Medicare Prescription Drug Savings and Choice Act of 2011

H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; S. 31: All provisions of the Prescription Drug and Health Improvement Act of 2011; S. 44: All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H. R. 1290/S. 1206 - All provisions of The Medicare Prescription Savings Act Health care issues before the Joint Select Committee on Deficit Reduction H.R. 3613 the Part D Beneficiary Appeals Fairness Act S. 1356 / H.R. 3343 the Affordable Medicines Utilization Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Ac

Client expense: $559,998 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

HR 891/S 274 - legislation that would expand the existing medication therapy management program in Medicare Part D; S 31/S 44/HR 2248/HR 6392 - legislation taht would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors; HR 999/S 560 - legislation that would establish a nationwide Part D plan administered by the federal government; HR 1055 - legislation that would allow Part D plans to offer "off-label" coverage HR 2190/S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" revates for covered prescription drugs purchased by dual eligibles under Medicare Part D; HR 3613 - legislation that would require Part D plans to establish an exceptions process for patient cost-sharing amounts; HR 4215 - legislation that would establish audit requirements and other transparency requirements for Part D plan sponsors; worked on proposed legislative language, which included consultation with Senate committee staff and discussions with personal staff of House and Senate members, that would amend the current prompt payment rules in Part D in the interest of preventing fraud.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5 - Protecting Access to Healthcare Act, provisions related to Independent Payment Advisory Board (IPAB) H.R. 8 - American Taxpayer Relief Act of 2012, provisions related to Medicare and tax H.R. 452 - Medicare Decisions Accountability Act, provisions related to the Independent Payment Advisory Board (IPAB) H.R. 999 - Medicare Prescription Drug Savings and Choice Act of 2011, provisions related to Medicare Part D H.R. 1063 - Strengthening Medicare & Repaying Taxpayers Act of 2011, provisions relating to reform of Secondary Payer rules H.R. 1845 - Medicare IVIG Access Act, provisions relating to reform of Secondary Payer rules H.R. 2190 - Medicare Drug Savings Act of 2011, provisions related to Medicare Part D S. 365- Budget Control Act of 2011, Deficit reduction issues related to Medicare and Medicaid S. 668 - Health Care Bureaucrats Elimination Act, provisions related to the Independent Payment Advisory Board (IPAB) S. 1206 - Medicare Prescription Drug Savings Act of 2011, provisions related to Medicare Part D S. 1251 - Medicare and Medicaid FAST Act, provisions related to Part D issues S. 1699 - Prescription Drug Cost Reduction Act, provisions related to Medicare Part B and drug rebates Dual eligibles coordination policy issues Deficit reduction policy issues Medicaid program, Covered Outpatient Drugs rulemaking Medicare, Medicaid, Children's Health Insurance Programs,; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking

Client expense: $1,370,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office

Medicare Benefit Redesign. (No Bill): proposals for providing a catastrophic cap on Medicare out-of-pocket spending to be paid for by a surcharge on private Medigap policies and employer-provided retiree health benefits. Medicare Drug Savings. S. 1206, H.R. 2190: provisions extending the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by people eligible for both Medicare and Medicaid (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Home Health Benefits. (No bill): proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Income-relating. (No bill): proposals to increase the cost of Medicare to higher-income beneficiaries. Medicare Eligibility Age (No Bill): proposals to increase the Medicare eligibility age. Medicare Parts C and D. P.L. 110-275, P.L. 108-173: implementation of regulations and issuance of guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and the appeals processes under Medicare Parts C and D. Medicare Part D Negotiation of Drug Prices. S. 31, S. 44, S. 560, H.R. 999, H.R. 6392: proposals to create a Medicare-operated prescription drug plan, allowing or requiring the Secretary of the Department of Health and Human Services to negotiate price concessions from pharmaceutical manufacturers for drugs purchased under the Part D program. Medicare Supplemental Health Insurance. (No bill): proposals to increase costs for Medicare beneficiaries who purchase Medigap insurance. Medicare Physician Fees. (P.L. 112-240): proposal to maintain current levels of physician fees under Part B. Comprehensive Health Care Reform. P.L. 111-148, P.L. 111-152: implementation of the provisions reducing Medicare Advantage plan payments; reducing the Part D coverage gap; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); improving the process for reassigning LIS beneficiaries to new plans; expanding coverage of prevention services; establishing a Medicare Commission; providing expanded Medicaid coverage for home and community-based services; authorizing the collection of data regarding disparities in the provision of care; providing safeguards and subsidies to assure affordability of health coverage for seniors. Center for Medicare and Medicaid Innovation. (No bill): proposals related to the planning for the Center for Medicare and Medicaid Innovations, and the approach the Center will take to test innovative payment and service delivery models to reduce program expenditures, while preserving or enhancing the quality of care for Medicare, Medicaid and CHIP beneficiaries. Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office). (No bill): proposals related to the activities of the Federal Coordinated Health Care Office intended to improve the quality of care for recipients who receive benefits from both Medicare and Medicaid, e.g, dual-eligibles.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), Office of Management & Budget (OMB), President of the U.S., SENATE, Social Security Administration (SSA), Treasury, Dept of, Vice President of the U.S.

H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733:All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 605 / S. 312 -All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 -All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H.R. 2672 the Preserving Access to Orphan Drugs Act H.R. 2182 the Generating Antibiotic Incentives Now Act H.R. 3026 the Safeguarding Americas Pharmaceuticals Act H.R. 2746 the Cancer Drug Coverage Parity Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act

Client expense: $518,430 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; S. 31: All provisions of the Prescription Drug and Health Improvement Act of 2011; S. 44: All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H. R. 1290/S. 1206 - All provisions of The Medicare Prescription Savings Act Health care issues before the Joint Select Committee on Deficit Reduction H.R. 3613 the Part D Beneficiary Appeals Fairness Act S. 1356 / H.R. 3343 the Affordable Medicines Utilization Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act

Client expense: $518,430 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 5: All provisions of the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 4 /S.18 / S.72 - All provisions of the Small Business Paperwork Mandate Elimination Act H.R. 605 / S. 312 - All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 - All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs), implementation of approval pathway for generic biologic drugs 340b program H.R. 2245/S. 296 - All provisions of the Preserving Access to Life-Saving Medications Act of 2011

Client expense: $518,430 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), 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

HR 891 and S 274 - legislation that would expand the existing medication therapy management program in Medicare Part D; S 31 and S 44 and HR 2248 and HR 3638 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors; HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government; HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D; HR 3613 - legislation that would require Medicare Part D plans to establish an exceptions process for patient cost-sharing amounts; HR 4215 - legislation that would establish audit requirements and other transparency requirements for Medicare part D plan sponsors; HR 6392 - legislation that would allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors; Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5, Protecting Access to Healthcare Act: Provisions related to Independent Payment Advisory Board (IPAB) H.R. 452, Medicare Decisions Accountability Act of 2011: Provisions related to Independent Payment Advisory Board (IPAB) H.R. 999, Medicare Prescription Drug Savings and Choice Act of 2011: Provisions related to Part D issues H.R. 2190 Medicare Drug Savings Act of 2011: Provisions related to Part D issues H.R. 4209, Patients Access to Treatments Act of 2012: Capping specialty tier drugs and no cost-sharing above the non-preferred brand tier S. 365, Budget Control Act of 2011: Deficit reduction issues related to Medicare/Medicaid S. 668, Health Care Bureaucrats Elimination Act: Provisions related to Independent Payment Advisory Board (IPAB) S. 1206, Medicare Prescription Drug Savings Act of 2011: Provisions related to Part D issues S. 1251, Medicare and Medicaid FAST Act: Provisions related to Part D issues. S. 1699, Prescription Drug Cost Reduction Act: Provisions related to Medicare Part B, 340B, least costly alternative, and other provisions Deficit reduction policy issues Medicaid Program, Covered Outpatient Drugs rulemaking Dual eligibles coordination policy issues Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking

Client expense: $4,140,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Economic Council (NEC), Natl Security Council (NSC), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), 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

Benefit Redesign. (No Bill): proposals for providing a catastrophic cap on Medicare out-of-pocket spending to be paid for by a surcharge on private Medigap policies and employer-provided retiree health benefits. Independent Payment Advisory Board. H.R. 1: provisions to repeal or modify P.L. 111-148/P.L. 111-152 authorizing the creation of an independent commission to promulgate Medicare policies designed to reduce Medicare spending growth. Medicare Drug Savings. S. 1206, H.R. 2190: provisions extending the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by people eligible for both Medicare and Medicaid (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Home Health Benefits. (No bill): proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Income-relating. (No bill): proposals to increase the cost of Medicare to higher-income beneficiaries. Medicare Part A Hospital Inpatient Status. S. 818, H.R. 1543: provisions ensuring beneficiaries receiving hospital services are designated as inpatients, thereby assuring coverage of prescription drugs and post-acute care under Part A following a three-day hospitalization. Medicare Parts C and D. P.L. 110-275, P.L. 108-173: implementation of regulations and issuance of guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and the appeals processes under Medicare Parts C and D. Medicare Part D Negotiation of Drug Prices. S. 31, S. 44, S. 560, H.R. 999, H.R. 6392: provisions creating a Medicare-operated prescription drug plan, allowing or requiring the Secretary of the Department of Health and Human Services to negotiate price concessions from pharmaceutical manufacturers for drugs purchased under the Part D program. Medicare Managed Care. H.R. 4254: provisions pertaining to revisions to the coding intensity adjustment factor in the formula for the demographic adjustment used in calculating payments to Medicare Advantage organizations for 2015 and subsequent years and setting the timing of prepayments to January 2013. Medicare Supplemental Health Insurance. (No bill): proposals to increase costs for Medicare beneficiaries who purchase Medigap insurance. Medicare Physician Fees. (No bill): proposals to maintain current levels of physician fees under Part B. Comprehensive Health Care Reform. P.L. 111-148, P.L. 111-152: provisions related to reducing Medicare Advantage plan payments; reducing the Part D coverage gap; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); improving the process for reassigning LIS beneficiaries to new plans; expanding coverage of prevention services; establishing a Medicare Commission; providing expanded Medicaid coverage for home and community-based services; authorizing the collection of data regarding disparities in the provision of care; providing safeguards and subsidies to assure affordability of health coverage for seniors. Center for Medicare and Medicaid Innovation. (No bill): proposals related to the planning for the Center for Medicare and Medicaid Innovations, and the approach this office will take to test innovative payment and service delivery models to reduce program expenditures, while preserving or enhancing the quality of care for Medicare, Medicaid and CHIP beneficiaries. Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office). (No bill): proposals related to activities of the Federal Coordinated Health Care Office intended to improve the quality of care for recipients who receive benefits from both Medicare and Medicaid, e.g, dual-eligibles. Long-term Services and Supports/Repeal of CLASS Act. S. 720, H.R. 1173: provisions repealing expanded support for long-term supports and services through the Community Living Assistance Services and Supports (CLASS) Act.

Client expense: $310,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Employment & Training Administration, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Vice President of the U.S.

S.1699 - Prescription Drug Cost Reduction Act - provisions related to Medicare Part B and drug rebates H.R.999 - Medicare Prescription Drug Savings and Choice Act of 2011 - provisions related to Medicare Part D H.R.2190 - Medicare Drug Savings Act of 2011 - provisions related to Medicare Part D H.R.452 - Medicare Decisions Accountability Act - provisions related to the Independent Payment Advisory Board (IPAB) S.668 - Health Care Bureaucrats Elimination Act - provisions related to the Independent Payment Advisory Board (IPAB) S.1206 - Medicare Prescription Drug Savings Act of 2011 - provisions related to Medicare Part D S.1251 - Medicare and Medicaid FAST Act - provisions related to Part D issues H.R.1063 - Strengthening Medicare & Repaying Taxpayers Act of 2011 - provisions relating to reform of Secondary Payer rules No bill # assigned - Dual eligibles coordination policy issues No bill # assigned - Deficit reduction policy issues No bill # assigned - Medicaid Program, Covered Outpatient Drugs rulemaking No bill # assigned - Medicare, Medicaid, Children's Health Insurance Programs,; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking

Client expense: $890,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Natl Security Council (NSC), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR), 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. 452, Medicare Decisions Accountability Act of 2011: Provisions related to Independent Payment Advisory Board (IPAB) H.R. 999, Medicare Prescription Drug Savings and Choice Act of 2011: Provisions related to Part D issues H.R. 2190 Medicare Drug Savings Act of 2011: Provisions related to Part D issues S. 365, Budget Control Act of 2011: Deficit reduction issues related to Medicare/Medicaid S. 668, Health Care Bureaucrats Elimination Act: Provisions related to Independent Payment Advisory Board (IPAB) S. 1206, Medicare Prescription Drug Savings Act of 2011: Provisions related to Part D issues S. 1251, Medicare and Medicaid FAST Act: Provisions related to Part D issues. S. 1699, Prescription Drug Cost Reduction Act: Provisions related to Medicare Part B, 340B, least costly alternative, and other provisions Deficit reduction policy issues Medicaid Program, Covered Outpatient Drugs rulemaking Dual eligibles coordination policy issues Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking

Client expense: $4,840,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Security Council (NSC), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

HR 891 and S 274 - legislation that would expand the existing medication therapy management program in Medicare Part D; S 31 and S 44 and HR 2248 and HR 3638 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors; HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government; HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D; HR 3613 - legislation that would require Medicare Part D plans to establish an exceptions process for patient cost-sharing amounts; HR 4215 - legislation that would establish audit requirements and other transparency requirements for Medicare part D plan sponsors; Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.Con.Res. 112, House budget resolution (Ryan) - Medicare, Medicaid, ACA issues H.R. 675, Strengthening Medicare Anti-Fraud Measures Act of 2011 (Herger) H.R. 999, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes 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

S 1699 - Prescription Drug Cost Reduction Act - provisions related to Medicare Part B and drug rebates HR 999 - Medicare Prescription Drug Savings and Choice Act of 2011- provisions related to Medicare Part D HR 2190 - Medicare Drug Savings Act of 2011- provisions related to Medicare Part D HR 2248 - Medicare Prescription Drug Price Negotiation Act of 2011- provision related to Medicare Part D HR 3765 - Temporary Payroll Tax Cut Continuation Act of 2011- provisions related to Medicare S 31 - Prescription Drug and Health Improvement Act of 2011-provisions related to Medicare Part D S 44 - Medicare Prescription Drug Price Negotiation Act of 2011- provisions related to Medicare Part D HR 452 - Medicare Decisions Accountability Act - provisions related to the Independent Payment Advisory Board (IPAB) H.R. 5 - To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system - provisions related to the Independent Payment Advisory Board (IPAB) S 560 - Medicare Prescription Drug Savings and Choice Act of 2011- provisions related to Medicare Part D S 668 - Health Care Bureaucrats Elimination Act - provisions related to the Independent Payment Advisory Board (IPAB) S 1206 - Medicare Prescription Drug Savings Act of 2011- provisions related to Medicare Part D S 1251 - Medicare and Medicaid FAST Act - provisions related to Part D issues H.R. 1063 - Strengthening Medicare & Repaying Taxpayers Act of 2011 - provisions relating to reform of Secondary Payer rules S 365 - Budget Control Act of 2011 - provisions related to deficit reduction through Medicare and Medicaid

Client expense: $1,440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1699 - Prescription Drug Cost Reduction Act - provisions related to Medicare Part B and drug rebates H.R. 999 - Medicare Prescription Drug Savings and Choice Act of 2011- provisions related to Medicare Part D H.R. 2190 - Medicare Drug Savings Act of 2011- provisions related to Medicare Part D H.R. 452 - Medicare Decisions Accountability Act - provisions related to the Independent Payment Advisory Board (IPAB) S. 668 - Health Care Bureaucrats Elimination Act - provisions related to the Independent Payment Advisory Board (IPAB) S. 1206 - Medicare Prescription Drug Savings Act of 2011- provisions related to Medicare Part D S. 1251 -Medicare and Medicaid FAST Act - provisions related to Part D issues H.R. 1063 - Strengthening Medicare & Repaying Taxpayers Act of 2011- provisions relating to reform of Secondary Payer rules No bill # assigned - Dual eligibles coordination policy issues No bill # assigned - Deficit reduction policy issues No bill # assigned - Medicaid Program, Covered Outpatient Drugs rulemaking No bill # assigned - Medicare, Medicaid, Children's Health Insurance Programs,; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking

Client expense: $1,220,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Natl Security Council (NSC), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

Medicare Dental Benefits. S. 3272, H.R. 5909: provisions creating a Medicare Part B dental benefit. Medigap Benefits. S. 3271: provisions expanding access to Medicare supplemental insurance. Benefit Redesign. (No Bill): proposal to provide a catastrophic cap on Medicare out-of-pocket spending funded by a surcharge on private Medigap policies and employer-provided retiree health benefits. Independent Payment Advisory Board. H.R. 452, S. 668, H.R. 1 (Sec. 4050): proposals to repeal or modify the provisions of P.L. 111-148 and P.L. 111-152 reducing Medicare spending growth through an independent commission. Medicare Drug Savings. S. 1206, H.R. 2190: provisions extending Medicaid drug rebates to prescription drugs paid for by Medicare on behalf of Medicare-Medicaid dual-eligibles, and by Medicare Part D Low-Income Subsidy beneficiaries. Home Health Benefits. (No bill): proposal to require copayments from people receiving the Medicare home health benefit. Medicare Income-relating. (No bill): proposals to increase the percent of Medicare beneficiaries paying higher income-related premiums. Medicare Part A Hospital Inpatient Status. S. 818, H.R. 1543: provisions ensuring beneficiaries receiving hospital services are designated as inpatients, thereby assuring coverage of prescription drugs and post-acute care under Part A following a three-day hospitalization. Medicare Parts C and D. P.L. 110-275, P.L. 108-173: implementation of regulations and the issuance of guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and the appeals processes under Medicare Parts C and D. Medicare Part D Negotiation of Drug Prices. S. 31, S. 44, S. 560, H.R. 999, H.R. 3638: provisions creating a Medicare-operated prescription drug plan, allowing or requiring the Secretary of the Department of Health and Human Services to negotiate price concessions from pharmaceutical manufacturers for drugs purchased under the Part D program. Medicare Managed Care. H.R. 4254: provisions pertaining to revising the coding intensity adjustment factor in the demographic adjustment formula (used in calculating payments to Medicare Advantage organizations) for 2015 and subsequent years and setting the timing of prepayments beginning with January 2013. Medicare Supplemental Health Insurance. (No bill): proposals to increase costs for Medicare supplemental insurance. Medicare Physician Fees. P.L. 112-96, (H.R. 3630): provisions maintaining current levels of physician fees under Part B; extending the therapy caps exceptions process; and extending the Qualified Individual program. Medicare Privatization/Premium Support. (H. Con. Res. 112 and S. Con. Res. 37): provisions to convert Medicare from a defined benefit plan to a premium support/voucher system. Raising Medicare Eligibility Age. (H. Con. Res. 112 and S. Con. Res. 37): provisions to raise the Medicare eligibility age from 65 to 67. Prescription Drug Safety. P.L.112-144 (S. 3187, H.R. 3988, H.R. 4087, H.R. 5334, S. 2236, S. 2289 and S. 2516): provisions facilitating the importation of prescription drugs; preventing pharmaceutical fraud by requiring good corporate behavior; facilitating the adoption of modern information technology; and prohibiting brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market. Public Health Service Act Dental Care. S. 1878, H.R. 4091: provisions pertaining to offering grant support to national dental programs that provide pro-bono dental care to Medicare and Medicaid eligible low-income children and adults. Comprehensive Health Care Reform. P.L. 111-148, P.L. 111-152: provisions related to reducing Medicare Advantage plan payments; reducing the Part D coverage gap; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); improving the process for reassigning LIS beneficiaries to new plans; expanding coverage of prevention services; establishing a Medicare Commission; providing expanded Medicaid coverage for home and community-based services; authorizing the collection of data regarding disparities in the provision of care; providing safeguards and subsidies to assure affordability of health coverage for seniors. Center for Medicare and Medicaid Innovations. (No bill): proposals related to planning for the Center for Medicare and Medicaid Innovations, and the approach this entity will take to test innovative payment and service delivery models to reduce program expenditures, while preserving or enhancing the quality of care for Medicare, Medicaid and CHIP beneficiaries. Federal Coordinated Health Care Office/Medicare-Medicaid Coordination Office. (No bill): proposals related to activities of the Federal Coordinated Health Care Office intended to improve the quality of care for Medicare and Medicaid dual-eligibles. Long-term Care Financing. (No bill): proposals to amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums; to permit the use of qualified long-term care insurance under cafeteria plans and flexible spending arrangements; and to provide a tax credit for individuals with long-term care needs. Long-term Services and Supports/Repeal of CLASS. S. 720, H.R. 1173: provisions repealing the Community Living Assistance Services and Supports (CLASS) Act.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Employment & Training Administration, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Vice President of the U.S.

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

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

Government targets: HOUSE OF REPRESENTATIVES

H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; S. 31: All provisions of the Prescription Drug and Health Improvement Act of 2011; S. 44: All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H. R. 1290/S. 1206 - All provisions of The Medicare Prescription Savings Act Health care issues before the Joint Select Committee on Deficit Reduction H.R. 3613 the Part D Beneficiary Appeals Fairness Act S. 1356 / H.R. 3343 the Affordable Medicines Utilization Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act

Client expense: $520,389 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733:All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 605 / S. 312 -All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 -All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H.R. 2672 the Preserving Access to Orphan Drugs Act H.R. 2182 the Generating Antibiotic Incentives Now Act H.R. 3026 the Safeguarding Americas Pharmaceuticals Act H.R. 2746 the Cancer Drug Coverage Parity Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act

Client expense: $520,389 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 5: All provisions of the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 4 /S.18 / S.72 - All provisions of the Small Business Paperwork Mandate Elimination Act H.R. 605 / S. 312 - All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 - All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs), implementation of approval pathway for generic biologic drugs 340b program H.R. 2245/S. 296 - All provisions of the Preserving Access to Life-Saving Medications Act of 2011

Client expense: $520,389 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

FY 2011 AG APRO BILL, 2008 & 2012 FARM BILL, ECONOMIC CRISIS IN PORK INDUSTRY, ANTIBIOTICS, FOOD SAFETY, MEXICAN TRUCKING, FREE TRADE AGREEMENTS, DOJ-USDA WORKSHOPS TO EXPLORE COMPETITION & REGULATORY ISSUES IN THE AG INDUSTRY, S. 3656 MANDATORY PRICE REPORTING ACT OF 2010, GIPSA PROPOSED RULE TO IMPLEMENT LIVESTOCK REGULATIONS HR 814 TRACEABILITY HR 815 AMENDMENT TO FEDERAL MEAT INSPECTION HR 875 FOOD SAFETY ADMINISTRATION HR 1332 SAFETY OF THE FOOD SUPPLY HR 2454 CLIMATE CHANGE HR 5504 IMPROVING NUTRITION FOR AMERICAS CHILDREN ACT S 3263/HR 5015 CHIEF VETERINARY OFFICER BILL S 3112/HR 4645 TRAVEL RESTRICTION REFORM & EXPORT ENHANCEMENT ACT S 510/HR 2749 FOOD SAFETY S 337/HR 1226 PROHIBITION OF IMPORTS (SWINE) FROM ARGENTINA S 3656/HR 5852 MANDATORY PRICE REPORTING ACT OF 2010 S 1089 PROMOTING AMERICAN AGRICULTURE & MEDICAL EXPORTS TO CUBA ACT OF 2009 S 1086 PACKERS/STOCKYARDS S 619/HR 1549 ANTIBIOTICS S 460 SPOT MARKETS S 3307 HEALTHY, HUNGER-FREE KIDS ACT OF 2010 HR 176 Anti-Hunger Empowerment Act of 2009 HR 305 Transportation of Horses HR 503 Prevention of Equine Cruelty Act of 2009 HR 540 Summer Food Service Rural Expansion Act HR 759 Food and Drug Administration Globalization Act of 2009 HR 814 Tracing and Recalling Agricultural Contamination Everywhere Act of 2009 HR 815 Safe and Fair Enforcement and Recall for Meat, Poultry and Food (SAFER) Act of 2009 HR 875 Food Safety Modernization Act of 2009 HR 999 A bill to amend the Federal Food, Drug and Cosmetic Act to improve food safety. HR 1225 Select Agent Program and Biosafety Improvement Act of 2009 (S 485) S 337/HR 1226 A bill to prohibit the importation of ruminants and swine, and fresh and frozen meat and products of ruminants and swine, from Argentina until the secretary of Agriculture certifies to Congress that every region of Argentina is free of foot and mouth disease without vaccination. S 92 Imported Seafood Safety Enhancement Act of 2009 S 337 Foot and Mouth Disease Prevention Act of 2009 (HR 1226) S 425 A bill to amend the Federal Food, Drug and Cosmetic Act to provide for the establishment of a traceability system for food, to amend the Federal Meat Inspection Act, the Poultry Products Inspections Act, the Egg Products Inspection Act and the Federal Food, Drug and Cosmetic Act to provide for improved public health and food safety through enhanced enforcement, and for other purposes. S 429 A bill to ensure the safety of imported food products for the citizens of the United States, and for other purposes. S 485 - Select Agent Program and Biosafety Improvement Act of 2009 (HR 1225) HR 5027 Eating Healthy School Act of 2010

Client expense: $300,410 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; S. 31: All provisions of the Prescription Drug and Health Improvement Act of 2011; S. 44: All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011; H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H. R. 1290/S. 1206 - All provisions of The Medicare Prescription Savings Act Health care issues before the Joint Select Committee on Deficit Reduction H.R. 3613 the Part D Beneficiary Appeals Fairness Act S. 1356 / H.R. 3343 the Affordable Medicines Utilization Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act

Client expense: $519,436 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 5: All provisions of the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011; H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733: All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 4 /S.18 / S.72 - All provisions of the Small Business Paperwork Mandate Elimination Act H.R. 605 / S. 312 - All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 - All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs Regulatory Implementation of the HITECH Act FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs), implementation of approval pathway for generic biologic drugs 340b program H.R. 2245/S. 296 - All provisions of the Preserving Access to Life-Saving Medications Act of 2011 Health care issues before the Joint Select Committee of Deficit Reduction H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act H.R.2182 - All Provisions of the Generating Antibiotic Incentives Now Act of 2011

Client expense: $519,436 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 1409: All provisions of the Quality Health Care Coalition Act of 2011; H.R. 891/S. 274: All provisions of the Medication Therapy Management Benefits Act of 2011; H.R. 905 /S. 733:All provisions of the legislation to exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price for drugs and biologicals under Medicare; H.R. 979 - All provisions of the FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act H.R. 605 / S. 312 -All provisions of the Patients Freedom to Choose Act S. 27 - All provisions of the Preserve Access to Affordable Generics Act S. 31 - All provisions of the Prescription Drug and Health Improvement Act of 2011 S. 44 -All provisions of the Medicare Prescription Drug Price Negotiation Act of 2011 H.R. 999 / S. 560 - All provisions of the Medicare Prescription Drug Savings and Choice Act of 2011 H.R. 1839 - All provisions of the Community Pharmacy Fairness Act of 2011; H.R. 1946 - All provisions of the Preserving or Hometown Independent Pharmacies Act of 2011; H.R. 1971 / S. 1058 - All provisions of the Pharmacy Competition and Consumer Choice Act of 2011 Provisions of PL 111-148 and PL 111-152 impacting Medicare Part D such as formulary requirements, PBM disclosure provisions, closing the Part D coverage gap Regulatory design and coverage of pharmacy benefits in health reform exchanges and the commercial market (essential health benefits, grandfathering, value-based insurance design, e-prescribing, PBM disclosure requirements, and medical loss ratio) Regulatory and proposed legislative changes to Medicare part D including EGWP waivers, MTM expansion, long term care short-term fills, recovery audit contractors Implementation of changes to the definition of Average Manufacturer Price in Medicaid Issues related to the management of Medicaid prescription drug benefits Legislation to promote generic drugs FDA issues related to the Prescription Drug User Fee Act (PDUFA) (generic user fees, pedigree, REMs); implementation of approval pathway for generic biologic drugs 340b program H.R. 2672 the Preserving Access to Orphan Drugs Act H.R. 2182 the Generating Antibiotic Incentives Now Act H.R. 3026 the Safeguarding Americas Pharmaceuticals Act H.R. 2746 the Cancer Drug Coverage Parity Act H.R.4215 - All provisions of the Medicare Pharmacy Transparency and Fair Auditing Act

Client expense: $519,436 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE

H.R. 452, Medicare Decisions Accountability Act of 2011: Provisions related to Independent Payment Advisory Board (IPAB) H.R. 999, Medicare Prescription Drug Savings and Choice Act of 2011: Provisions related to Part D issues H.R. 2190 Medicare Drug Savings Act of 2011: Provisions related to Part D issues S. 365, Budget Control Act of 2011: Deficit reduction issues related to Medicare/Medicaid S. 668, Health Care Bureaucrats Elimination Act: Provisions related to Independent Payment Advisory Board (IPAB) S. 1206, Medicare Prescription Drug Savings Act of 2011: Provisions related to Part D issues S. 1251, Medicare and Medicaid FAST Act: Provisions related to Part D issues. S. 1699, Prescription Drug Cost Reduction Act: All provisions including Medicare Part B and 340B Deficit reduction policy issues Medicaid Program, Covered Outpatient Drugs rulemaking: Provisions related to the AMP calculation, definition of line extension, and extension of the rebate to the territories Medicare, Medicaid, Childrens Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests rulemaking: Provisions related to implementation of the Sunshine reporting provisions of the Affordable Care Act Dual eligibles coordination policy issues

Client expense: $5,310,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Security Council (NSC), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

S 1699 - Prescription Drug Cost Reduction Act - provisions related to Medicare Part B and drug rebates HR 999 - Medicare Prescription Drug Savings and Choice Act of 2011- provisions related to Medicare Part D HR 2190 - Medicare Drug Savings Act of 2011- provisions related to Medicare Part D HR 2248 - Medicare Prescription Drug Price Negotiation Act of 2011- provision related to Medicare Part D HR 3765 - Temporary Payroll Tax Cut Continuation Act of 2011- provisions related to Medicare S 31 - Prescription Drug and Health Improvement Act of 2011-provisions related to Medicare Part D S 44 - Medicare Prescription Drug Price Negotiation Act of 2011- provisions related to Medicare Part D HR 452 - Medicare Decisions Accountability Act - provisions related to the Independent Payment Advisory Board (IPAB) H.R. 5 - To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system - provisions related to the Independent Payment Advisory Board (IPAB) S 560 - Medicare Prescription Drug Savings and Choice Act of 2011- provisions related to Medicare Part D S 668 - Health Care Bureaucrats Elimination Act - provisions related to the Independent Payment Advisory Board (IPAB) S 1206 - Medicare Prescription Drug Savings Act of 2011- provisions related to Medicare Part D S 1251 - Medicare and Medicaid FAST Act - provisions related to Part D issues H.R. 1063 - Strengthening Medicare & Repaying Taxpayers Act of 2011 - provisions relating to reform of Secondary Payer rules S 365 - Budget Control Act of 2011 - provisions related to deficit reduction through Medicare and Medicaid

Client expense: $2,120,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare/Commission. P.L. 111-148, P.L. 111-152 (Sec. 4050): provisions pertaining to the repeal or modification of provisions creating an independent commission authorized to establish Medicare payment and policy designed to reduce Medicare spending growth. Medicare Drug Savings. S. 1206, H.R. 2190: provisions extending Medicaid drug rebates to prescription drugs paid for by Medicare and used by people eligible for both Medicare and Medicaid (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare/Home Health Benefits. (No bill): proposals regarding potential copayments for beneficiaries receiving the Medicare home health benefit. Medicare/Income-relating. (No bill): proposals to increase costs for higher-income Medicare beneficiaries. Medicare/Part A Hospital Inpatient Status. S. 818, H.R. 1543: provisions ensuring beneficiaries receiving hospital services are designated as inpatients, thereby assuring coverage of prescription drugs and post-acute care under Part A following a three-day hospitalization. Medicare Part B Drug Savings. S. 1699: provisions pertaining to provisions that reduce the cost of prescription drugs paid for under Medicare Part B. Medicare/Parts C and D. P.L. 110-275, P.L. 108-173: provisions pertaining to the implementation of regulations and issuance of guidance relating to beneficiary eligibility, enrollment, and effectiveness of exceptions and the appeals processes under Medicare Parts C and D. Medicare/Part D plan, Negotiation of Part D Drug Prices. S. 31, S. 44, S. 560, H.R. 999: provisions creating a Medicare-operated prescription drug plan, allowing or requiring the Secretary of the Department of Health and Human Services to negotiate price concessions from pharmaceutical manufacturers for drugs purchased under the Part D program. Medicare/Managed Care. Medicare Advantage Program Integrity Act of 2012. H.R. 4254: provisions pertaining to revisions of the coding intensity adjustment factor in the formula for the demographic adjustment used in calculating payments to Medicare Advantage organizations for 2015 and subsequent years and sets the timing of prepayments to beginning with January 2013. Medicare/Medicare Supplemental Health Insurance. (No bill): proposals to increase costs for Medicare beneficiaries who purchase Medigap insurance. Medicare/Physician Fees. P.L. 112-96, (H.R. 3630): provisions pertaining to provisions that maintain current levels of physician fees under Medicare Part B; extending the therapy caps exceptions process; extending the Qualified Individual program. Medicare/Premium Support/Privatization. (No bill): proposals to convert Medicare from a defined benefit plan to a premium support/voucher system. Medicare/Raising Eligibility Age. (No bill): proposals to raise the Medicare eligibility age from 65 to 67. Medicare/Medicaid. Comprehensive Health Care Reform. P.L. 111-148, P.L. 111-152: provisions related to reducing Medicare Advantage plan payments; reducing the Part D coverage gap; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); improving the process for reassigning LIS beneficiaries to new plans; expanding coverage of prevention services; establishing a Medicare Commission; providing expanded Medicaid coverage for home and community-based services; authorizing the collection of data regarding disparities in the provision of care; providing safeguards and subsidies to assure affordability of health coverage for seniors. Medicare and Medicaid/Center for Medicare and Medicaid Innovations. (No bill): proposals related to the planning for the Center for Medicare and Medicaid Innovations, and the approach this office will take to test innovative payment and service delivery models to reduce program expenditures, while preserving or enhancing the quality of care for Medicare, Medicaid and CHIP beneficiaries. Medicare and Medicaid/Federal Coordinated Health Care Office (Medicare-Medicaid Coordination Office). (No bill): proposals related to activities of the Federal Coordinated Health Care Office intended to improve the quality of care for recipients who receive benefits from both Medicare and Medicaid, i.e., dual-eligibles. Long-term Care Financing via Tax Deduction. (No bill): provisions amending the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long -term care needs. Long-term Services and Supports/Community Living Assistance Services and Supports (CLASS) Act. S. 720, H.R. 1173: provisions repealing previously enacted expanded support for long-term supports and services.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Employment & Training Administration, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Vice President of the U.S.

HR 891 and S 274 - legislation that would expand the existing medication therapy management program in Medicare Part D S 31 and S 44 and HR 2248 and HR 3638 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage of medications HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D HR 3613 - legislation that would require Medicare Part D plans to establish an exceptions process for patient cost-sharing amounts. HR 4215 - legislation that would establish audit requirements and other transparency requirements for Medicare Part D plan sponsors. Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY 2011 AG APRO BILL, 2008 & 2012 FARM BILL, ECONOMIC CRISIS IN PORK INDUSTRY, ANTIBIOTICS, FOOD SAFETY, MEXICAN TRUCKING, FREE TRADE AGREEMENTS, DOJ-USDA WORKSHOPS TO EXPLORE COMPETITION & REGULATORY ISSUES IN THE AG INDUSTRY, S. 3656 MANDATORY PRICE REPORTING ACT OF 2010, GIPSA PROPOSED RULE TO IMPLEMENT LIVESTOCK REGULATIONS HR 814 TRACEABILITY HR 815 AMENDMENT TO FEDERAL MEAT INSPECTION HR 875 FOOD SAFETY ADMINISTRATION HR 1332 SAFETY OF THE FOOD SUPPLY HR 2454 CLIMATE CHANGE HR 5504 IMPROVING NUTRITION FOR AMERICAS CHILDREN ACT S 3263/HR 5015 CHIEF VETERINARY OFFICER BILL S 3112/HR 4645 TRAVEL RESTRICTION REFORM & EXPORT ENHANCEMENT ACT S 510/HR 2749 FOOD SAFETY S 337/HR 1226 PROHIBITION OF IMPORTS (SWINE) FROM ARGENTINA S 3656/HR 5852 MANDATORY PRICE REPORTING ACT OF 2010 S 1089 PROMOTING AMERICAN AGRICULTURE & MEDICAL EXPORTS TO CUBA ACT OF 2009 S 1086 PACKERS/STOCKYARDS S 619/HR 1549 ANTIBIOTICS S 460 SPOT MARKETS S 3307 HEALTHY, HUNGER-FREE KIDS ACT OF 2010 HR 176 Anti-Hunger Empowerment Act of 2009 HR 305 Transportation of Horses HR 503 Prevention of Equine Cruelty Act of 2009 HR 540 Summer Food Service Rural Expansion Act HR 759 Food and Drug Administration Globalization Act of 2009 HR 814 Tracing and Recalling Agricultural Contamination Everywhere Act of 2009 HR 815 Safe and Fair Enforcement and Recall for Meat, Poultry and Food (SAFER) Act of 2009 HR 875 Food Safety Modernization Act of 2009 HR 999 A bill to amend the Federal Food, Drug and Cosmetic Act to improve food safety. HR 1225 Select Agent Program and Biosafety Improvement Act of 2009 (S 485) S 337/HR 1226 A bill to prohibit the importation of ruminants and swine, and fresh and frozen meat and products of ruminants and swine, from Argentina until the secretary of Agriculture certifies to Congress that every region of Argentina is free of foot and mouth disease without vaccination. S 92 Imported Seafood Safety Enhancement Act of 2009 S 337 Foot and Mouth Disease Prevention Act of 2009 (HR 1226) S 425 A bill to amend the Federal Food, Drug and Cosmetic Act to provide for the establishment of a traceability system for food, to amend the Federal Meat Inspection Act, the Poultry Products Inspections Act, the Egg Products Inspection Act and the Federal Food, Drug and Cosmetic Act to provide for improved public health and food safety through enhanced enforcement, and for other purposes. S 429 A bill to ensure the safety of imported food products for the citizens of the United States, and for other purposes. S 485 - Select Agent Program and Biosafety Improvement Act of 2009 (HR 1225) HR 5027 Eating Healthy School Act of 2010

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

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)

FY 2011 AG APRO BILL, 2008 & 2012 FARM BILL, ECONOMIC CRISIS IN PORK INDUSTRY, ANTIBIOTICS, FOOD SAFETY, MEXICAN TRUCKING, FREE TRADE AGREEMENTS, DOJ-USDA WORKSHOPS TO EXPLORE COMPETITION & REGULATORY ISSUES IN THE AG INDUSTRY, S. 3656 MANDATORY PRICE REPORTING ACT OF 2010, GIPSA PROPOSED RULE TO IMPLEMENT LIVESTOCK REGULATIONS HR 814 TRACEABILITY HR 815 AMENDMENT TO FEDERAL MEAT INSPECTION HR 875 FOOD SAFETY ADMINISTRATION HR 1332 SAFETY OF THE FOOD SUPPLY HR 2454 CLIMATE CHANGE HR 5504 IMPROVING NUTRITION FOR AMERICAS CHILDREN ACT S 3263/HR 5015 CHIEF VETERINARY OFFICER BILL S 3112/HR 4645 TRAVEL RESTRICTION REFORM & EXPORT ENHANCEMENT ACT S 510/HR 2749 FOOD SAFETY S 337/HR 1226 PROHIBITION OF IMPORTS (SWINE) FROM ARGENTINA S 3656/HR 5852 MANDATORY PRICE REPORTING ACT OF 2010 S 1089 PROMOTING AMERICAN AGRICULTURE & MEDICAL EXPORTS TO CUBA ACT OF 2009 S 1086 PACKERS/STOCKYARDS S 619/HR 1549 ANTIBIOTICS S 460 SPOT MARKETS S 3307 HEALTHY, HUNGER-FREE KIDS ACT OF 2010 HR 176 Anti-Hunger Empowerment Act of 2009 HR 305 Transportation of Horses HR 503 Prevention of Equine Cruelty Act of 2009 HR 540 Summer Food Service Rural Expansion Act HR 759 Food and Drug Administration Globalization Act of 2009 HR 814 Tracing and Recalling Agricultural Contamination Everywhere Act of 2009 HR 815 Safe and Fair Enforcement and Recall for Meat, Poultry and Food (SAFER) Act of 2009 HR 875 Food Safety Modernization Act of 2009 HR 999 A bill to amend the Federal Food, Drug and Cosmetic Act to improve food safety. HR 1225 Select Agent Program and Biosafety Improvement Act of 2009 (S 485) S 337/HR 1226 A bill to prohibit the importation of ruminants and swine, and fresh and frozen meat and products of ruminants and swine, from Argentina until the secretary of Agriculture certifies to Congress that every region of Argentina is free of foot and mouth disease without vaccination. S 92 Imported Seafood Safety Enhancement Act of 2009 S 337 Foot and Mouth Disease Prevention Act of 2009 (HR 1226) S 425 A bill to amend the Federal Food, Drug and Cosmetic Act to provide for the establishment of a traceability system for food, to amend the Federal Meat Inspection Act, the Poultry Products Inspections Act, the Egg Products Inspection Act and the Federal Food, Drug and Cosmetic Act to provide for improved public health and food safety through enhanced enforcement, and for other purposes. S 429 A bill to ensure the safety of imported food products for the citizens of the United States, and for other purposes. S 485 - Select Agent Program and Biosafety Improvement Act of 2009 (HR 1225) HR 5027 Eating Healthy School Act of 2010

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

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)

FY 2011 AG APRO BILL, 2008 & 2012 FARM BILL, ECONOMIC CRISIS IN PORK INDUSTRY, ANTIBIOTICS, FOOD SAFETY, MEXICAN TRUCKING, FREE TRADE AGREEMENTS, DOJ-USDA WORKSHOPS TO EXPLORE COMPETITION & REGULATORY ISSUES IN THE AG INDUSTRY, S. 3656 MANDATORY PRICE REPORTING ACT OF 2010, GIPSA PROPOSED RULE TO IMPLEMENT LIVESTOCK REGULATIONS HR 814 TRACEABILITY HR 815 AMENDMENT TO FEDERAL MEAT INSPECTION HR 875 FOOD SAFETY ADMINISTRATION HR 1332 SAFETY OF THE FOOD SUPPLY HR 2454 CLIMATE CHANGE HR 5504 IMPROVING NUTRITION FOR AMERICAS CHILDREN ACT S 3263/HR 5015 CHIEF VETERINARY OFFICER BILL S 3112/HR 4645 TRAVEL RESTRICTION REFORM & EXPORT ENHANCEMENT ACT S 510/HR 2749 FOOD SAFETY S 337/HR 1226 PROHIBITION OF IMPORTS (SWINE) FROM ARGENTINA S 3656/HR 5852 MANDATORY PRICE REPORTING ACT OF 2010 S 1089 PROMOTING AMERICAN AGRICULTURE & MEDICAL EXPORTS TO CUBA ACT OF 2009 S 1086 PACKERS/STOCKYARDS S 619/HR 1549 ANTIBIOTICS S 460 SPOT MARKETS S 3307 HEALTHY, HUNGER-FREE KIDS ACT OF 2010 HR 176 Anti-Hunger Empowerment Act of 2009 HR 305 Transportation of Horses HR 503 Prevention of Equine Cruelty Act of 2009 HR 540 Summer Food Service Rural Expansion Act HR 759 Food and Drug Administration Globalization Act of 2009 HR 814 Tracing and Recalling Agricultural Contamination Everywhere Act of 2009 HR 815 Safe and Fair Enforcement and Recall for Meat, Poultry and Food (SAFER) Act of 2009 HR 875 Food Safety Modernization Act of 2009 HR 999 A bill to amend the Federal Food, Drug and Cosmetic Act to improve food safety. HR 1225 Select Agent Program and Biosafety Improvement Act of 2009 (S 485) S 337/HR 1226 A bill to prohibit the importation of ruminants and swine, and fresh and frozen meat and products of ruminants and swine, from Argentina until the secretary of Agriculture certifies to Congress that every region of Argentina is free of foot and mouth disease without vaccination. S 92 Imported Seafood Safety Enhancement Act of 2009 S 337 Foot and Mouth Disease Prevention Act of 2009 (HR 1226) S 425 A bill to amend the Federal Food, Drug and Cosmetic Act to provide for the establishment of a traceability system for food, to amend the Federal Meat Inspection Act, the Poultry Products Inspections Act, the Egg Products Inspection Act and the Federal Food, Drug and Cosmetic Act to provide for improved public health and food safety through enhanced enforcement, and for other purposes. S 429 A bill to ensure the safety of imported food products for the citizens of the United States, and for other purposes. S 485 - Select Agent Program and Biosafety Improvement Act of 2009 (HR 1225) HR 5027 Eating Healthy School Act of 2010

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

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)

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 (cont.) 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 MMM (Regulatory Issues): Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, data, and audit issues, bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits), application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff, measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training, andMedicare/Medicaid integration and contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, and other operational issues; 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; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues, MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; 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; implementation of MA and Part D changes made in the Accountable Care Act (ACA), including application of the MA STAR system for payment purposes starting 2012 and changes to the Part D coverage gap; 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 intergovernmental transfers (IGTs), State flexibility, and block grants; 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 documentation of citizenship requirements, state benefit flexibility options, and Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including the managed care organization (MCO) prescription drug rebate provisions; and health information technology standards and policies. Komendant (con't): Altmire: 01-2007 to 04-2009; Blue Dog Coalition (Shared Employee) 04-2009 to 02-2011; Full list available at : http://www.legistorm.com/person/Erik_Komendant/33059.html.

Client expense: $2,430,000 · Firm income: Not reported

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

FY 2011 AG APRO BILL, 2008 & 2012 FARM BILL, ECONOMIC CRISIS IN PORK INDUSTRY, ANTIBIOTICS, FOOD SAFETY, MEXICAN TRUCKING, FREE TRADE AGREEMENTS, DOJ-USDA WORKSHOPS TO EXPLORE COMPETITION & REGULATORY ISSUES IN THE AG INDUSTRY, S. 3656 MANDATORY PRICE REPORTING ACT OF 2010, GIPSA PROPOSED RULE TO IMPLEMENT LIVESTOCK REGULATIONS HR 814 TRACEABILITY HR 815 AMENDMENT TO FEDERAL MEAT INSPECTION HR 875 FOOD SAFETY ADMINISTRATION HR 1332 SAFETY OF THE FOOD SUPPLY HR 2454 CLIMATE CHANGE HR 5504 IMPROVING NUTRITION FOR AMERICAS CHILDREN ACT S 3263/HR 5015 CHIEF VETERINARY OFFICER BILL S 3112/HR 4645 TRAVEL RESTRICTION REFORM & EXPORT ENHANCEMENT ACT S 510/HR 2749 FOOD SAFETY S 337/HR 1226 PROHIBITION OF IMPORTS (SWINE) FROM ARGENTINA S 3656/HR 5852 MANDATORY PRICE REPORTING ACT OF 2010 S 1089 PROMOTING AMERICAN AGRICULTURE & MEDICAL EXPORTS TO CUBA ACT OF 2009 S 1086 PACKERS/STOCKYARDS S 619/HR 1549 ANTIBIOTICS S 460 SPOT MARKETS S 3307 HEALTHY, HUNGER-FREE KIDS ACT OF 2010 HR 176 Anti-Hunger Empowerment Act of 2009 HR 305 Transportation of Horses HR 503 Prevention of Equine Cruelty Act of 2009 HR 540 Summer Food Service Rural Expansion Act HR 759 Food and Drug Administration Globalization Act of 2009 HR 814 Tracing and Recalling Agricultural Contamination Everywhere Act of 2009 HR 815 Safe and Fair Enforcement and Recall for Meat, Poultry and Food (SAFER) Act of 2009 HR 875 Food Safety Modernization Act of 2009 HR 999 A bill to amend the Federal Food, Drug and Cosmetic Act to improve food safety. HR 1225 Select Agent Program and Biosafety Improvement Act of 2009 (S 485) S 337/HR 1226 A bill to prohibit the importation of ruminants and swine, and fresh and frozen meat and products of ruminants and swine, from Argentina until the secretary of Agriculture certifies to Congress that every region of Argentina is free of foot and mouth disease without vaccination. S 92 Imported Seafood Safety Enhancement Act of 2009 S 337 Foot and Mouth Disease Prevention Act of 2009 (HR 1226) S 425 A bill to amend the Federal Food, Drug and Cosmetic Act to provide for the establishment of a traceability system for food, to amend the Federal Meat Inspection Act, the Poultry Products Inspections Act, the Egg Products Inspection Act and the Federal Food, Drug and Cosmetic Act to provide for improved public health and food safety through enhanced enforcement, and for other purposes. S 429 A bill to ensure the safety of imported food products for the citizens of the United States, and for other purposes. S 485 - Select Agent Program and Biosafety Improvement Act of 2009 (HR 1225) HR 5027 Eating Healthy School Act of 2010

Client expense: $426,496 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)

FY 2011 AG APRO BILL, 2008 & 2012 FARM BILL, ECONOMIC CRISIS IN PORK INDUSTRY, ANTIBIOTICS, FOOD SAFETY, MEXICAN TRUCKING, FREE TRADE AGREEMENTS, DOJ-USDA WORKSHOPS TO EXPLORE COMPETITION & REGULATORY ISSUES IN THE AG INDUSTRY, S. 3656 MANDATORY PRICE REPORTING ACT OF 2010, GIPSA PROPOSED RULE TO IMPLEMENT LIVESTOCK REGULATIONS HR 814 TRACEABILITY HR 815 AMENDMENT TO FEDERAL MEAT INSPECTION HR 875 FOOD SAFETY ADMINISTRATION HR 1332 SAFETY OF THE FOOD SUPPLY HR 2454 CLIMATE CHANGE HR 5504 IMPROVING NUTRITION FOR AMERICAS CHILDREN ACT S 3263/HR 5015 CHIEF VETERINARY OFFICER BILL S 3112/HR 4645 TRAVEL RESTRICTION REFORM & EXPORT ENHANCEMENT ACT S 510/HR 2749 FOOD SAFETY S 337/HR 1226 PROHIBITION OF IMPORTS (SWINE) FROM ARGENTINA S 3656/HR 5852 MANDATORY PRICE REPORTING ACT OF 2010 S 1089 PROMOTING AMERICAN AGRICULTURE & MEDICAL EXPORTS TO CUBA ACT OF 2009 S 1086 PACKERS/STOCKYARDS S 619/HR 1549 ANTIBIOTICS S 460 SPOT MARKETS S 3307 HEALTHY, HUNGER-FREE KIDS ACT OF 2010 HR 176 Anti-Hunger Empowerment Act of 2009 HR 305 Transportation of Horses HR 503 Prevention of Equine Cruelty Act of 2009 HR 540 Summer Food Service Rural Expansion Act HR 759 Food and Drug Administration Globalization Act of 2009 HR 814 Tracing and Recalling Agricultural Contamination Everywhere Act of 2009 HR 815 Safe and Fair Enforcement and Recall for Meat, Poultry and Food (SAFER) Act of 2009 HR 875 Food Safety Modernization Act of 2009 HR 999 A bill to amend the Federal Food, Drug and Cosmetic Act to improve food safety. HR 1225 Select Agent Program and Biosafety Improvement Act of 2009 (S 485) S 337/HR 1226 A bill to prohibit the importation of ruminants and swine, and fresh and frozen meat and products of ruminants and swine, from Argentina until the secretary of Agriculture certifies to Congress that every region of Argentina is free of foot and mouth disease without vaccination. S 92 Imported Seafood Safety Enhancement Act of 2009 S 337 Foot and Mouth Disease Prevention Act of 2009 (HR 1226) S 425 A bill to amend the Federal Food, Drug and Cosmetic Act to provide for the establishment of a traceability system for food, to amend the Federal Meat Inspection Act, the Poultry Products Inspections Act, the Egg Products Inspection Act and the Federal Food, Drug and Cosmetic Act to provide for improved public health and food safety through enhanced enforcement, and for other purposes. S 429 A bill to ensure the safety of imported food products for the citizens of the United States, and for other purposes. S 485 - Select Agent Program and Biosafety Improvement Act of 2009 (HR 1225) HR 5027 Eating Healthy School Act of 2010

Client expense: $311,638 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Environmental Protection Agency (EPA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, U.S. Trade Representative (USTR)

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 891 and S 274 - legislation that would expand the exisiting medication therapy management program in Medicare Part D S 31 and S 34 - legislation that would require or allow the federal government to negotiate prescription drug prices on behalf of Medicare Part D plan sponsors HR 999 and S 560 - legislation that would establish a nationwide Part D plan administered by the federal government HR 2190 and S 1206 - legislation that would require prescription drug manufacturers to pay Medicaid "best price" rebates for covered prescription drugs purchased by dual eligibles under Medicare Part D. HR 1055 - legislation that would allow Part D plan sponsors to offer "off-label" coverage of medications Worked on proposed legislative language, work which included consultation with Senate committee staff, that would amend the current prompt payment rules in Medicare Part D in the interest of preventing fraud.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

H.R. 452, Medicare Decisions Accountability Act of 2011: Provisions related to Independent Payment Advisory Board (IPAB) H.R. 675 Strengthening Medicare Anti-Fraud Measures Act of 2010: Provisions related to exclusion issues H.R. 999, Medicare Prescription Drug Savings and Choice Act of 2011: Provisions related to Part D issues H.R. 2190 Medicare Drug Savings Act of 2011: Provisions related to Part D issues H.R. 2248 Medicare Prescription Drug Price Negotiation Act of 2011: Provisions related to Part D non-interference issues H.R. 3765, Temporary Payroll Tax Cut Continuation Act of 2011: Provisions related to Medicare S. 31, Prescription Drug and Health Improvement Act of 2011: Provisions related to Part D non-interference provisions S. 44, Medicare Prescription Drug Price Negotiation Act of 2011: Provisions related to Part D issues S. 365, Budget Control Act of 2011: Deficit reduction issues related to Medicare/Medicaid S. 560, Medicare Prescription Drug Savings and Choice Act of 2011: Provisions related to Part D issues S. 668, Health Care Bureaucrats Elimination Act: Provisions related to Independent Payment Advisory Board (IPAB) S. 1206, Medicare Prescription Drug Savings Act of 2011: Provisions related to Part D issues S. 1251, Medicare and Medicaid FAST Act: Provisions related to Part D issues. S. 1699, Prescription Drug Cost Reduction Act: Provisions related to Medicare Part B and drug rebates Advocacy on Medicare/Medicaid issues being considered by the Joint Select Committee on Deficit Reduction

Client expense: $4,820,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Security Council (NSC), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office