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 preventative health savings; H.R. 4209 Patients' Access to Treatments Act; H.R. 451 Healthcare, Truth and Transparency Act; H.R. 6352 Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act; H.R. 6562 Resident Physician Shortage Reduction Act; H.R. 5 Protecting Access to Healthcare Act; H.R. 2245 / S. 296 Preserving Access to Life-Saving Medications Act

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

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

H.R. 6352, Physician Shortage Reduction and Graduate Medical Education Accountability Act: Expanding graduate medical education funding H.R. 6598, Electronic Health Records Improvements Act: modifications to Medicares electronic health records program No Bill: Medicare cuts to imaging services No Bill: Elimination of Medicares in-office ancillary exception for imaging No Bill: Medicare physician payment reform No Bill: Eliminating the Physician Quality Reporting System (PQRS) penalties, e-prescribing penalties, electronic health record penalties and value based payment modifier No Bill: Budget Control Act sequestration cuts related to physician reimbursement

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6352, Physician Shortage Reduction and Graduate Medical Education Accountability Act: Expanding graduate medical education funding H.R. 6598, Electronic Health Records Improvements Act: modifications to Medicares electronic health records program No Bill: Medicare cuts to imaging services No Bill: Elimination of Medicares in-office ancillary exception for imaging No Bill: Medicare physician payment reform No Bill: Eliminating the Physician Quality Reporting System (PQRS) penalties, e-prescribing penalties, electronic health record penalties and value based payment modifier No Bill: Budget Control Act sequestration cuts related to physician reimbursement

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Increasing NIH appropriations for FY2013 and opposing NIH cuts called for by sequestration; Support federal medical malpractice liability reform (HR. 5); Support protections for neurology patients participating in clinical trial participant; Support for maintaining the Stark In-Office Ancillary Services Exception, Support for broad physician payment reform; Support HR 4209 for patient access to biologic drugs; Advocating for changes in bills to promote Graduate Medical Education, HR 6352 and HR 6352, to remove list of eligible specialties; Support for neurology's inclusion in pediatric loan repayment programs offered by the Affordable Care Act; Oppose creating an exclusivity period for drugs that treat neurological and psychiatric diseases; Support expedited FDA review for drugs treating neurological and psychiatric diseases; Offered recommendations to improve the MEPS survey.

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

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

Long Term Acute Care Hospitals, Issues pertaining to innovation at the Center for Medicare and Medicaid Services (CMS). Medicare and Medicaid Reimbursement, Issues pertaining to Disproportionate Share Hospital payments and possible reductions to provider payments. H.R. 5707, Medicare Physician Payment Innovation Act of 2012, Issues pertaining to the SGR and changes to health delivery. H.R.6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, Issues pertaining to reimbursement for graduate medical education, and disproportionate share hospital payments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

State-based medical licensure; license portability; telemedicine; prescriber/patient education and responsible opioid prescribing policies to combat prescription drug abuse; improving provider screening to combat Medicare/Medicaid fraud and abuse; graduate medical education; health care workforce data; online pharmacy safety; patient safety and medical errors reporting; scope of practice H.R. 6107, The Veterans E-Health & Telemedicine Support (VETS) Act of 2012 H.R. 6719, The Telehealth Promotion Act of 2012 H.R. 6352, The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act The Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer (FAST) Dollars Act

Client expense: $110,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

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

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. 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. 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. 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. H.R. 8, American Taxpayer Relief Act of 2012. Monitor the implementation of the Continuing Appropriations Resolution, 2013. (P.L. 112-175) Monitor federal issues and legislation associated with health care policy.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.8: American Taxpayer Relief Act of 2012; H.R.6352: Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transfer Act; H.R.6575: The Medicare Audit Improvement Act of 2012; H.J. Res.66: Permanent Tax Relief for Families and Small Businesses Act of 2012; S. 958 Children's Hospital GME Support Reauthorization Act of 2011 S. 2620/H.R. 5943, Rural Hospital Access Act (MDH/LV Adjustment 1-year extension) S. 1680/H.R. 3859, Craig Thomas Rural Hospital and Provider Equity (R-HOPE) Act S.1627/H.R. 6562, Resident Physician Shortage Reduction Act (Medicare residency slots) Medicare physician fee schedule fix Medicare and Medicaid Recovery Audit Contractor (RAC) Programs New York State 1115 Medicaid Waiver Application to CMS Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, inpatient coding offset, outpatient department hold harmless for certain rural and Sole Community Hospitals, hospital outpatient department (HOPD) evaluation and management (E/M) services, and Medicaid provider taxes. Medicare and Medicaid Programs; Electronic Health Record Incentive ProgramStage 2; Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology; Final Rules (CMS and ONC Medicare and Medicaid EHR Meaningful Use Incentive Program Stage 2 final rules) Issues related to Superstorm Sandy and the supplemental appropriations bills

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

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

H.R. 5707, Medicare Physician Payment Innovation Act of 2012, Issues pertaining to the SGR formula. H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, Issues pertaining to funding for Graduate Medical Education and Indirect Medical Education.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Long Term Acute Care Hospitals, Issues pertaining to funding for the payment structure for Long Term Acute Care Hospitals Medicare and Medicaid Reimbursement, Issues pertaining to Disproportionate Share Hospital payments and possible reductions to provider payments. Medicare and Medicaid Reimbursement, Issues pertaining to Disproportionate Share Hospital payments and possible reductions to provider payments. H.R.6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency ActIssues pertianing to funding for Graduate Medical Education and Indirect Medical Education. H.R. 6611, The Patient Access to Drugs in Shortage Act, Issues pertaining to the 340B program. H.R. 5707, Medicare Physician Payment Innovation Act of 2012, Issues pertaining to the SGR and changes to health delivery. H.R. 6575, The Medicare Audit Improvement Act of 2012, Issues pertaining to RAC audits.

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Long Term Acute Care Hospitals, Issues pertaining to innovation at the Center for Medicare and Medicaid Services (CMS). Medicare and Medicaid Reimbursement, Issues pertaining to Disproportionate Share Hospital payments and possible reductions to provider payments. H.R. 5707, Medicare Physician Payment Innovation Act of 2012, Issues pertaining to the SGR and changes to health delivery. H.R.6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, Issues pertaining to reimbursement for graduate medical education, and disproportionate share hospital payments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, Issues pertaining to Graduate Medical Education.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Advocated consideration of HR 6352, the Physcian Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, which increases the number of residency slots by 15 thousand over five years and S.1627, The Resident Physician Shortage Act of 2011. These bills address the nation's projected shortage of physicians.

Client expense: $75,225 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support legislation to eliminate the Independent Payment Advisory Board (HR 452, HR 5) & (S 2118) Lobby Congress on enacting a permanent repeal to the Medicare sustainable growth rate (SGR) Lobby Congress on proposed legislation to repeal in-office ancillary and physician services for anatomic pathology services, oppose inclusion of language in HR 8 Support legislation to increase residency slots for Graduate Medical Education (HR 6352)

Client expense: $274,307 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

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; H.R. 5707, Medicare Physician Payment Innovation Act of 2012. H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act; H.R. 3667, Primary Care Workforce Access Improvement Act of 2011; H.R. 3269/S. 2347, Diagnostic Imaging Services Access Protection Act of 2011.

Client expense: $245,727 · 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

P.L. 111-148 - Patient Protection and Affordable Care Act Health Information Technology H.R. 2224 - Improving Physician Access in Teaching Hospitals (PATH) Act S. 1052, H.R. 1970 - National Childhood Brain Tumor Prevention Network Act Health workforce shortage issues, Title VII and Title VIII of the Public Health Service Act, nursing, graduate nursing education, nursing-managed health clinics Health wellness and prevention programs H.R. 5707 - Medicare Physician Payment Innovation Act H.R.5651, Food and Drug Administration Reform Act of 2012 H.R. 6352 Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act (Schock Bill combines Schumer/Nelson/Reid bill and Reed RI bills) H.R. 6562 Resident Physician Shortage Reduction Act of 2012

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 8 - American Taxpayer Relief Act of 2012 H.R. 6352 - Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transfer Act H.R. 6575 - The Medicare Audit Improvement Act of 2012 H.J. Res. 66 - Permanent Tax Relief for Families and Small Businesses Act of 2012 S. 958 - Children's Hospital GME Support Reauthorization Act of 2011 Internal Revenue Service, Additional Requirements for Charitable Hospitals, Proposed Rule, [REG-130266-11] Centers for Medicare & Medicaid Services; Department of Health and Human Services, Request for Information Regarding Health Care Quality for Exchanges [CMS-9962-NC]

Client expense: $197,000 · Firm income: Not reported

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

H.R.751, Mental Health in Schools Act of 2011 S.37, Autonomy for Psychologists and Social Workers Act of 2011 S.541, Achievement Through Prevention Act Draft, Juvenile Justice and Delinquency Prevention Act Draft, Elementary and Secondary Education Act S. 1481, Medical Education Development Act of 2011 H.R. 5996, the Mental Health First Aid Higher Education Act of 2012 S.1627, Resident Physician Shortage Reduction S. 3201, H.R. 6352, Graduate Medical Education Act

Client expense: $122,658 · Firm income: Not reported

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

HR 2/S 192, Repealing the Job-Killing Health Care Law Act HR 5/S 218, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 HR 439/S 73, State Leadership in Health Care Act H.R.451, Healthcare Truth and Transparency Act of 2011 H.R.751, Mental Health in Schools Act of 2011 H.R. 831/S 483, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program S.483, Medicare Mental Health Access Act S.37, Autonomy for Psychologists and Social Workers Act of 2011 S.40, Graduate Psychology Education Act of 2011 S.43, Psychologists in the Service of the Public Act of 2011 S.539, Behavioral Health Information Technology Act of 2011 S 248/ HR 844, Empowering States to Innovate Act S. 525, Positive Aging Act of 2011 S 650/HR 1184, Health Care Waiver Transparency Act S. 374, Medicare Mental Health Inpatient Equity Act S. 1627, Resident Physician Shortage Reduction Act of 2011, A bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes. HR 5/S 218, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 H Res 92, Providing for consideration of the bill (H.R. 1) making appropriations for the Department of Defense and the other departments and agencies of the Government for the fiscal year ending September 30, 2011, and for other purposes, and waiving a requirement of clause 6(a) of rule XIII with respect to consideration of certain resolutions reported from the Committee on Rules. S. 1542, H.R. 2883, Child and Family Services Improvement and Innovation Act S. 1925, H.R. 4970 Violence against Women Act Reauthorization Act S. 3604, A bill to amend title XVIII of the Social Security Act to provide for the implementation of prescriber education programs and to establish requirements relating to the administration of antipsychotics to residents of skilled nursing facilities and nursing facilities under the Medicare and Medicaid programs, and for other purposes. H.R. 6043, the Behavioral Health Information Technology Act of 2012 H.R. 5989, the Excellence in Mental Health Act of 2012 H.R. 5996, the Mental Health First Aid Higher Education Act of 2012 H.R. 5707, the Medicare Physician Payment Innovation Act of 2012 H. R. 6562, the Resident Physician Shortage Act of 2012 H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act of 2012 H.R. 6079, the Repeal of Obamacare Act H.R. 8, American Taxpayer Relief Act H.R. 6645, Save and Stregthen Medicare Act of 2012 H.R. 6598, Electronic Health Records Improvement Act Proposed Rule on the Patient Protection and Affordable Care Act: Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation. CMS-2012-0142-0001.

Client expense: $122,658 · Firm income: Not reported

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

HR 340, To amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid Program of items and services for patients in an institution for mental diseases. HR 831/S 483, to amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare program S.483, Medicare Mental Health Access Act (companion bill to HR 831 above) HR 1256, Medicare Physician Payment Transparency and Assessment Act of 2011 S.37, Autonomy for Psychologists and Social Workers Act of 2011 S.40, Graduate Psychology Education Act of 2011 S.43, Psychologists in the Service of the Public Act of 2011 S 374, Medicare Mental Health Inpatient Equity Act S. 525, Positive Aging Act of 2011 S 539, Behavioral Health Information Technology Act of 2011 S. 1627, Resident Physician Shortage Reduction Act of 2011, A bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes. H.R. 6043, the Behavioral Health Information Technology Act of 2012 H.R. 5707, the Medicare Physician Payment Innovation Act of 2012 H.R. 5989, the Excellence in Mental Health Act of 2012 H. R. 6562, the Resident Physician Shortage Act of 2012 H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act of 2012 H.R. 6079, the Repeal of Obamacare Act H.R. 6598, Electronic Health Records Improvement Act H.R. 6645, Save and Strength Medicare Act of 2012 Medicare Program: Revisions to Payment Policies Under the Physician Fee Schedule, DME Face to Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013. (CMS-2012-0083-3524) Medicaid Program: Payments for Services Furnished by Certain Primary Care Physicians and Charges for Vaccine Administration under the Vaccines for Children Program; Correction. (CMS-2012-0061-0150)

Client expense: $122,658 · Firm income: Not reported

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

H.R. 8: American Tax Payer Relief Act of 2012 H.R. 6352: Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transfer Act H.R. 6575: The Medicare Audit Improvement Act of 2012 H.J. Res. 66: Permanent Tax Relief for Families and Small Businesses Act of 2012 S. 958 Children's Hospital GME Support Reauthorization Act of 2011 Centers for Medicare and Medicaid Services, Meaningful Use Stage 2, Final Rule September 4, 2012

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1627: The Resident Physician Shortage Reduction Act of 2011--entire bill HR 6352:Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act--entire bill HR 6562:Resident Physician Shortage Reduction Act of 2012--entire bill HR 8: American Taxpayer Relief Act of 2012 -- provisions related to graduate medical education

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Presidents Budget, 2013, Department of Health and Human Services Unnumbered House subcommittee bill/S.3295 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013, Title II Issues: Support funding for National Institutes of Health (NIH), human embryonic stem cell research, Health Resources and Services Administration (HRSA), Title VII and Title VIII health professions and nursing education programs, National Health Service Corps, Childrens Hospitals graduate medical education (GME), Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), and CDCs National Center for Health Statistics. Restore NIH salary cap to Executive Level I. Oppose elimination of AHRQ, and research policy provisions in House subcommittee bill H.R. 6400, RDOCS Act of 2012 Issue: Support additional scholarship opportunities for medical students. President's Budget, 2013, Department of Health and Human Services Issues: Oppose proposed reduction in Medicare Graduate Medical Education (GME) support and proposed Medicaid reductions and reforms. Presidents Budget, 2014, Department of Veterans Affairs H.R. 5854/S. 3215, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2013, Title II Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. P.L. 111-148, Patient Protection and Affordable Care Act, Section 4002 and Title V Issue: Support the Prevention and Public Health Fund and preserve PPHF funds for workforce training. P.L. 111-148, Patient Protection and Affordable Care Act, Title V and Section 10503 Issue: Funding for Community Health Centers and the National Health Service Corps. Debt in Health Education Loan programs (Dbt HELP) bill proposal (draft) Issue: Expand National Health Service Corps State Loan Repayment program, align Department of Education and Health Resources and Services Administration student loan programs. S. 1627, Resident Physician Shortage Reducation Act Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. P.L. 111-148, Patient Protection and Affordable Care Act, Title V Issue: Implementing provisions reauthorizing health professions education programs under Title VII of the Public Health Service Act, and reauthorizing National Health Service Corps. S. 3201 Graduate Medical Education Reform Act of 2012 Issue: Increase Medicare Graduate Medical Education (GME) accountability H.R. 3667, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act Section 5503 and 5506 Issue: Redistribution of residency positions Issue: Implementation of Teaching Health Center Graduate Medical Education programs under section 340G of the Public Health Service Act. H.R. 1852/S. 958, Children's Hospital GME Support Reauthorization Act of 2011 S. 1440, The Prematurity Research Expansion and Education for Mothers who Deliver Infants Early Act. Issue: Support reauthorization of Children's Hospitals Graduate Medical Education. H.R. 1855/H.R. 2405, Pandemic and All-Hazards Preparedness Reauthorization Act. Issue: Complete reauthorization of preparedness legislation Act. H.R. 5707, Medicare Physician Payment Innovation Act Issue: Repeal of Medicare's sustainable growth rate (SGR) formula. H.R. 1513/S. 810, Great Ape Protection and Cost Saving Act of 2011 H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act Issue: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments and increase GME accountability and transparency. H.R. 6562, Resident Physician Reduction Shortage Act of 2012 Issue: Support lifting cap on the number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments. Issue: Promote interprofessional education and training of the health care workforce. S. 799, Commercial Privacy Bill of Rights Act of 2011 Issue: Collection, retention, and dissemination of personal health information. Issue: Discuss with Administration impact of Medicaid expansions and Medicaid DSH cuts under the Affordable Care Act on AAMC member institutions. Issue: Funding for the National Healthcare Workforce Commission. H.R. 2954/S. 2474, Health Equity and Accountability Act of 2011 Issue: Developing health care workforce that promotes health equity. Issue: Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Institute of Medicine (IOM) study on Graduate Medical Education (GME) financing and policies Issue: Support Medicare physician payment reform Issue: Oppose reduction in Medicare hospital outpatient department reimbursement Issue: Clarify policy changes on how to count Labor and Delivery beds when calculating Medicare GME payments. Issue: Oppose Medicare Graduate Medical Education (GME) spending cuts through sequestration. Issue: 340b Drug Discount program eligibility Issue: Oppose nondefense discretionary spending cuts through sequestration, including NIH and Title VII and VIII health professions and nursing education programs. Issue: Preventing, Identifying, and Treating Prescription Drug Abuse Issue: Primary Care Workforce Development Issue: Funding for Title VII and VIII in President's FY 2014 Budget Issue: Implementation of ACA Exchanges and Medicaid Expansions. Submitted comments on: AHRQ's Consumer Reporting System for Patient Safety Events Enhancing Community-Engaged Research Through the Clinical and Translational Science Awards Program

Client expense: $960,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

President's Budget, 2013, Department of Health and Human Services Issue: Oppose proposed reductions in Medicare GME support and proposed reductions and reforms in Medicaid. S. 1627, Resident Physician Shortage Reduction Act Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. Issue: Implementation of Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Institute of Medicine (IOM) study on Graduate Medical Education (GME) financing and policies. Issue: Support Medicare physician payment reform Issue: Oppose reduction in Medicare hospital outpatient department reimbursement Issue: Oppose restrictions on states' use of Medicaid provider assessments to pay for reduced student loan interest rates. S. 3201 Graduate Medical Education Reform Act of 2012 Issue: Support legislation to increase Medicare GME accountability and support H.R. 3667, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act Section 5503 and 5506 (Redistribution of Residency Positions) Issue: Redistribution of residency positions Issue: Support draft legislation to create womens hospital Graduate Medical Education program H.R. 5707, Medicare Physician Payment Innovation Act Issue: Repeal of Medicare's sustainable growth rate (SGR) formula. H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act Issue: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments and increase GME accountability and transparancy. H.R. 6562, Resident Physician Reduction Shortage Act of 2012 Issue: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments Issue: Discuss with Administration Impact of Medicaid expansions and Medicaid DSH cuts under the Affordable Care Act on AAMC member institutions Issue: Preventing, identifying, and treating prescription drug abuse Issue: Primary Care Workforce Development Issue: Implementation of ACA Exchanges and Medicaid expansions

Client expense: $960,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Implementation of Affordable Care Act; Electronic Health Record (H.R.4066) Stark Self-Referral Reform; HR 6118 Essential Steps for Testing Act Elimination of SGR Formula Under Medicare; HR 6352 Physician Shortage Reduction & GME Accountability Act Appropriations for Federal Health Agencies; Global Health Initiative

Client expense: $40,000 · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. S. 296 A bill to amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages. All Provisions. H.R. 6352 The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act. All Provisions. S. 1627 Resident Physician Shortage Reduction Act of 2011. All Provisions. S. 3201 Graduate Medical Education Reform Act of 2012. All Provisions. H.R. 6611 Patient Access to Drugs In Shortage Act. All Provisions

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

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

H.R. 3765 - PL 112-078 Temporary Payroll Tax Cut Continuation Act of 2011. All provisions related to Medicare physician and hospital payments. H.R. 3630 Middle Class Tax Relief and Job Creation Act of 2012. All provisions related to Medicare physician and hospital payments. H.R. 2500 Equal Access and Parity for Multi-Campus Hospitals Act. All Provisions. P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers, and individuals. Conference Report on H.R. 4348 Surface Transporation Extension Act of 2012/P.L. 112-141. Provisions related to Louisiana Medicaid Federal Medical Assistance Percentage. H.R. 6352 The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act. All Provisions. S. 1627 Resident Physician Shortage Reduction Act of 2011. All Provisions. S. 3201 Graduate Medical Education Reform Act of 2012. All Provisions. H.R. 8 American Taxpayer Relief Act of 2012. All Provisions. H.R. 6611 Patient Access to Drugs In Shortage Act. All Provisions

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

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

S.3187 - Food and Drug Administration and Safety and Innovation Act and Related Conference Report PL 112-144 (drug shortage provisions). S.296/H.R.2245 - Preserving Access to Life-Saving Medications Act (drug shortage provisions). S.319 - Pharmaceutical Market Access and Drug Safety Act (drug shortages provisions). H.R.5651 - Food and Drug Administration Reform Act (drug shortage provisions). H.R.3839 - Drug Shortage Prevention Act (drug shortage provisions). Medicare physician fee schedule fix (issue only). Medicare hospital wage index (issue only). Inpatient Prospective Payment system final proposed regulation (coding offset). H.R.3519 - To exempt the Medicare program from fallback sequestration under the Budget Control Act of 2011, (entire bill). S.2620/H.R.5943 - Rural Hospital Access Act, (entire bill). H.R.2224 - Improving Physician Access to Teaching Hospitals Act, (entire bill). S.1627/H.R.6562 - Resident Physician Shortage Reduction Act (entire bill). H.R.452 - Medicare Decisions Accountability Act (IPAB repeal). S.668 - Health Care Bureaucrats Elimination Act. Resident Physician Shortage Reduction and Graduate Medical Education Accountability Act, H.R.6352 (entire bill).

Client expense: $209,000 · Firm income: Not reported

Government targets: 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), SENATE

Promoted HSHS innovation aimed at quality and efficiency in the delivery of care. Pressed lawmakers to avoid blunt cuts in upcoming budget negotiations, extend certain rural payment provisions, and avoid policy changes that would hurt ability of Critical Access Hospitals to serve their communities. Asked lawmakers to co-sponsor S.2620/H.R.5943, the Rural Hospital Access Act of 2012. Supported introduction of H.R.6352, the Resident Shortage Reduction and Graduate Medical Education Accountability Act.

Client expense: $195,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Long Term Acute Care Hospitals, Issues pertaining to innovation at the Center for Medicare and Medicaid Services (CMS). Medicare and Medicaid Reimbursement, Issues pertaining to Disproportionate Share Hospital payments and possible reductions to provider payments. H.R. 5707, Medicare Physician Payment Innovation Act of 2012, Issues pertaining to the SGR and changes to health delivery. H.R.6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, Issues pertaining to reimbursement for graduate medical education, and disproportionate share hospital payments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 6352: Resident Physician Shortage Reduction and Graduate Medical Education Transparency Act; accountability and extension of sustainable growth rate and impact of reduction rate on faculty practice and care of medicare patients HR 6562, S 1627: Resident Physician Shortage Act- encouraged Congressman and Senators to co-sponsor legislation

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5888; HR 6352

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

Advocated consideration of HR 6352, the Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act, which increases the number of residency slots by 15 thousand over five years, and S. 1627, The Resident Physician Shortage Act of 2011. These bills address the nation's projected shortage of physicians.

Client expense: $76,205 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5 Protecting Access to Healthcare Act; H.R. 2245 / S. 296 Preserving Access to Life-Saving Medications Act; H.R. 3839 Drug Shortage Prevention Act; H.R. 4209 Patients' Access to Treatments Act; 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 services; H.R. 6562 Resident Physician Shortage Reduction Act

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

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

State-based medical licensure; license portability; telemedicine; prescriber / patient education and responsible opioid prescribing policies to combat prescription drug abuse; improving provider screening to combat Medicare/Medicaid fraud and abuse; graduate medical education; health care provider workforce data; online pharmacy safety. - The Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayer (FAST) Dollars Act - H.R. 6107, The Veterans E-Health & Telemedicine Support (VETS) Act of 2012 - H.R. 6352, The Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

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: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

President's Budget, 2013, Department of Health and Human Services Issue: Oppose proposed reductions in Medicare GME support and proposed reductions and reforms in Medicaid. S. 1627, Resident Physician Shortage Act Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. Issue: Implementation of Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Institute of Medicine (IOM) study on Graduate Medical Education (GME) financing and policies. Issue: Support Medicare physician payment reform Issue: Oppose reduction in Medicare hospital outpatient department reimbursement Issue: Clarify policy changes on how to count Labor and Delivery beds when calculating Medicare GME payments. Issue: Oppose restrictions on states' use of Medicaid provider assessments to pay for reduced student loan interest rates. S. 3201 Graduate Medical Education Reform Act of 2012 Issue: Support legislation to increase Medicare GME accountability and support H.R. 3667, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act Section 5503 and 5506 (Redistribution of Residency Positions) Issue: Redistribution of residency positions Issue: Support draft legislation to create womens hospital Graduate Medical Education program H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act Issue: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments and increase GME accountability and transparancy. H.R. 6562, Resident Physician Reduction Shortage Act of 2012 Issue: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments Issue: Discuss with Administration scenarios for Medicaid expansions and Medicaid DSH cuts under the Affordable Care Act and impact on AAMC member institutions Submitted comments on: CY 2013 End Stage Renal Disease Quality Incentive Program CDC Request for Information Regarding Inclusion of Work Information in EHR CY 2013 Physician Fee Schedule Proposed Rule CY 2013 Hospital Outpatient and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Issue: Support highest possible 302(b) allocation for Labor-HHS-Education Appropriations Subcommittee. Presidents Budget, 2013, Department of Health and Human Services Unnumbered House subcommittee bill/S.3295 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013, Title II Issues: Support funding for National Institutes of Health (NIH), human embryonic stem cell research, Health Resources and Services Administration (HRSA), Title VII and Title VIII health professions and nursing education programs, National Health Service Corps, Childrens Hospitals graduate medical education (GME), Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), and CDCs National Center for Health Statistics. Restore NIH salary cap to Executive Level I. Oppose elimination of AHRQ, research policy provisions in House subcommittee bill H.R. 6400, RDOCS Act of 2012 Issue: Support additional scholarship opportunities for medical students. President's Budget, 2013, Department of Health and Human Services Issues: Oppose proposed reduction in Medicare Graduate Medical Education (GME) support and proposed Medicaid reductions and reforms. Presidents Budget, 2014, Department of Veterans Affairs H.R. 5854/S. 3215, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2013, Title II Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. P.L. 111-148, Patient Protection and Affordable Care Act, Section 4002 and Title V Issue: Support the Prevention and Public Health Fund and preserve PPHF funds for workforce training. P.L. 111-148, Patient Protection and Affordable Care Act, Title V and Section 10503 Issue: Funding for Community Health Centers and the National Health Service Corps. Health professions loans reform bill proposal (draft) Issue: Expand National Health Service Corps State Loan Repayment program, align Department of Education and Health Resources and Services Administration student loan programs. S. 1627, Resident Physician Shortage Act Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. P.L. 111-148, Patient Protection and Affordable Care Act, Title V Issue: Implementing provisions reauthorizing health professions education programs under Title VII of the Public Health Service Act, and reauthorizing National Health Service Corps. S. 3201 Graduate Medical Education Reform Act of 2012 Issue: Increase GME accountability H.R. 3667, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act Section 5503 and 5506 Issue: Redistribution of residency positions Issue: Implementation of Teaching Health Center Graduate Medical Education programs under section 340G of the Public Health Service Act. H.R. 1852/S. 958, Children's Hospital GME Support Reauthorization Act of 2011 Issue: Support reauthorization of Children's Hospitals Graduate Medical Education. H.R. 6352, Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act Issue: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments and increase GME accountability and transparency. H.R. 6562, Resident Physician Reduction Shortage Act of 2012 Issue: Support lifting cap on the number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments. Issue: Promote interprofessional education and training of the health care workforce. S. 799, Commercial Privacy Bill of Rights Act of 2011 Issue: Collection, retention, and dissemination of personal health information. Issue: Discuss with Administration scenarios for Medicaid expansions and Medicaid DSH cuts under the Affordable Care Act and impact on AAMC member institutions. Issue: Funding for the National Healthcare Workforce Commission. H.R. 2954/S. 2474, Health Equity and Accountability Act of 2011 Issue: Developing health care workforce that promotes health equity. Issue: Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Institute of Medicine (IOM) study on Graduate Medical Education (GME) financing and policies Issue: Support Medicare physician payment reform Issue: Support draft legislation to create womens hospital Graduate Medical Education program Issue: Oppose reduction in Medicare hospital outpatient department reimbursement Issue: Clarify policy changes on how to count Labor and Delivery beds when calculating Medicare GME payments. Issue: Oppose restrictions on states' use of Medicaid provider assessments to pay for reduced student loan interest rates. Issue: Oppose Medicare Graduate Medical Education (GME) spending cuts through sequestration. Issue: 340b Drug Discount program eligibility Issue: Oppose nondefense discretionary spending cuts through sequestration, including NIH and Title VII and VIII health professions and nursing education programs. Submitted comments on: CY 2013 End Stage Renal Disease Quality Incentive Program CDC Request for Information Regarding Inclusion of Work Information in EHR CY 2013 Physician Fee Schedule Proposed Rule CY 2013 Hospital Outpatient and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs IRS Proposed Rule for Additional Requirements for Charitable Hospitals

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

H.R. 1700, Medicare Payment Empowerment Act: Medicare Private Contracting S. 1042, Medicare Patient Empowerment Act: Medicare private contracting H.R. 6352, Physician Shortage Reduction and Graduate Medical Education Accountability Act: Expanding graduate medical education funding No Bill: Medicare cuts to imaging services No Bill: Medicare physician payment reform No Bill: Eliminating the Physician Quality Reporting System (PQRS) penalties, e-prescribing penalties, electronic health record penalties and value based payment modifier No Bill: Budget Control Act sequestration cuts related to physician reimbursement

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1700, Medicare Payment Empowerment Act: Medicare Private Contracting S. 1042, Medicare Patient Empowerment Act: Medicare private contracting H.R. 6352, Physician Shortage Reduction and Graduate Medical Education Accountability Act: Expanding graduate medical education funding No Bill: Medicare cuts to imaging services No Bill: Medicare physician payment reform No Bill: Eliminating the Physician Quality Reporting System (PQRS) penalties, e-prescribing penalties, electronic health record penalties and value based payment modifier No Bill: Budget Control Act sequestration cuts related to physician reimbursement

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE