals regarding changes/scope of Medicare Part D rebates HR 5979 - issues related to proposed changes in Medicaid payments

Client expense: $980,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR)

- Legislative ideas for addressing health care costs, financing & dual eligible demonstration programs. - H.R. 1370, "A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - H.R. 5979, "Medicaid Accountability and Care Act", regarding all provisions

Client expense: $440,000 · Firm income: Not reported

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

(1) Issues related to Public Law 111-148 The Patient Protection and Affordable Care Act (provisions related to Medicaid and Medicare); (2) Issues related to Public Law 111-152 Health Care and Education Reconciliation Act of 2010 (provisions related to Medicaid and Medicare); (3) Issues raised by H.R. 5979 Medicaid Accountability and Care Act of 2012 (capping the federal government's share of every state's Medicaid expenditures); (4) Issues raised by H.R. 6498 Medicaid Integrity Act (require independent audits and actuarial services under Medicaid managed care programs); (5) Issues raised by H.R. 6482 The Preventative Health Savings Act of 2012 (wellness programs and population health); and (6) Issues pertaining to entitlement reform, Medicare Advantage, premium support models, reimbursement and enrollment.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Treasury, Dept of

Medicare Access to Community Health Centers Act/MATCH Act; Medicare Payment to Health Centers; The FIX-HIT Act(H.R.1187/S.643); Prompt Payment for FQHCs under Medicaid; House Budget Committee Concurrent Resolution-Medicaid; State Medicaid Budget issues; Medicaid Prospective Payment System for FQHCs; Middle Class Tax Relief and Job Creation Act of 2011 (H.R.3630); Temporary Payroll Tax Cut Continuation of 2011 (H.R.3765); Medicaid Accountability and Care (MAC) Act (H.R.5979); Fair Pay to Medicaid Providers Act (H.R.3587); FQHC and QHP payment rules per final rule on Establishment of Exchanges and Qualified Health Plans.

Client expense: $270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), 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; and Sequestration Repeal.

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

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. Sequestration Repeal.

Client expense: $440,000 · 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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of the Patient Protection and Affordable Care Act (PL 111-148), insurer fees, issues relating to managed care organizations, managed care for dual eligible individuals, issues relating to health insurance market provisions; H.R. 5979, Medicaid Accountability and Care Act of 2012; managed care services, including state Medicaid programs.

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

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

1) Integration of health services for the "dual eligible" population under Medicaid and Medicare through financial alignment demonstrations authorized under 3021 of the Affordable Care Act, including rate setting and risk adjustment for capitation payments to health plans. 2) Medicaid Accountability and Care Act of 2012, HR 5979.

Client expense: Not reported · Firm income: Not reported

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

Issues pertaining to Medicaid reform, block grant proposals, Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments and maintenance of effort provisions in the health reform law Medicaid waivers Extension of Medicare sustainable Growth Rate Medicaid Blended FMAP Medicare Evaluation and Management Reimbursement Reduction Proposal Medicaid Disproportionate Share Hospital Payments, H.R.5979: Medicaid Accountability and Care Act of 2012, all provisions H.R.6258: Healthy Start Act of 2012, all provisions Issues related to "waste, fraud and abuse" in Medicaid Medicare Disproportionate Share Hospital Payments

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

Government targets: HOUSE OF REPRESENTATIVES, 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.

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), 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; 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.

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), Housing & Urban Development, Dept of (HUD), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Legislation and issues related to: Physician/nurse reimbursement; Accountable Care Organizations; Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148); Graduate Nurse Education demonstration; Home health face-to-face examination requirements; Medicare-Medicaid Program Integrity policies; Ordering of Medicare portable x-ray services; Provisions of the 2013 Medicare physician payment proposed rule; Medicaid payment for primary care services; S. 227/H.R. 2267 - Home Health Care Planning Improvement Act; S. 1680 - Craig Thomas Rural Hospital and Provider Equity Act; H.R. 3859 - Rural Hospital and Provider Equity Act; H.R. 5979 - Medicaid Accountability and Care (MAC) Act; H.R. 6079 - Repeal of Obamacare Act.

Client expense: Not reported · Firm income: $7,500

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), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

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

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

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

H.R.5979, Medicaid Accountability and Care Act of 2012; Implementation of the Patient Protection and Affordable Care Act (PL 111-148), issues relating to evaluation of healthcare plans, medicaid block grants, medical loss ratios, medicare advantage, managed care for dual eligible individuals, broker fees, and health insurance exchanges; Medicare reimbursement rates; Potential legislation regarding insurance exchange programs; Issues relating to medicaid and entitlement reform.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to oral-health and dental practice in the following bills: H.R. 2/S. 192, 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. 38, A bill to rescind funds appropriated to the Health Insurance Reform Implementation Fund under the Health Care and Education Reconciliation Act of 2010; HR105, Empowering Patients First Act; HR157, Health Care Safety Net Enhancement Act of 2011; HR165, Informed Choice Act; H.R. 969, the Medical Practice Freedom Act of 2011; H.R. 314, Medical Liability Procedural Reform Act of 2011; H.R. 570, Dental Emergency Responder Act; H.R. 1578/S. 1765, Violence Against Women Health Initiative Act of 2011; H.R. 2119, Ryan Creedon Act of 2011; H.R. 2405/S. 1855, Pandemic and All Hazards Preparedness Act of 2011; H.R. 3586, Good Samaritan Health Professionals Act of 2011; S. 197, Medical Care Access Protection (MCAP) Act of 2011; S. 312/H.R. 605, Patients Freedom to Choose Act; S. 966, Bone Health Promotion and Research Act of 2011; S. 296/H.R. 2245, Preserving Access to Life-Saving Medications Act; S. 1878/H.R. 4091, Coordination of Pro Bono Medically Recommended Dental Care Act; S. 1925, Violence Against Women Reauthorization Act of 2011; H.R. 3765, Temporary Payroll Tax Cut Continuation Act of 2011; H.R. 3839, Drug Shortage Prevention Act of 2012; S. 296/H.R. 2245, Preserving Access to Life-Saving Medications Act; S. 3187 [H.R. 5651] - Prescription Drug User Fee Act. H.R. 5909 - Comprehensive Dental Reform Act of 2012 H.R. 5979 - Medicaid Accountability and Care Act of 2012 S. 3272 - Comprehensive Dental Reform Act of 2012 Community water fluoridation Medicaid and CHIP Payment and Access Commission: -Center for Consumer Information and Insurance Oversight; -Center for Medicaid, CHIP and Survey and Certification; Implementation of P.L. 111-148; 111-152, Patient Protection and Affordable Care Act; Oral-health issues within Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020, Healthy People 2020; Comments on planning and establishment of state level exchanges; Office of the Assistant Secretary for Preparedness and Response, National Health Security Strategy (biennial implementation plan), National Disaster Medical System (disaster medical assistance team) regarding issues related to utlization of dental professionals in the event of a disaster; Office of Global Health (United Nations high-level meeting on non-communicable diseases); Division of Oral Health Reorganization; CMS Limited English Proficiency Guidelines; Advisory Committee on Training in Primary Care Medicine and Dentistry Nominations, Ninth Report to Congress; National Advisory Dental and Craniofacial Research Council Nominations; Center for Substance Abuse Treatment, National Recovery Month; United Nations Summit on Non-Communicable Diseases; National Drug Control Strategy / Prescription Drug Abuse Prevention Plan; DEA National Prescription Drug Take Back Campaign; FDA Center for Drug Evaluation and Research regarding dry mouth labeling; Medical/Dental Coding Issues; Comparative Effectiveness regarding Dental Quality Alliance; Health Information Technology (HIT) Regulations; Health care issues before the Joint Select Committee on Deficit Reduction. United Nations General Assembly's High-level Meeting on Non-communicable Diseases CMS proposed rule on reporting and returning Medicare overpayments Food and Drug Administration Sedation Product Guidance Centers for Disease Control and Prevention recommendations for identification of persons with Hepatitis C (HCV) chronic infection H.R. 5711 - Access to Substance Abuse Treatment Act of 2012 Department of Health and Human Services media campaign to educate the public about the dangers of tobacco use SAMHSA National Recovery Month Food and Drug Administration clinical development and use of sedation products Surgeon General report on sugar-sweetened beverages S. 3562, Older Americans Act Amendments of 2012

Client expense: $600,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Air Force, Dept of, Army, Dept of (Other), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), Navy, Dept of, Occupational Safety & Health Administration (OSHA), Office of Natl Drug Control Policy (NDCP), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

H.R.5979 Medicaid Accountability and Care Act of 2012 H.R. 5707 Medicare Physician Payment Innovation Act H.R. 1063 Strengthening Medicare and Repaying Taxpayers Act S. 3539 Medicaid Information Technology to Enhance Community Health Act (MITECH Act) H.R. 6232 Medicare Better Health Rewards Program Act of 2012 S.2243 Medicare Better Health Rewards Program Act of 2012 S. 3463 Medicare Diabetes Prevention Act H.R.6142 Assuring Medicare Stability and Access for Seniors Act of 2012

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

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

Issues pertaining to Medicaid reform, block grant proposals, Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments and maintenance of effort provisions in the health reform law Medicaid waivers Extension of Medicare sustainable Growth Rate Automatic enrollment of newborns in Medicaid, Medicaid Blended FMAP Medicare Evaluation and Management Reimbursement Reduction Proposal Medicaid DSH H.R.5979: Medicaid Accountability and Care Act of 2012

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, 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. H.R. 3630: Middle Class Tax Relief and Job Creation Act of 2012. H.R. 2032: To protect the interests of each resident of intermediate care facilities for the mentally retarded in class action lawsuits by federally-funded entities involving such residents and in Department of Justice actions that could result in an agreement to move such a resident from that resident's facility. 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.

Client expense: $450,000 · 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

- Legislative ideas for addressing health care costs, financing & dual eligible demonstration programs. - H.R. 1370, "A bill to repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act", regarding all provisions. - S.1880, "Jobs and Premium Protection Act", regarding all provisions. - S.1049/H.R. 2676 "The Small Business Health Relief Act", regarding all provisions. - H.R. 5979, "Medicaid Accountability and Care Act", regarding all provisions

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, 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; 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.

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), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Medicaid Accountability and Care Act of 2012 (H.R. 5979), all provisions related to revising payments to states under the Medicaid program, including granting an option to receive Medicare payments for full-benefit dual eligible individuals

Client expense: $32,495 · Firm income: Not reported

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; 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.

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), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

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

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

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

H.R.5651, Food and Drug Administration Reform Act of 2012, issues relating to Medicare and Medicaid; S.3187, Food and Drug Administration Safety and Innovation Act, issues relating to Medicare and Medicaid; Implementation of the Patient Protection and Affordable Care Act (PL 111-148), issues relating to evaluation of healthcare plans, medicaid block grants, medical loss ratios, medicare advantage, and managed care for dual eligible individuals, broker fees; Medicare reimbursement rates. H.R.5979, Medicaid Accountability and Care Act of 2012.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of H.R. 3590, The Patient Protection and Affordable Care Act Sections (P.L. 111-148) Title IIIImproving the Quality and Efficiency of Health Care. H.R. 5651 FDA Reform Act of 2012 - Sec. 773. Report on health information technology. H.R.5979 - Medicaid Accountability and Care Act of 2012.S.3295, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013- Provisions relating to prevention and chronic disease.

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE