Removing Barriers to Colorectal Cancer Screening Act of 2013

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 6 - 21st Century Cures H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 33/S. 420 - Protecting Volunteer Firefighters and Emergency Responders Act/Standard of Care protection act H.R. 1462/S. 799 - Protecting Our Infants Act of 2015 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. H.R. 3309 - Flex-IT 2 Act H.R. 3024 - Disproportionate Share Hospital bill GME Surgical Workforce Shortages/Issues ICD-10 HEALTH Act Response to Senate FDA report HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system Health Insurance Mergers Stark Law APMS Alternative Payment Models Meaningful Use Stage 3 Delay Gun safety Primary Care Incentive Payment Merit-Based Incentive Payment System (MIPS) implementation Medicare Physician Fee Schedule Quality and Payment Issues

Client expense: $22,111 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 6 - 21st Century Cures H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 33/S. 420 - Protecting Volunteer Firefighters and Emergency Responders Act/Standard of Care protection act H.R. 1462/S. 799 - Protecting Our Infants Act of 2015 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. H.R. 3309 - Flex-IT 2 Act H.R. 3024 - Disproportionate Share Hospital bill GME Surgical Workforce Shortages/Issues ICD-10 HEALTH Act Response to Senate FDA report HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system Health Insurance Mergers Stark Law APMS Alternative Payment Models Meaningful Use Stage 3 Delay Gun safety Primary Care Incentive Payment Merit-Based Incentive Payment System (MIPS) implementation Medicare Physician Fee Schedule Quality and Payment Issues

Client expense: $105,253 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 6 - 21st Century Cures H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 33/S. 420 - Protecting Volunteer Firefighters and Emergency Responders Act/Standard of Care protection act H.R. 1462/S. 799 - Protecting Our Infants Act of 2015 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. H.R. 3309 - Flex-IT 2 Act H.R. 3024 - Disproportionate Share Hospital bill GME Surgical Workforce Shortages/Issues ICD-10 HEALTH Act Response to Senate FDA report HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system Health Insurance Mergers Stark Law APMS Alternative Payment Models Meaningful Use Stage 3 Delay Gun safety Primary Care Incentive Payment Merit-Based Incentive Payment System (MIPS) implementation Medicare Physician Fee Schedule Quality and Payment Issues

Client expense: $105,253 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. GME Surgical Workforce Shortages/Issues 21st Century Cures ICD-10 HEALTH Act Standard of Care protection act Response to Senate FDA report Bonus Payments for Rural General Surgery Providers HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system

Client expense: $22,567 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. GME Surgical Workforce Shortages/Issues 21st Century Cures ICD-10 HEALTH Act Standard of Care protection act Response to Senate FDA report Bonus Payments for Rural General Surgery Providers HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system

Client expense: $22,567 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. GME Surgical Workforce Shortages/Issues 21st Century Cures ICD-10 HEALTH Act Standard of Care protection act Response to Senate FDA report Bonus Payments for Rural General Surgery Providers HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system

Client expense: $138,863 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. GME Surgical Workforce Shortages/Issues 21st Century Cures ICD-10 HEALTH Act Standard of Care protection act Response to Senate FDA report Bonus Payments for Rural General Surgery Providers HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system

Client expense: $138,863 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S.258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act GME Surgical Workforce Shortages/Issues 21st Century Cures ICD-10 HEALTH Act Standard of Care protection act Response to Senate FDA report Saving Lives, Saving Costs Act Bonus Payments for Rural General Surgery Providers

Client expense: $43,429 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S.258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act GME Surgical Workforce Shortages/Issues 21st Century Cures ICD-10 HEALTH Act Standard of Care protection act Response to Senate FDA report Saving Lives, Saving Costs Act Bonus Payments for Rural General Surgery Providers

Client expense: $43,429 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S.258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act GME Surgical Workforce Shortages/Issues 21st Century Cures ICD-10 HEALTH Act Standard of Care protection act Response to Senate FDA report Saving Lives, Saving Costs Act Bonus Payments for Rural General Surgery Providers

Client expense: $212,946 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S.258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act GME Surgical Workforce Shortages/Issues 21st Century Cures ICD-10 HEALTH Act Standard of Care protection act Response to Senate FDA report Saving Lives, Saving Costs Act Bonus Payments for Rural General Surgery Providers

Client expense: $212,946 · Firm income: Not reported

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

H.R. 1070 / S. 2348 - Support "Removing Barriers to Colorectal Cancer Screening Act." Bill would waive Medicare beneficiary coinsurance for a screening colonoscopy with polyp removal. Oppose expansion or modification of the Medicare misvalued codes initiative (Achieving a Better Life Experience Act)

Client expense: Not reported · Firm income: $19,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to in office ancillary services exception; colonoscopy/endoscopy reimbursement issues; H.R. 2914, Promoting Integrity in Medicare Act of 2013; S. 2348/H.R. 1070, Removing Barriers to Colorectal Cancer Screening Act of 2014; appropriate use criteria for medical imaging; ICD-10 delay; issues in the CY2015 CMS Physician Fee Schedule Proposed Rule related to transparency in misvalued codes and the inclusion of anesthesia in colonoscopy screenings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to implementation of changes to Medicare and Medicaid, pursuant to P.L. 111-148, the Patient Protection and Affordable Care Act of 2010, and tobacco cessation programs within Medicaid. Issues relating to inclusion of palliative care as a bundled service within CMS "value-based purchasing", and H.R.1070 & S.2348, Removing Barriers to Colorectal Cancer Screening Act of 2013; H.R.2810, Medicare Patient Access & Quality Improvement Act, S.1871, the SGR Repeal & Medicare Beneficiary Access Act, and S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014.

Client expense: $1,340,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

H.R. 2500/S. 1137 - Ambulatory Surgical Center Quality and Access Act of 2013 H.R. 1070 - Removing Barriers to Colorectal Cancer Screening Act of 2013 Reform of Medicare payments to ASCs Reform of Medicare regulations dealing with ASCs H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 1331 - Electronic Health Records improvement Act H.R. 5556 - Electronic Health Fairness Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment Act of 2013

Client expense: $163,606 · Firm income: Not reported

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

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) H.R. 1717 - Discussed Medicare DMEPOS Market Pricing Program Act. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R.3830/S.1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) extension and CHIP Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice - Final 2014 CMS Guidance. H.R.5294, Health Equity & Accountability Act of 2014 - Addresses health care disparities; no endorsement due to budget impact. Medicare Advantage- Answered questions from some Hill offices. (no bill) Medicare Supplemental Insurance - Stated opposition to the elimination of first dollar coverage. (no bill) Discussed LTSS issues, including financing. (no bill)Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013. Discussed Medicaid expansion and estate recovery. (no bill) S. 2491, Discussed Medicare Protection Act. Discussed concern about CMS guidance on prescription drugs for medicare beneficiaries receiving hospice and coordination between hospice providers and medicare Part D sponsors. (no bill) Discussed long-term services and supports in Hill briefings. (no bill) H.R. 1173 - Discussed advance care planning, CMS payment for advance care planning, advanced illness, and Personalize Your Care Act.H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship and advancement of the bill. Discussed CMS information regarding healthcare marketplaces. H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) H.R. 83, Consolidated and Further Continuing Appropriations, 2015 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.(no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiares. (no bill) Discussed pending U.S. trade agreement negotiations, including trade promotional or 'fast track' authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) Discussed fraud, Medicare home healthcare, ways to find savings in Medicare without harming Medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). Discussed You've Earned A Say, ways to find savings in medicare without harming medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). PL.111-148 - Discussed implementation of provision to require reporting of nursing home staffing data based on payroll data and executive actions related to nursing homes, IMPACT Act, PL 113-185).. Discussed the draft legislation on Medicare fraud and abuse. Protecting the Integrity of Medicare Act. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740 - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 3830/S. 1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice-Final 2014 CMS Guidance. Discussed the Protecting Integrity of Medicare Act. (no bill) H.R.5435, Home Infusion Site of Care Act - Sent letter of endorsement H.R. 5958 - Discussed the ACO Improvement Act. H.J. Res. 124, Continuing Appropriations Resolution - Lobbied to protect funding levels for CMS program management under Continuing Resolution. H.R. 1179/S. 569 - Discussed observation impace on Medicare beneficiaries, counting time in observation toward Medicare's three-day inpatient hospital stay requirement for Medicare skilled nursing facility coverage, and the Improving Access to Medicare Coverage Act (CMS & MedPAC). PL. 113-295 - Responded to inquiry about Medicare offsets on Achieving a Better Life Expense Act.Discussed Medicare Advantage. (no bill) Discussed H.R. 3616, Protecting Seniors from Healthcare Fraud Act. Discussed observation care and "two-midnight rule". (no bill) H.R. 1070, the Removing Barriers to Colorectal Cancer Screening Act - Discussed and sent letter of endorsement to bill. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740, Medicaid Drug Savings Act - Discussed the requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed pending U.S. Trade agreement negotiations, including trade promotional or "fast track" authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S.1871/H.R. 4015/S.2110 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program. H.R. 4418, The Expanding Availability of Medicare Data Act - Sent letter of endorsement. Discussed Medicare data and billing transparency. (no bill) Discussed socio-economic risk adjustment. (no bill) S. 2240 - Discussed Medicare Choices Empowerment and Protection Act. H.R. 3024 - Discussed the Medicare Common Access Card Act. Discussed Medicare expansion. (no bill) Discussed Medicaid Labs Spousal Impoverishment provisions (PL. 111-198). Discussed transparency in healthcare. (no bill) Discussed Medicaid managed care regulations. (CMS, no bill) PL.111-148 - Discussed long-term services and supports broadly and Older Americans Act. Submitted comments on Medicare Physician fee schedule final rule and advance care planning (CMS - 1612-FC). Discussed Medicare enrollment and notification of eligibility. (no bill) Discussed Medicare in-office ancillary services exception. (no bill)

Client expense: $2,180,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Congressional Budget Office (CBO), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Prevent changes to in office ancillary services exception. HR 1070, "Removing Barriers to Colorectal Cancer Screening Act of 2013," and S 2348, "Removing Barriers to Colorectal Cancer Screening Act of 2014." Greater transparency in CMS rulemaking.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Cash Method of Accrual, Tax related patents, Net Operating Loss, Small Business Capital Formation, Tax Reform, Tax reform oversight, R&D tax credit as part of tax reform, HR 1070 Small Business Access to Capital Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Appropriations for the National Institutes of Health, National Cancer Institute, Center for Disease Control. HR 1070 S.2348 legislation to waive co-insurance for polyp removal in colonoscopy

Client expense: Not reported · Firm income: $11,200

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1070 / S. 2348 - Support "Removing Barriers to Colorectal Cancer Screening Act." Bill would waive Medicare beneficiary coinsurance for a screening colonoscopy with polyp removal. Preserve the Medicare In-Office Ancillary Services Exception under the Stark Self-Referral Law / Oppose H.R. 2914 Support increased transparency and improved process for Medicare rate setting under the Medicare Physician Fee Schedule

Client expense: Not reported · Firm income: $21,000

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

H.R. 2500/S. 1137 - Ambulatory Surgical Center Quality and Access Act of 2013 H.R. 1070 - Removing Barriers to Colorectal Cancer Screening Act of 2013 Reform of Medicare payments to ASCs Reform of Medicare regulations dealing with ASCsH.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S.2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 1331 - Electronic Health Records improvement Act H.R. 5556 - Electronic Health Fairness Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment Act of 2013

Client expense: $169,779 · Firm income: Not reported

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

Issues relating to implementation of changes to Medicare and Medicaid, pursuant to P.L. 111-148, the Patient Protection and Affordable Care Act of 2010, and tobacco cessation programs within Medicaid. Issues relating to inclusion of palliative care as a bundled service within CMS "value-based purchasing", and H.R.1070 & S.2348, Removing Barriers to Colorectal Cancer Screening Act of 2013; H.R.2810, Medicare Patient Access & Quality Improvement Act, S.1871, the SGR Repeal & Medicare BeneficiaryAccess Act, and S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014.

Client expense: $1,210,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

Prevent changes to in office ancillary services exception. HR 1070, "Removing Barriers to Colorectal Cancer Screening Act of 2013," and S 2348, "Removing Barriers to Colorectal Cancer Screening Act of 2014." Greater transparency in CMS rulemaking.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) H.R. 1717 - Discussed Medicare DMEPOS Market Pricing Program Act. Discussed implementation of regulations regarding minimum wage and overtime for home care workers and consumer-directed care. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H. R. 1588/S.740 - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R.3830/S.1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) extension and CHIP Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice - Final 2014 CMS Guidance. H.R.5294, Health Equity & Accountability Act of 2014 - Addresses health care disparities; no endorsement due to budget impact. Medicare Advantage- Answered questions from some Hill offices. (no bill) Medicare Supplemental Insurance - Stated opposition to the elimination of first dollar coverage. (no bill)Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013. Discussed Medicaid expansion and estate recovery. (no bill) Discussed Medicaid and asset transfers. (no bill) H.R.4994/S. 2553, Improving Medicare Post-Acute Care Transformation Act of 2014 - Discussed the bill and AARP support for the bill. Shared our letter of support. S. 2491, Discussed Medicare Protection Act. Discussed concern about CMS guidance on prescription drugs for medicare beneficiaries receiving hospice and coordination between hospice providers and medicare Part D sponsors. (no bill) H.R. 1179/S.569 - Submitted statement for the record for Senate Aging Committee hearing on Observation Improving Access to Medicare Coverage Act and Notice of Observation Treatment and Implication for Care Eligibility Act (H.R. 5232). Discussed aging in place, HCBS, family caregiving. (no bill)H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship and advancement of the bill. Discussed CMS information regarding healthcare marketplaces. H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill) Labor, Health and Human Services Appropriations Act, 2015 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.(no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiares. (no bill) Discussed pending U.S. trade agreement negotiations, including trade promotional or 'fast track' authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) Discussed fraud, Medicare home healthcare, ways to find savings in Medicare without harming Medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). Discussed You've Earned A Say, ways to find savings in medicare without harming medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). PL.111-148 - Discussed implementation of provision to require reporting of nursing home staffing data based on payroll data. Discussed the draft legislation on Medicare fraud and abuse. Protecting the Integrity of Medicare Act. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740 - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 3830/S. 1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice-Final 2014 CMS Guidance. Discussed the Protecting Integrity of Medicare Act. (no bill) H.R.5435, Home Infusion Site of Care Act - Sent letter of endorsement H.R. 5958 - Discussed the ACO Improvement Act. H.R. 5232 - Discussed and sent letter on the Notice of Observation Treatment and Implication for Care Eligibility Act. Met with Centers for Medicare and medicaid services to discuss three-day stay requirement for medicare skilled nursing coverage. H.J. Res. 124, Continuing Appropriations Resolution - Lobbied to protect funding levels for CMS program management under Continuing Resolution. Discussed coordination with hospice providers and Medicare Part D plans guidance for Medicare beneficiaries receiving hospice. (no bill) H.R. 1179/S. 569 - Discussed observation impace on Medicare beneficiaries, counting time in observation toward Medicare's three-day inpatient hospital stay requirement for Medicare skilled nursing facility coverage, and the Improving Access to Medicare Coverage Act (CMS & MedPAC). Discussed caucus for military/veteran family caregivers and support for family caregivers. (no bill) Discussed draft working paper on impact of observation on Medicare beneficiary out of pocket. (no bill)Discussed District of Columbia EPD Medicaid HCBS waiver. (no bill) H.R. 5232 - Discussed legislation and shared letter of support for the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act of 2014. Discussed Medicare Advantage. (no bill) Discussed H.R. 3616, Protecting Seniors from Healthcare Fraud Act. Discussed observation care and "two-midnight rule". (no bill) H.R. 1070, the Removing Barriers to Colorectal Cancer Screening Act - Discussed and sent letter of endorsement to bill. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740, Medicaid Drug Savings Act - Discussed the requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed pending U.S. Trade agreement negotiations, including trade promotional or "fast track" authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S.1871/H.R. 4015/S.2110 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program. H.R. 4418, The Expanding Availability of Medicare Data Act - Sent letter of endorsement. Discussed Medicare data and billing transparency. (no bill) Discussed socio-economic risk adjustment. (no bill) S. 2240 - Discussed Medicare Choices Empowerment and Protection Act. H.R. 3024 - Discussed the Medicare Common Access Card Act. H.R. 4673-Discussed the Bundling and Coordinating Post Acute Care (BACPAC) Act and shared views on post-acute care return. Discussed Medicare expansion. (no bill) Discussed Medicaid Labs Spousal Impoverishment provisions (PL. 111-198). S. 2361, Discussed Stop Schemes and cons against Medicare and seniors. Discussed transparency in healthcare. (no bill) Discussed LTSS Hill briefing series. (no bill) Met with CMS on observation status. (no bill) Submitted comment letter to CMS on the FY2015 Medicare Hospice proposed regulation. Shared comment letter with some Hill staff. H.R. 4994/S.2553 - Shared letter of support for Improving Medicare Post-Acute Care Transformation Act and discussed the status of the bill. Discussed long-term survey and supports Hill briefings. (no bill) Submitted comment letter to CMS on the FY 2015 Medicare Home Health proposed regulation. Shared draft working paper on impact of observation on Medicare beneficiary out of pocket cost. (no bill) Responded to inquiry on observation. (no bill)

Client expense: $2,380,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Congressional Budget Office (CBO), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Issues related to in office ancillary services exception; colonoscopy/endoscopy reimbursement issues; H.R. 2914, Promoting Integrity in Medicare Act of 2013; S. 2348/H.R. 1070, Removing Barriers to Colorectal Cancer Screening Act of 2014; appropriate use criteria for medical imaging

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5380 The Medicare Telehealth Parity Act of 2014 S. 2552 The Medicare Advantage Participants Bill of Rights Act H.R. 4998, The Medicare Advantage Participants Bill of Rights Act S. 2553 The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) H.R. 4994, The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) S. 1932 The Better Care, Lower Cost Act H.R. 3890, The Better Care, Lower Cost Act S. 1422 The Preventive Health Savings Act H.R. 2663, The Preventive Health Savings Act H.R. 5279, The Sugar-Sweetened Beverages Tax (SWEET) Act S.2574, The Healthy Families Act of 2014 H.R. 1024, The Medication Therapy Management Empowerment Act S. 2240, The Medicare Choices Empowerment and Protection Act S. 2000 SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act of 2014 HR. 4418, the Expanding the Availability of Medicare Data Act H.R. 2843 Medicare Data Access for Transparency and Accountability Act S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 3077, TELEmedicine for MEDicare (TELE-MED) Act H.R. 4190, a bill that would will allow Medicare reimbursement for Part B services performed by a pharmacist in underserved communities, among other activities. H.R.1070, Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 1074 National Diabetes Clinical Care Commission Bill S. 539, National Diabetes Clinical Care Commission Bill

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 842: Functional Gastrointestinal & Motility Disorder (FGIMD) Research Enhancement Act H.R. 2108 & S. 1173: Ambulatory Surgical Center Quality & Access Act H.R. 2195 & S. 1203: Medicare Home Infusion Therapy Coverage H.R. 842: The Functional Gastrointestinal & Motility Disorders (FGIMD) Research Enhancement Act H.R. 225: Senate passage of the National Pediatric Research Network Act H.R. 991: The CT Colonography Screening for Colorectal Cancer Act H.R. 1070: The Removing Barriers to Colorectal Cancer Screening Act H.R. 460: The Patient's Access to Treatments Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Cash Method of Accrual, Tax related patents, Net Operating Loss, Small Business Capital Formation, Tax Reform, Tax reform oversight, R&D tax credit as part of tax reform, HR 1070 Small Business Access to Capital Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

NIH, CDC Appropriations H.R. 1070,S. 2348 Legislation to Remove Barriers to Colrectal Cancer Screening Fight Colorectal Cancer Congressional Advisory Committee

Client expense: Not reported · Firm income: $11,200

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1070 / S. 2348 - Support "Removing Barriers to Colorectal Cancer Screening Act." Bill would waive Medicare beneficiary coinsurance for a screening colonoscopy with polyp removal. Preserve the Medicare In-Office Ancillary Services Exception under the Stark Self-Referral Law / Oppose H.R. 2914 Support increased transparency and improved process for Medicare rate setting under the Medicare Physician Fee Schedule

Client expense: Not reported · Firm income: $21,000

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

Issues relating to implementation of changes to Medicare and Medicaid, pursuant to P.L. 111-148, the Patient Protection and Affordable Care Act of 2010, and tobacco cessation programs within Medicaid. Issues relating to inclusion of palliative care as a bundled service within CMS "value-based purchasing", general deficit reduction issues impacting Medicare & Medicaid, and H.R.1070, Removing Barriers to Colorectal Cancer Screening Act of 2013; H.R.2810, Medicare Patient Access & QualityImprovement Act, S.1871, the SGR Repeal & Medicare Beneficiary Access Act, and S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014.

Client expense: $610,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

Issues relating to implementation of changes to Medicare and Medicaid, pursuant to P.L. 111-148, the Patient Protection and Affordable Care Act of 2010, and tobacco cessation programs within Medicaid. Issues relating to inclusion of palliative care as a bundled service within CMS "value-based purchasing", general deficit reduction issues impacting Medicare & Medicaid, and H.R.1070 & S.2348, Removing Barriers to Colorectal Cancer Screening Act of 2013; H.R.2810, Medicare Patient Access & QualityImprovement Act, S.1871, the SGR Repeal & Medicare Beneficiary Access Act, and S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) H.R. 1717 - Discussed Medicare DMEPOS Market Pricing Program Act. Discussed implementation of regulations regarding minimum wage and overtime for home care workers and consumer-directed care. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H. R. 1588/S.740 - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R.3830/S.1900 - Discussed pending U.S. trade agreement negotiations and trade promotional or "fast track" authority legislation and their potential impact on Medicare and Medicaid prescription drug programs. S. 2461 - Discussed Children's Health Insurance Program (CHIP) extension and CHIP Extension Act of 2014. Discussed Part D Payment for Drugs for Beneficiaries Enrolled in Hospice - Final 2014 CMS Guidance.Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013. H.R. 1173 - Discussed Personalize Your Care Act. Discussed Medicaid expansion and estate recovery. (no bill) Discussed Medicaid and asset transfers. (no bill) Discussed the Improving Medicare Post-Acute Care Transformation Act of 2014 and provided feedback on the draft bill. (no bill number at the time, but later bill number was H.R. 4944/S. 2553) S. 2491, Discussed Medicare Protection Act. Submitted comment letter on FYIS Medicare Skilled Nursing Facility payment rule. (no bill) Discussed concern about CMS guidance on prescription drugs for medicare beneficiaries receiving hospice and coordination between hospice providers and medicare Part D sponsors. (no bill)H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship and advancement of the bill. Discussed comments regarding Medicare and You handbook. (no bill) Discussed CMS information regarding healthcare marketplaces. H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill) Labor, Health and Human Services Appropriations Act, 2014 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.(no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiares. (no bill) Discussed pending U.S. trade agreement negotiations, including trade promotional or 'fast track' authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) Discussed fraud, Medicare home healthcare, ways to find savings in Medicare without harming Medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). Discussed You've Earned A Say, ways to find savings in medicare without harming medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). PL.111-148 - Discussed implementation of provision to require reporting of nursing home staffing data based on payroll data.Discussed Medicare Advantage. (no bill) Discussed H.R. 3616, Protecting Seniors from Healthcare Fraud Act. Discussed observation care and "two-midnight rule". (no bill) H.R. 1070, the Removing Barriers to Colorectal Cancer Screening Act - Discussed and sent letter of endorsement to bill. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740, Medicaid Drug Savings Act - Discussed the requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed pending U.S. Trade agreement negotiations, including trade promotional or "fast track" authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S.1871/H.R. 4015/S.2110 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program. H.R. 4418, The Expanding Availability of Medicare Data Act - Sent letter of endorsement. Discussed Medicare data and billing transparency. (no bill) Discussed socio-economic risk adjustment. (no bill) Discussed nursing home staffing data in meeting with CMS. (no bill) Discussed advanced care planning, Welcome to Medicare visit, and Medicare wellness visits. Discussed language access in managed long-term services and supports in meeting with the HHS Office for Civil Rights. S. 2240, Discussed Medicare Choices Empowerment and Protection Act. S. 1439, Discussed support for Care Planning Act. Discussed LTSS Scorecard and reserving a room/logistics for Hill briefing on the LTSS Scorecard. (no bill). Discussed managed LTSS and language access. (no bill) H.R. 3024, Discussed the Medicare Common Access Card Act. H.R. 9673, Discussed the Bundling and Coordinating Post Acute Care (BACPAC) Act and shared views on post-acute care return. Discussed Medicare expansion. (no bill) H.R. 1179/S. 569, Improving Access to Medicare Coverage Act - Submitted written statement for the record for the current hospital ---in the Medicare program hearings. Shared draft witness questions with some subcommittee members and committee staff. Discussed Medicaid Labs Spousal Impoverishment provisions (PL. 111-198). S. 2361, Discussed Stop Schemes and cons against Medicare and seniors. Invited Hill staff to attend the LTSS Scorecard briefing. (no bill) Participated in a roundtable discussion on long-term services and supports. (no bill) Discussed Welcome to Medicare Visit and advance care planning. (no bill) Discussed transparency in healthcare. (no bill) Discussed New York State Community first choice option and workforce issues. (no bill)

Client expense: $2,360,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Tax related patents, Net Operating Loss, Small Business Capital Formation, Tax Reform, Cash Method of Accrual Tax reform oversight, R&D tax credit as part of tax reform, HR 1070 Small Business Access to Capital Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2552, A bill to enhance beneficiary and provider protections and improve transparency in the Medicare Advantage market, and for other purposes, all provisions H.R. 1180, Resident Physician Shortage Reduction Act of 2013, all provisions S. 577, Resident Physician Shortage Reduction Act of 2013, all provisionsH.R. 1701, Cutting Costly Codes Act of 201, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions H.R. 1179, Improving Access to Medicare Coverage Act of 2013, all provisions S. 569, Improving Access to Medicare Coverage Act of 2013, all provisions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions H.R. 962, Medicare Diabetes Prevention Act of 2013, all provisions S. 452, Medicare Diabetes Prevention Act of 2013, all provisions H.R. 1070, Removing Barriers to Colorectal Cancer Screening Act of 2013, all provisions S. 2348, Removing Barriers to Colorectal Cancer Screening Act of 2014, all provisions H.R. 3750, Telehealth Modernization Act of 2013, all provisions H.R. 3698, Two-Midnight Rule Delay Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, all provisions S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, all provisions H.R. 4302, Protecting Access to Medicare Act of 2014, provisions relating to the SGR patch Medicare program - Medicare Advantage Medicare program - SGR Repeal Medicare program - ICD-10 Repeal Medicare program - HIPAA (ICD-10, EFT) Medicare program - Physician payment and delivery reform issues Medicare program - Payment for short hospital stays Medicare program - Quality reporting penalty Medicare program - Independent Payment Advisory Board (IPAB) Medicare program - Medicare Patient Empowerment Act Medicare program - Funding for quality measure development Medicare program - Claims Data release Medicare program - Telemedicine Medicare program - Molecular diagnostics Medicare program - In-office Ancillary Services Exception Medicare program - Laboratory payments Medicare program - Graduate Medical Education Medicare program - Continuity of Care Medicare program - Coding Issues (Misvalued Codes and RUC Timeline) Medicare program - Current Procedural Terminology (CPT) Medicare program - Two-Midnight Rule Medicare program - Recovery Audit Contractors (RACs) Medicare program - Appeals backlog Medicare program - Program Integrity Medicare program - EHR Fraud Medicare program - Nursing home patients' access to Schedule II pain medication Medicare program - Physician identity theft Medicare program - Enrollment Medicare program - Grace period Medicare program - Exchanges Medicare program - Smart Cards Medicare program - Electronic Submission of Medical Documentation (esMD) Medicare program - Licensure Medicare program - Part D and Hospice Patients Medicare program - Physician Compare Medicare program - Conditions of Participation Medicare program - Quality resource use reports Medicare program - Physician Quality Reporting System (PQRS)Medicare program - Value-based modifier Medicare program - Narrow networks Medicare program - Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey Medicare and Medicaid programs - Meaningful Use of EHRs/Health Information Technology Medicare and Medicaid programs - Mental health care Medicaid program - Parity for primary care physician services

Client expense: $3,860,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Natl Drug Control Policy (NDCP), President of the U.S., SENATE, Treasury, Dept of, U.S. Secret Service, White House Office

Prevent changes to in office ancillary services exception. HR 1070, "Removing Barriers to Colorectal Cancer Screening Act of 2013," and S 2348, "Removing Barriers to Colorectal Cancer Screening Act of 2014."

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 842: Functional Gastrointestinal & Motility Disorder (FGIMD) Research Enhancement Act H.R. 2108 & S. 1173: Ambulatory Surgical Center Quality & Access Act H.R. 2195 & S. 1203: Medicare Home Infusion Therapy CoverageH.R. 842: The Functional Gastrointestinal & Motility Disorders (FGIMD) Research Enhancement Act H.R. 225: Senate passage of the National Pediatric Research Network Act H.R. 991: The CT Colonography Screening for Colorectal Cancer Act H.R. 1070: The Removing Barriers to Colorectal Cancer Screening Act H.R. 460: The Patient's Access to Treatments Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Appropriations House and Senate for NIH, CDC H.R. 1070 Legislation to Revomve Barriers to Colorectal Cancer Screening S. 2349 Legislation to Remove Barriers to Colorectal Cancer Screening

Client expense: Not reported · Firm income: $11,200

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied in support of a permanent fix to the SGR Medicare Physician Payment formula. Lobbied in support of more transparency at CMS when publishing changes in physician values. Lobbied in support of H.R. 1070, Removing Barriers to Colorectal Cancer Screening Act. Lobbied in support of repealing IPAB.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1070, Removing Barriers to Colorectal Cancer Screening Act, which would waive Medicare beneficiary coinsurance for a screening colonoscopy with polyp removal. Support repeal of the Medicare sustainable growth rate formula and reform the Medicare physician payment system (S. 2000 / HR. 4015). Oppose HR 4302,the Protecting Access to Medicare Act of 2014. Specifically oppose Sec 220 to expand misvalued codes initiative at the Centers for Medicare and Medicaid Services. Oppose inclusion of colonoscopy measures in the Ambulatory Surgery Center Quality Reporting Program. Support increased transparency in Medicare physician rate setting by the Centers for Medicare and Medicaid Services, and reversal of payment cuts to upper endoscopy codes. Preserve the Medicare In-Office Ancillary Services Exception under the Stark Self Referral Law / Oppose HR 2914

Client expense: Not reported · Firm income: $21,000

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

H.R. 1070, Removing Barriers to Colorectal Cancer Screening Act. Waive Medicare beneficiary coinsurance for colorectal cancer screening colonoscopy

Client expense: Not reported · Firm income: Not reported

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

Issues relating to implementation of changes to Medicare and Medicaid, pursuant to P.L. 111-148, the Patient Protection and Affordable Care Act of 2010, and tobacco cessation programs within Medicaid. Issues relating to inclusion of palliative care as a bundled service within CMS "value-based purchasing", general deficit reduction issues impacting Medicare & Medicaid, and H.R.1070, Removing Barriers to Colorectal Cancer Screening Act of 2013; H.R.2810, Medicare Patient Access & QualityImprovement Act, S.1871, the SGR Repeal & Medicare Beneficiary Access Act, and S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), White House Office

Pub.Law 111-148 & 111-152 - Discussed implementation of health care law that would reform the health care system to provide affordable quality health care, reduce drug costs and expand access to long-term services and supports. Discussed how to implement Medicaid provisions of Affordable Care Act. (PL. 111-148)S. 374, Medicare Mental Health Inpatient Equity Act - Lobbied in support of this legislation to eliminate the 190-day lifetime limit on Medicare coverage for in-patient psychiatric hospital services (112th). Discussed improving access to care for underserved population. (no bill) Discussed importance of maintaining low income subsididies and supports in Medicare. (no bill) Discussed the importance of coordinating services for those who qualify for both Medicare and Medicaid in order to ensure that beneficiaries receive all needed benefits but there is no duplication. (no bill) Discussed whether, and under what circumstances, managed care could effectively be used to provide benefits to dual eligible beneficiaries. (no bill) Discussed additional methods for fighting fraud and waste in Health Care. (no bill) Discussed Medigap and need for guaranteed issue for all populations and need to increase medical loss ratio. Discussed durable medical equipment bidding. (no bill) Lobbied for legislation to provide Medicare beneficiaries with additional opportunities to enroll in Medicare Part B.(no bill) Lobbied against the use of the Social Security account number on Government-issued identification cards issued in connection with Medicare, Medicaid, and SCHIP benefits and for other purposes. (no bill) Discussed support to curb waste and fraud from the Medicare and Medicaid programs. (no bill) H.R. 3630, Middle Class Tax Relief and Job Creation Act of 2012 - Discussed the legislation as it pertained to SGR. Discussed Medicaid long-term services and supports. (no bill) Discussed Medicare Reform. (no bill) H.R. 2305/S. 1123, PRIME ACT (Preventing and Reducing Improper Medicare Expenditures) - Discussed support for bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs. (no bill) H.R. 1588/S. 740, Medicare Drug Savings Act - Discussed the Medicare Drug Savings Act to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income befeficiaries. (no bill) Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed measures for re-balancing in medicaid managed LTSS waivers and dual demonstration programs in sign on letter to CMS. (no bill) H.R. 1717 - Discussed Medicare DMEPOS Market Pricing Program Act. H.R. 3531 - Discussed Creating Access to Rehabilitation for Every Senior (CARES) Act. Discussed implementation of regulations regarding minimum wage and overtime for home care workers and consumer-directed care.Discussed Medicare Graduate Nursing Education pilot design. (no bill) Discussed Prescription Drug Affordability. (no bill) Discussed Prescription Drug Shortages. (no bill) H.R. 3342, Affordable Medicines Utilization Act of 2011 - Lobbied to encourage state Medicaid programs to use safe, effective generic medications. H.R. 2576 - Discussion to amend the Internal Revenue Code of 1986 to modify the calculation of modified adjusted gross income for purposes of determining eligibility for certain healthcare-related programs. Discussed opposition to caps on dual eligibles; discussed managed care and dual eligibles. (no bill) Discussed with CMS demonstration programs for dual eligibles and process related to the demonstrations, as well as other work of the Medicare-Medicaid Coordination Office, discussed consumer choice and continuity of care in Medicaid managed long-term services and supports programs, discussed focus groups on dual eligibles. Discussed Medicaid managed care and long-term services and supports broadly. Discussed Hospital & Critical Access Hospitals Conditions of Participation proposed regulations; requested that advanced practice registered nurses and physicians assistants be allowed the full scope of services in hospital admitting and visiting privileges. (no bill) Discussed Hospital Outpatient Therapeutic Services Final Rule underscoring that advanced practice registered nurses and physicians should be allowed to supervise such outpatient service clinics without physician oversight as long as in line with state scope of practice laws. (no bill) Discussed health disparities. (no bill) Discussed Medicaid reform, Medicare/Medicaid "dual eligibles" integration efforts and financial alignment demonstrations; and other CMS demonstration initiatives. (no bill) Discussed the AARP Initiative called "You've Earned a Say". (no bill) S. 3586, Recruiting Individuals to Drive Elders (RIDE) Act - Discussed Medicaid non-emergency transportation bill (112th). Discussed proposals that would establish per-capita caps under Medicaid as well as other Medicaid financing proposals including block grants and changes to the current FMAP structure. (no bill) Discussed extension of funding originally provided under the Medicare Improvement for Patients and Providers Act (P.L. 110-275) to State Health Insurance Assistance Programs (SHIPs), Aging and Disability Resource Centers (ADRICs), and Area Agencies on Aging (AAAs) for Medicare outreach and enrollment counseling. (no bill) Discussed the prevention of cuts to beneficiaries in the Medicare program. (no bill) Discussed the prevention of an increase in the age of eligibility in the Medicare program. (no bill) Discussed the patch to the Sustainable Growth Rate (SGR) in the Medicare program. (no bill) Discussed concerns of block granting Medicaid. (no bill) Discussed the Kansas managed long-term services and supports waiver proposals and related implementation issues. (no bill). H.R.928/S.408, the Medicare Drug Savings Act - Discussed requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed Health Disparities. (no bill) Discussed medicare demonstration project replacing standard medicare cards with Smart Card technology. (no bill) H.R. 574 - The Medicare Physician Payment Innovation Act of 2013. H.R. 1173 - Discussed Personalize Your Care Act. Discussed observation issues. (no bill) Discussed rebalancing measures in Medicaid managed LTSS in 1115 waivers and duals demonstration programs. (no bill) Discussed proposed regulation relating to Medicaid expansion coverage and minimum essential coverage. (no bill) Discussed Medicaid expansion and estate recovery. (no bill) Discussed Medicaid and asset transfers. (no bill) Discussed draft legislation regarding Dual Eligible Special Need Plans (D-SNP) - Strengthing Healthcare Options for Vulnerable Populations Act. (no bill) Discussed post-acute care reform. (no bill)H.R. 1179/S.569, Improving Access to Medicare Act - Discussed support of Improving Access to Medicare Coverage Act and urged cosponsorship and advancement of the bill. Participated on press call on the bill. Discussed comments regarding Medicare and You handbook. (no bill) Discussed CMS information regarding healthcare marketplaces. H. R. 933, Consolidated and Further Continuing Appropriations Act, 2013 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. S. Con. Res. 8, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. H.Con. Res. 25, Concurrent Resolution on the Budget, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation.Lobbied on expected "QM" safe harbor amendment. (The amendment was not offered) H.R. 2305/S.1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act. Bill reduces waste, fraud, and abuse in Medicare and Medicaid programs. Discussed Competitive bidding of durable medical equipment, prosthetics, orthotics, and supplies. (no bill) Discussed repeal of Affordable Care Act provision making prescriptions necessary for over-the-counter drugs purchased with flexible spending accounts. (no bill) Discussed Medicare supplemental coverage. (no bill) Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug cost. (no bill) Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed Recruiting Individuals to Drive Our Elders Act (RIDE) would increase state flexibility by giving states the option to receive federal assistance to reimburse their volunteer drivers for no-load miles. (no bill) H.R. 3547/H.J.R. 59/H.R. 2775/H.J.R. 106, Consolidated Appropriations Act, 2014 - Lobbied to prevent inclusion of Medicare, Medicaid and Social Security benefit cuts and to protect vital health, social services, housing and transportation programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. S. 1284, Labor, Health and Human Services Appropriations Act, 2014 - Lobbied to protect vital health and social services programs from enhanced reductions from the prior year baseline, and to prevent repeal of certain financial and health care-related regulation. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiares. (no bill) Discussed pending U.S. trade agreement negotiations, including trade promotional or 'fast track' authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S. 1871 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program. Discussed fraud, Medicare home healthcare, ways to find savings in Medicare without harming Medicare beneficiaries (care coordination, prescription drugs, waste, fraud and abuse). Discussed you've earned a say, ways to find savings in medicare without harming medicare beneficiaries (care coordination, prescriotion drugs, waste, fraud and abuse). Discussed implementation of provision to require reporting of nursing home staffing data based on payroll data. (no bill) S. 1932/H.R. 3890 - Discussed logistics and attended event to introduce the Better Care, Lower Cost Act. Discussed non-residential settings and Medicaid home and community-based setting final regulation. (no bill) Discussed person-centered planning and family caregiver assessment in Medicaid HCBS state plan option final rule. Submitted comment letter on distaster preparedness requirements for Medicare and Medicaid providers. (no bill) Discussed Money Follows the Person Rebalancing Demonstration and Balancing Incentive Payments Program. (no bill)Discussed Medicare Advantage. H.R. 3616, Protecting Seniors from Medicare Act- Sent letters endorsing bill. H.R. 2810, The SGR Repeal and Medicare Beneficiary Improvement Act - Sent letters endorsing bill. Discussed observation care and "two-midnight rule". H.R. 1070, the Removing Barriers to Colorectal Cancer Screening Act - Discussed and sent letter of endorsement to bill. Discussed the Medicare Part D prescription drug benefit program and changes needed to further lower prescription drug costs and related agency proposed rule changes. (no bill) H.R. 1588/S.740, Medicaid Drug Savings Act - Discussed the requirement for drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. Discussed potential improvements to the Medicare Savings Programs for low-income beneficiaries. (no bill) Discussed pending U.S. Trade agreement negotiations, including trade promotional or "fast track" authority, and their potential impact on Medicare and Medicaid prescription drug programs. (no bill) H.R. 2810/S.1871/H.R. 4015/S.2110 - Discussed SGR repeal and health care extender provisions, including the Qualified Individual low-income Medicare beneficiary assistance program.

Client expense: $1,990,000 · Firm income: Not reported

Government targets: Administration on Aging, Agriculture, Dept of (USDA), Bureau of the Census, Centers For Medicare and Medicaid Services (CMS), Commodity Futures Trading Commission (CFTC), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Communications Commission (FCC), Federal Highway Administration (FHA), Federal Reserve System, Federal Trade Commission (FTC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Tax related Patents, Net Operating Loss, Small Business Capital Formation, Tax Reform, Cash Method of Accrual Tax reform oversight, AMT oversight, R&D tax credit as part of tax reform, HR 1070 Small Business Access to Capital Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 842: Functional Gastrointestinal & Motility Disorder (FGIMD) Research Enhancement Act H.R. 2108 & S. 1173: Ambulatory Surgical Center Quality & Access Act H.R. 2195 & S. 1203: Medicare Home Infusion Therapy CoverageH.R. 842: The Functional Gastrointestinal & Motility Disorders (FGIMD) Research Enhancement Act H.R. 225: Senate passage of the National Pediatric Research Network Act H.R. 991: The CT Colonography Screening for Colorectal Cancer Act H.R. 1070: The Removing Barriers to Colorectal Cancer Screening Act H.R. 460: The Patient's Access to Treatments Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE