Resident Physician Shortage Reduction Act of 2013

SGR/payment reform, graduate medical education (H.R.1201, H.R.1180, S.1152), private contracting for Medicare beneficiaries and their physicians (S.236/H.R.1301), electronic health records (H.R.1331), clinical data registry reporting.

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

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

H.R. 1201- Training Tomorrow's Doctors Today; Graduate Medical Education provisions S. 577, H.R. 1180- Resident Physician Shortage Reducation Act Hospital Evaluation and Management site-neutrality payment proposal H.R. 1920- DSH Reducation Relief Act of 2013 H.R. 1787, S. 842- Rural Hospital Access Act of 2013; Critical Access Hospitals S. 1143, H.R. 2801- Protecting Access to Rural Therapy Services Act- provisions re "direct supervision" at Critical Access Hospitals S. 1871- SGR Repeal and Medicare Beneficiary Access Improvement Act; Medicare Sustainable Growth Rate provisions and "general supervision" provisions for rural and Critical Access Hospitals H.R. 2810- Medicare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077-Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2014 H.R. 5558- ACO Improvement Act H.R. 4851- FLEX-IT Act; provsions related to "Meaningful Use"

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

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

HR 1309 - Health Information Technology Action of 2013 - Excludes pathologists from receiving incentives for purchasing electronic health records as well as being exempt from payment penalties under meaningful use standards. HR 1180, S 577, HR 2914 - GME legislation - proposed legislation to increase the number of federally funded residency slots HR 2914 - Stark Self-Referral Law HR 4250, S 2141 - Sunscreen Innovation Act.

Client expense: $277,572 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1201, Training Tomorrows Doctors Today Act H.R. 1250, the Medicare Audit Improvement Act H.R. 1180/S. 577, The Resident Physician Shortage Reduction Act of 2013 H.R. 1920, the DSH Reduction Relief Act S. 2728, Community-Based Medical Education Act of 2014 S. 2658, The Accelerating Biomedical Research Act S. 2501, the Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014 H.R. 5339, The Expanding Opportunities for Recovery Act H.R. 5110, SAVE Medicare Home Health Act of 2014 H.R. 5458, Building a Healthcare Workforce of the Future Act H.R. 5481, The Flexibility in Health IT Reporting (Flex-IT) Act OMHA-1401-NC, Medicare Program; Administrative Law Judge Hearing Program for Medicare Claim Appeals, Request for Information CMS-3819-P, Medicare and Medicaid Program: Conditions of Participation for Home Health Agencies; Proposed Rule

Client expense: $312,120 · Firm income: Not reported

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

HR 1201 "Training Tomorrow's Doctors Today Act" All Provisions S 577 "Resident Physician Shortage Act of 2013" All Provisions HR 574 "Medicare Physician Payment Innovation Act" All Provisions H.R. 4302 Protecting Access to Medicare Act of 2014 All Provisions P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to implementation of health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers and individuals. H.R. 1180 The Resident Physician Shortage Reduction Act of 2013. All Provisions. H.R. 1920 DSH Reduction Relief Act of 2013. All Provisions. S. 1012 The Medicare Audit Improvement Act of 2013. All Provisions. H.R. 1250 The Medicare Audit Improvement Act of 2013. All Provisions. H. R. 2810 Medicare Patient Access and Quality Improvement Act of 2013. All Provisions. Senate Finance Committee: The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. All Provisions. The SGR Repeal and Medicare Beneficiary Accesst Improvement Act of 2013, offered as a substitute amendment to H.R.2810 Medicare Patient Access and Quality Improvement Act of 2013. All Provisions. H.J. Res.59 Continuing Appropriations Resolution, 2014 Short Title: Bipartisan Budget Act of 2013 and Pathway for SGR Reform Act of 2013. All Provisions related to the Medicare Physican Payment H.R. 3698 Two-Midnight Rule Relay Act, All provision Medicare Advantage 2015 Advance Notice of Methodological Changes for Calendar Year 2015 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2015 Call Letter. All Provisions S.1932 Medicare Better Care Program. All provisions. H.R. 3890 Medicare Better Care Program. All provisions. H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act. All provisions. H.R. 1920 DSH Reduction Relief Act of 2013. All provisions. S. 2082 Two-Midnight Rule Coordination and Improvement Act of 2014. All provisions. H.R. 4673 Bundling and Coordinating Post-Acute Care Act of 2014. All provisions. H.R. 4994 Impact Act of 2014 - Improving Medicare Post-Acute Care Transformation Act of 2014. All provisions. H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act. All provisions. Medicare Shared Savings Program/Accountable Care Organizations: Potential Regulatory Reforms H.R. 5481 To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes. Hospital Improvements for Payment Act of 2014 Discussion Draft - All Provisions H.R. 5771 Tax Increase Prevention Act of 2014. All Provisions CMMI Demonstration Project

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

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

HR 1201 "Training Tomorrow's Doctors Today Act" All Provisions S 577 "Resident Physician Shortage Act of 2013" All Provisions S 619 "Conrad State 30 and Physician Access Act" All Provisions H.R. 4302 Protecting Access to Medicare Act of 2014 All Provisions PL 112-25 "Budget Control Act of 2011" Provisions related to Medicare, Medical Education and Research Sequestration P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to implementation of health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers and individuals. H.R. 1180 The Resident Physician Shortage Reduction Act of 2013. All Provisions. H. R. 2810 Medicare Patient Access and Quality Improvement Act of 2013. All Provisions. The SGR Repeal and Medicare Beneficiary Accesst Improvement Act of 2013, offered as a substitute amendment to H.R.2810 Medicare Patient Access and Quality Improvement Act of 2013. All Provisions. H.J. Res.59 Continuing Appropriations Resolution, 2014 Short Title: Bipartisan Budget Act of 2013 and Pathway for SGR Reform Act of 2013. All Provisions related to the Medicare Physican Payment S. 1822 Foreign Medical School Accountability Act of 2013. All Provisions H.R. 3903 Foreign Medical School Accountability Act of 2014. All Provisions H.R. 83 Consolidated and Further Continuing Appropriations Act of 2015 - All provisions Hospital Improvements for Payment Act of 2014 Discussion Draft - All provisions H.R. 5771 Tax Increase Prevention Act of 2014. All provisions CMMI Demonstration Project

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

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

Preventing reductions to Medicare physician payment; Reforming the sustainable growth rate formula: "The SGR Repeal and Medicare Provider Payment Modernization Act of 2014" (S 2000/HR 4015); Preventing cuts to Medicare Graduate Medical Education and Disproportionate Share Hospital Payments; Preventing reductions to Hospital Inpatient and Outpatient PPS Payments; Provider reimbursements for end of life care counseling: "Personalize Your Care Act of 2013" (HR 1173); Medicare reimbursements for molecular diagnostics; Medicare coding & reimbursement associated with Screening, Brief Invention and Referral to Treatment; Additional Medicare support for Medicare Graduate Medical Education by expanding Medicare resident limits: "Training Tomorrows Doctors Today Act" (HR 1201), "The Resident Physician Shortage Reduction Act of 2013" (HR 1180), "The Resident Physician Shortage Reduction Act of 2013" (S 577), "Community-Based Medical Education Act of 2014 (S 2728); Allowing nurse practitioners, certified nurse-midwives, and clinical nurse specialists to certify home health services for Medicare patients: "Home Health Care Planning Improvement Act (HR 2504, S 1332); Medicare payment for chronic care: "Better Care, Lower Cost Act of 2014" (S 1932); Medicare payment for short hospital stays: "Two- Midnight Rule Coordination and Improvement Act of 2014" (S 2082); Critical Access Hospital Relief Act (HR 3991/S. 2037); Improving the Medicare hospital readmissions program: "The Establishing Beneficiary Equity in the Hospital Readmission Program Act" (HR 4188); Preventing reductions to the Medicaid program including the provider tax; Improvements to the Medicaid program for medically complex children, "Advancing Care for Exceptional Kids Act of 2014" (HR 4930).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1180, S. 577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Endowment for the Arts, SENATE

H.R. 4302, Protecting Access to Medicare Act of 2014: Medicare reimbursement pertaining to Medicare Sustainable Growth Rate Formula (SGR). S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2013; H.R. 3698, Two-Midnight Rule Delay Act of 2013: executive action pertaining to two-midnight rule issue; H.R. 1180, S. 577, Resident Physician Shortage Reduction Act of 2013, entire bill.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. S 2728, Community-Based Medical Education Act of 2014, Issues relating to concerns about reductions to IME and other items.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Endowment for the Arts, SENATE

S.183, Hospital Payment Fairness Act of 2013, Issues pertaining to sunsetting national budget neutrality for the hospital wage index. H.R. 2053, S. 1012, Medicare Hospital Wage Index Equity Act, Issues pertaining to changing the national budget neutrality for the hospital wage index to a state neutrality. H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1250, S. 1012, Medicare Audit Improvement Act of 2013, Issues pertaining to RAC audits for hospitals. H.R. 1920, S. 1555, DSH Reduction Relief Act of 2013, Issues regarding delaying implementation of DSH cuts. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S 2728, Community-Based Medical Education Act of 2014, Issues relating to concerns about reductions to IME and other items. S 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. Emergency preparedness funding for hospitals. Implementation of H.R. 152, Disaster Relief Appropriations Act, 2013, funding for mitigation projects. H.R. 1180, Resident Physician Shortage Reduction Act of 2013. FY15 Labor HHS appropriations, NIH funding. S. 2658, Accelerating Biomedical Research Act.H.R. 83, Consolidated and Further Continuing Appropriations Act, 2015, Ebola funding and NIH funding.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. H.R. 1180, Resident Physician Shortage Reduction Act of 2013. CMMI demonstration program. Mental health issues in general. S. 1557, Children's Hospital GME Support Reauthorization Act of 2013. S. 1405, Medicare Ambulance Access Act of 2013. ICD-10 implementation. H.R. 4930, ACE Kids Act of 2014.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Higher Education Act with respect to U.S. Medical Licensing Examinations. H.R. 1180, Resident Physician Shortage Reduction Act of 2013. S. 1557, Children's Hospital GME Support Reauthorization Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

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. 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. 647, Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014), provisions relating to Misvalued Codes S. 313, Achieving a Better Life Experience Act of 2013 (ABLE Act of 2013), provisions relating to Misvalued Codes H.R. 962, Medicare Diabetes Prevention Act of 2013, all provisions S. 452, Medicare Diabetes Prevention Act of 2013, all provisions H.R. 4282, Creating Access to Residency Education Act of 2014, all provisions H.R. 4843, Native Contract and Rate Expenditure Act of 2014 (Native CARE Act of 2014), all provisions H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes, all provisions H.R. 4998, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions S. 2552, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions H.R. 1180, Resident Physician Shortage Reduction Act of 2013, all provisions S. 577, Resident Physician Shortage Reduction Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, all provisions H.R. 5723, Ensuring Access to Primary Care for Women & Children Act, all provisions S. 2694, Ensuring Access to Primary Care for Women & Children Act, all provisions H.R. 5780, Protecting the Integrity of Medicare Act (PIMA) of 2014, all provisions H.R. 4302, Protecting Access to Medicare Act of 2014, provisions relating to coding and pricing issues Medicare program: SGR Repeal Medicare program: Independent Payment Advisory Board (IPAB) Repeal Medicare program: Medicare Patient Empowerment Act Medicare program: Graduate Medical Education Medicare program: ICD-10 Repeal Medicare program: Overlapping Medicare incentive programs Medicare program: HIPAA including ICD-10 Medicare program: Electronic Health Records (EHR) - Meaningful Use Medicare program: EHR Certification Medicare program: Physician Quality Reporting System (PQRS) Medicare program: Laboratory Developed Tests Medicare program: Alternative Payment Models/quality performance measures Medicare program: Physician payment and delivery reform issues Medicare program: Hospital short stay Medicare program: Medicare funding for quality measure development Medicare program: Value-Based Modifiers Medicare program: Global Surgical Codes Medicare program: In-Office Ancillary Services Exception Medicare program: RUC - Misvalued and Care Coordination Codes Medicare program: Diabetes Medicare program: Recovery Audit Contractors Medicare program: Program Integrity - Meaningful Use Audits Medicare program: Program Integrity - Modifiers Medicare program: Program Integrity - Electronic Health Records Medicare and Medicaid programs: Coverage of lung cancer screening for high-risk patients

Client expense: $4,390,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

H.R. 4282, Creating Access to Residency Education Act of 2014, all provisions H.R. 1180, Resident Physician Shortage Reduction Act of 2013, all provisions S. 577, Resident Physician Shortage Reduction Act of 2013, all provisions Graduate Medical Education

Client expense: $4,390,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. Emergency preparedness funding for hospitals. Implementation of H.R. 152, Disaster Relief Appropriations Act, 2013, funding for mitigation projects. H.R. 1180, Resident Physician Shortage Reduction Act of 2013. FY15 Labor HHS appropriations, NIH funding. S. 2658, Accelerating Biomedical Research Act.H.R. 83, Consolidated and Further Continuing Appropriations Act, 2015, Ebola funding and NIH funding.

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE

Implementation of H.R. 3590, the Patient Protection and Affordable Care Act. Medical education funding and medical school construction in general. H.R. 1180, Resident Physician Shortage Reduction Act of 2013. CMMI demonstration program. Mental health issues in general. S. 1557, Children's Hospital GME Support Reauthorization Act of 2013. S. 1405, Medicare Ambulance Access Act of 2013. ICD-10 implementation. H.R. 4930, ACE Kids Act of 2014.

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE

Higher Education Act with respect to U.S. Medical Licensing Examinations. H.R. 1180, Resident Physician Shortage Reduction Act of 2013. S. 1557, Children's Hospital GME Support Reauthorization Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE

Medicare-funded graduate medical education; HRSA THCGME Program; S. 1759, The Teaching Health Center Reauthorization Act; H.R. 1201, Training Tomorrow's Doctors Today Act; H.R. 1180, Resident Physician Shortage Reduction Act of 2013; S. 577, Resident Physician Shortage Reduction Act of 2013; H.R. 4282, Creating Access to Residency Education Act of 2014; S. 2728, The Community-Based Medical Education Act of 2014; S. 1152/H.R. 5458, Building a Healthcare Workforce for the Future Act; S. 1978, Increasing Primary Care Access Act of 2014; S. 2229, Expanding Primary Care Access and Workforce Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.36 - Health Care Safety Net Enhancement Act of 2013 H.R.235 - Veteran Emergency Medical Technician Support Act of 2013 H.R.351 - Protecting Seniors' Access to Medicare Act of 2013 H.R.574 - Medicare Physician Payment Innovation Act of 2013 H.R.647 - Achieving a Better Life Experience (ABLE) Act of 2014 H.R.809 - Field EMS Quality, Innovation, and Cost Effectiveness Improvements Act of 2013 H.R.1098 - Traumatic Brain Injury Reauthorization Act of 2013 H.R.1201 - Training Tomorrow's Doctors Today Act H.R.1263 - Excellence in Mental Health Act H.R.1179 - Improving Access to Medicare Coverage Act of 2013 H.R.1180 - Resident Physician Shortage Reduction Act of 2013 H.R.1487 - Improved Health Care Lower Cost Act of 2013 H.R.1838 - Enhanced Access to Medicaid Services H.R.2186 - Verifying Authority and Legality In Drug Compounding Act of 2013 H.R.2900 - Offering Patients True Individualized Options Now (Option Act of 2013) H.R.2300 - Empowering Patients First Act of 2013 H.R.2810 - Medicare Patient Access and Quality Improvement Act of 2013 H.R.3392 - Patient Safety and Drug Abuse Prevention Act H.R.3528 - National All Schedules Prescription Electronic Reporting Reauthorization Act of 2013 H.R.3548 - Improving Trauma Care Act of 2013 H.R.3717 - Helping Families in Mental Health Crisis Act of 2013 H.R.4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R.4080 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.4106 - Saving Lives, Saving Costs Act H.R.4169 - Stop Overdose Stat Act H.R.4574 - Strengthening Mental Health in Our Communities Act of 2014 H.R.5460 - Medicare Ambulance Access, Fraud Prevention and Reform Act of 2014 S.44 - Medical Care Access Protection (MCAP) Act of 2013 S.264 - Excellence in Mental Health Act S.265 - Community-Based Mental Health Infrastructure Improvements Act S.313 - Achieving a Better Life Experience (ABLE) Act of 2014 S.328 - Strengthening Rural Access to Emergency Services Act S.351 - Protecting Seniors' Access to Medicare Act of 2013 S.569 - Improving Access to Medicare Coverage Act of 2013 S.577 - Resident Physician Shortage Reduction Act of 2013 S.755 - Enhanced Access to Medicaid Services S.961 - Health Care Safety Net Enhancement Act of 2013 S.1871 - SGR Repeal and Medicare Beneficiary Access 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 S.2240 - Medicare Choices Empowerment and Protection Act S.2400 - Field EMS Innovation Act S.2405 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.2406 - Improving Trauma Care Act of 2014 S.2501 - Hospital Readmission Accuracy and Accountability Act S.2539 - Traumatic Brain Injury Reauthorization Act of 2014 S.2755 - Overdose Prevention Act

Client expense: $228,645 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1180 - Resident Physician Shortage Reduction Act of 2013 H.R.1201 - Training Tomorrow's Doctors Today Act S.577 - Resident Physician Shortage Reduction Act of 2013

Client expense: $228,645 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 83: "Consolidated and Further Continuing Appropriations Act, 2015, provisions related to Ebola funding. HR 1180/S 577: Resident Physician Shortage Reduction Act of 2013 (all provisions). Issues related to graduate medical education and medical research. Issues related to Organ Transplant and United Network of Organ Sharing liver allocation system.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R 4920- ACE Kids Act of 2014; issues related to CHIP H.R. 5364: S. 2461- Issues related to CHIP H.R. 2810 Meducare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077- Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System- Update for FY 2015 H.R. 5558- ACO Improvement Act H.R. 4851 FLEX-IT Act; provisions related to "Meaningful Use" H.R. 1180; S. 577 Resident Physician Shortage Reduction Act; issues related to Graduate Medical Education slots, criteria, and funding H.R. 1201 Training Tomorrow's Doctors Today; issues related to Graduate Medical Education slots, criteria, and funding

Client expense: Not reported · Firm income: $34,400

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 83: Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) Funding for Ebola preparedness and treatment Medicare Audit Improvement Act of 2013 (H.R. 1250) Resident Physician Shortage Reduction Act (S. 577/H.R. 1180) Protecting Seniors Access to Medicare Act of 2013 (H.R. 351 and S. 351) The DSH Reduction Relief Act of 2013 (H.R. 1920) Rural Hospital Access Act (H.R. 1787) Rural Hospital Fairness Act (H.R. 2578) Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 4188)/ Hospital Readmissions Program Accuracy and Accountability Act of 2014 (S. 2501) Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Flexibility in Health IT Reporting Act (HR 5481) Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Medicare physician fee schedule fix Severe sepsis protocols Medicare and Medicaid Recovery Audit Contractor (RAC) Programs Funding for National Institutes of Health Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) Payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, inpatient coding offset, hospital outpatient department (HOPD) evaluation and management (E/M) services, and sequestration. Medicare and Medicaid Electronic Health Record Incentive Payment Programs Medicaid, New York State Medicaid Vital Access Provider Program Hospital and health system pricing transparency Clinical quality measures and electronic clinical quality measures FY 2014 Inpatient Prospective Payment System Final Rule (CMS-1599-F) - Two-Midnight Policy FFY 2015 Inpatient Prospective Payment System Proposed Rule (CMS-1607-P) - Two-Midnight Policy

Client expense: $250,000 · Firm income: Not reported

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

H.R. 4920- ACE Kids Act of 2014; issues related to CHIP H.R. 5364; S. 2461- Issues related to CHIPH.R. 2810- Medicare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077-Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2014 H.R. 5558- ACO Improvement Act H.R. 4851- FLEX-IT Act; provsions related to "Meaningful Use" H.R. 1180; S. 577 Resident Physician Shortage Reduction Act; issues related to Graduate Medical Education slots, criteria, and funding H.R. 1201- Training Tomorrow's Doctors Today; issues related to Graduate medical Education slots, criteria, and funding

Client expense: $60,391 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5464 and draft Senate legislation, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division G, Title II Issues: Support funding for NIH, Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Children's Hospitals Graduate Medical Education program (CHGME), HRSA, biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Support emergency supplemental funding to prepare and respond to Ebola and to reimburse for Ebola Virus Disease treatment. H.R. 4486 and draft Senate legislation, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division I, Title II President's Budget, FY 2016 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Funding for Community Health Centers and the NHSC. Debt in Health Education Loan programs (DebtHELP) bill (draft) Issues: Expand National Health Service Corps State Loan Repayment program, align Department of Education and Health Resources and Services Administration student loan programs. S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction Act of 2013 Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. H.R. 487, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act, Sections 5503 and 5506 Issue: Redistribution of residency positions. Issue: Implementation of and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the Affordable Care Act. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform. Issue: Support the use of animals in medical research. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014 Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Implementation of Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose discretionary spending cuts through sequestration, including NIH, Titles VII and VIII health professions and nursing education programs, and other science programs. Issue: Support primary care workforce development S. 1759, Teaching Health Center Reauthorization Act Issue: Legislation to reauthorize the Teaching Health Center Program and payments. Issue: Draft legislation on pain education in undergraduate and graduate medical education. H.R.548/S. 1152, The Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 5294, Health Equity and Accountability Act of 2014 Issue: Support bill to improve health equity. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. H.R. 3698, Two Midnight Rule Delay Act of 2013 S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act. S. 2501, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. Issue: Educating health professionals regarding prescription drug abuse and appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Support use of holistic review in admissions. Issue: Support ACA consumer outreach and enrollment efforts. Issue: Implementation of the 340B drug discount program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Support preservation of funding for the Primary Care Residency Expansion program. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 5411, Trafficking Awareness Training for Health Care Act of 2014 Issue: Medical education curricula content pertaining to human trafficking. S. 2658/H.R.5580, Accelerating Biomedical Research Act Issue: To increase discretionary spending cap to increase funding for the National Institutes of Health (NIH). S. 2450, Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 4810, Veteran Access to Care Act Issue: Addressing VA backlogs by increasing care for veterans provided by non-VA facilities. S. 2115, American Cures Act H.R. 4384, America HEALS ACT Issue: Support establishment of a fund to provide an expanded and sustained investment in biomedical research. H.R. 4879, Research for All Act Issues: Support inclusion of male and female cells, tissues and animals in basic biomedical research. Support update of NIH guidelines to increase participation of women in clinical trials. Issue: FDA regulation of Laboratory Developed Tests (LDTs) S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 2645, The Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids S. 2942, The Infectious Disease Hospitals Hubs Act Issue: Support legislation to establish a network of hospitals in preparing for and responding to infectious diseases. Issue: Support nomination of Dr. Vivek Murthy as U.S. Surgeon General Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: U.S. Census Bureau on the American Community Survey CMS on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program CMS on final rule regarding definition of uninsured for purposes of Medicaid DSH limits HHS on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.) FDA on strategies for increasing patient involvement in regulatory processes. White House Ebola Response Coordinator offering to work with federal and state officials to prepare and respond to Ebola cases. NIH in response to an RFI related to the development of grant program to help facilitate the transition from training to independence. NIH on the consideration of sex as a biological variable in biomedical research The Patient-Centered Outcomes Research Institute (PCORI) on the proposed process for peer review and public release of its primary research finding. DEA on delaying the Disposal of Controlled Substances Final Rule.

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

H.R. 4486 and draft Senate legislation, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division I, Title II President's Budget FY 2016 Issue: Support funding for Veterans Affairs medical research, research infrastructure, and health care. H.R. 4942, Underserved Veterans Access to Health Care Act Issue: Increasing funding for VA GME and Medicare GME. S. 2450, Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 4810, Veteran Access to Care Act P.L. 113-564, Veterans Access, Choice, and Accountability Act of 2014 Issues: Addressing VA backlogs by increasing care for veterans provided by non-VA facilities. Support improved contracting with academic affiliates and increased VA and Medicare GME funding. S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction of 2013 H.R. 1201, Training Tomorrow's Doctors Today Act Issue: Support adding a priority for teaching hospitals that have residency affiliations with VA medical centers Issue: Explaining the relationship between VA GME and Medicare GME

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction of 2013. Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments and increase GME accountability and transparency. Issue: Implementation and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Support Medicare physician payment reform. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. H.R. 487, Primary Care Workforce Access Improvement Act. Issue: Residency training in community-based settings. Issue: Primary Care Workforce Development. President's Budget, FY 2015 Issue: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 H.R. 3698, Two Midnight Rule Delay Act of 2013 Issue: Support delay of Enforcement of new Centers for Medicare and Medicaid Services inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare Graduate Medical Education (GME) per resident amount technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act S. 2501, Hospital Readmission Accuracy and Accountability Act Issue: Support inclusion of socioeconomic status as part of hospital readmissions program. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Issues: Support repeal of Medicares Sustainable Growth Rate (SGR) formula; Medicare physician payment reform. Issue: Draft legislation on educating health professionals regarding appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Issue: Implementation of the 340B drug discount program. H.R. 4302, Protecting Access to Medicare Act of 2013. Issues: Support Medicare physician payment relief and extended delay of Medicare's "two-midnights" policy for hospital admissions; support the addition of GME language related to establishing Medicare caps and PRA; support delayed implementation of Medicaid DSH cuts. H.R. 4282, Creating Access to Residency Education Act of 2014 Issue: Create CMS grant program for new residency programs. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program including support for adoption of National Quality Forum (NQF) recommendations. Issue: Support Medicaid expansion advocacy efforts. Issue: Draft legislation on pain education in undergraduate and graduate medical education. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 4942, Underserved Veterans Access to Health Care Act Issue: Increasing funding for VA GME and Medicare GME. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014. Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the ACA. Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: Centers for Medicare & Medicaid Services (CMS) on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program. Centers for Medicare & Medicaid Services (CMS) on final rule regarding definition of uninsured for purposes of Medicaid DSH limits The Department of Health and Human Services (HHS) on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.)

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Monitor legislative activity related to health funding; graduate medical education funding; H.R. 487 - Primary Care Workforce Access Improvement Act; HR 1180 - Resident Physician Shortage Reduction Act; HR 1201 Training Tomorrow's Doctors Today Act; S. 577 - Resident Physician Shortage Reduction Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation expanding the GME program: H.R. 1201, S. 577, H.R. 1180, H.R. 297, and H.R. 487.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid funding Proposed changes to Medicare hospital reimbursement policies Health Care Reform Implementation Graduate Medical Education - H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Graduate Medical Education H.R. 1180 and S. 577, "Resident Physician Shortage Reduction Act of 2013" Health Care Delivery and Payment Reform proposals Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Graduate Medical Education, H.R. 1180 and S. 577, "Resident Physician Shortage Reduction Act of 2013" Proposed changes to Medicare hospital reimbursement policies H.R. 3698, "Two Midnight Rule Delay Act" S. 2082, "Two-Midnight Rule Coordination and Improvement Act of 2014" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, "Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Extension/renewal of Medicare Physician Reimbursement payments Resident Physician Shortage Act (HR 1180); Next Generation Research Act (S 1552) NIH funding Graduate Medical Education

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments Medicare and Medicaid paymentMedicaid Waivers Extension of Medicare Sustainable Growth Rate Medicare Evaluation and Management Reimbursement Reduction Proposal Issues related to waste, fraud, and abuse in Medicaid Medicare Disproportionate Share Hospital Payments H.R. 574 Medicare Physician Payment Innovation Act of 2013, all provisions H.R. 1853 Medicaid Accountability and Care Act, all provisions H.R. 574 Medicare Physician Payment Act, all provisions 5.577/HR 1180 Resident Physician Shortage Reduction Act , all provisions H.R. 1201 Training Tomorrow's Doctors Act, all provisions H.R. 1250/5.1012 Medicare Audit Improvement Act, all provisions H.R. 1487 Improved Healthcare at a Lower Cost Act, all provisions H.R. 1698 Stabilize Medicaid and CHIP Coverage, all provisions H.R. 1326 Health Care Price Transparency Promotion Act, all provisions H.R. 1920 DSH Reduction Relief Act, all provisions Issues related to Medicaid enrollment of newborns CMS FY2014 Hospital Inpatient Prospective Payment System Rule Issues related to admission and medical review criteria for inpatient services ("two midnights rule") S.1555 DSH Reduction Relief Act of 2013, all provisions S.1871 SGR Repeal and Medicare Beneficiary Access Act - all sections H.R. 2810 Medicare Patient Access and Quality Improvement Act - all sections H.R. 4302 Protecting Access to Medicare Act - all sections H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act S. 1980 Medicaid and CHIP Continuous Quality Act H.R. 3678 Two-Midnight Rule Delay Act - all sections H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 2082 Two-Midnight Rule Coordination and Improvement Act S. 2501 Hospitals Readmissions Program Accuracy and Accountability Act, all sections Issues related to quality measures reporting in Medicaid S. 2461 CHIP Extension act of 2014, all provisions Issues related to Medicare payment for patients in "observation status" in hospitals CMS FY 2014 Outpatient Prospective Payment System Rule Issues related to Medicare Recovery Audit Contractors S. 2941 Medicare Protection Act, all Provisions Extension of SSA 1902 (a) (b) (c) - Medicaid Primary Care payment parity Childrens Health Insurance Program Medicare Hospital Re-admissions Program Meaningful Use Stage 2 H.R. 5481 The Flexibility in Health IT Reporting Act H.R. 5364 CHIP Extension and Improvement Act, All provisions Hospital Improvements for Payment Act of 2014 (generally and specific sections) Section 101: Hospital Prospective Payment System 102: Per Diem payment rate for short lengths of stay 103: Repeal of the Two- Midnights payment reduction 104 and 105: Monitoring performance of and improvements to the RAC program 109: Hospital assessment data 110: Cost information on hospital payments 201: Repeal of the moratorium on physician owned hospitals 214: Tennessee DSH allotment for FY2015 and succeeding fiscal years 216: NOTICE Act 217: Establishing equity in the Hospital Readmissions Program Act

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

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

Graduate medical education; Resident Physician Shortage Reduction Act of 2013 (HR 1180/S 577); Training Tomorrow's Doctor's Today Act; Student Loan Fairness Act (HR 1330); Higher Education Reauthorization Act; Teaching Health Center Reauthorization Act (HR 1201/S1759)

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

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

Medicare and Medicaid disproportionate share hospital cuts, including DSH Reduction Relief Act - support amendments to mitigate the impact of cuts on losing hospitals, postpone Medicaid DSH cuts; Graduate Medical Education issues (including Resident Physician Shortage Reduction Act (S.577/H.R.1180) - support; Amendments to the Medicare hospital readmissions penalty program methodology (providing SES adjustments, fixing the formula flaw), H.R.4188/S.2501 - support; IMPACT Act (S.2553/H.R.4994), support reducing burdensome hospital requirements in original bill; support of final bill; Medicare Audit Improvement Act (H.R.1250/S.1012) and other issues related Medicare claims appeal backlogs - support; Proposals to amend the 2 Midnight Policy (CMS-1599-F)(H.R. 3698/S.2082) - support; comments on House Ways and Means discussion draft legislation, Hospital Improvements for Payment Act of 2014, concerns about new proposed short stay payment methdology and impact on teaching hospitals; CMS Disallowance to NYS File No.:NY-2014-03-MAP - oppose, support NYS Congressional delegation letter to CMS; legislation to create a comprehensive Medicare home infusion benefit (H.R.5435) - support; comments on physician services pertaining to non-face-to-face chronic care management services (CMS-1612-P); support NYS Congressional delegation letter to CMS on NYS State plan amendments on Medicaid rates for hospitals (2% cut restoration, Vital Access Provider funds).

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), SENATE, White House Office

H.R. 398, the Two Midnight Delay Act H.R. 4302, P.L. 113-93, Protecting Access to Medicare Act of 2014 Medicare Physician Payment/Sustainable Growth Rate Graduate Medical Education H.R. 1180, Resident Physician Shortage Reduction Act S. 577, Resident Physician Shortage Reduction Act Disproportionate Share Hospital payments The 340B Program Improvement and Integrity Act Medicare Wage Index Federal Medical Assistance Percentage Extension Inpatient Prospective Payment System Outpatient Prospective Payment System Bad debt/charity care

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

President's Budget, FY2015, Medicare and Medicaid hospital reimbursement issues. Health care reform, Hospital related issues and initiatives. Public Law 111-148, The Patient Protection and Affordable Care Act, Hospital related issues and initiatives. H.R.4872, Health Care and Education Reconciliation Act of 2010, Hospital related issues and initiatives. Sequestration and fiscal cliff issues generally. S.Con.Res.8, Concurrent Resolution on the Budget Fiscal Year 2014, Hospital related issues and initiatives. H.R.1250, Medicare Audit Improvement Act of 2013, Recovery Audit Contractors H.R.1326, Health Care Price Transparency Promotion Act of 2013, Pricing Transparency issues. H.R.1920, DSH Reduction Relief Act of 2013, Disproportionate Share Hospital payment H.R.1180, Resident Physician Shortage Reduction Act of 2013, Graduate Medical Expense (GME) Public Law 113-93, Protecting Access to Medicare Act of 2014, SGR related issues. S.2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014, SGR related issues. H.R.4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Hospital related issues. H.R.3776, Stark Administrative Simplification Act, Hospital related issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Mental Health in Schools Act of 2013 (S 195, HR 628) Mental Health on Campus Improvement Act (HR 1100) Resident Physician Shortage Reduction Act of 2013 (HR 1180, S 577) Ending Corporal Punishment in Schools Act of 2014 (HR 5005) Keeping all Students Safe Act (HR 1893, S 2036) Tyler Clementi Higher Education Anti-Harassment Act of 2014 (S 2164, HR 482) National Health Service Corps reauthorization and funding

Client expense: $43,400 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institute of Mental Health (NIMH), Natl Institutes of Health (NIH), Office of Juvenile Justice & Delinquency Prevention, Office of Natl Drug Control Policy (NDCP), Office of the Vice President of the United States, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

H.R.3698, Two-Midnight Rule Delay Act of 2013; S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014; H.R.1180/S.577, Resident Physician Shortage Reduction Act of 2013; H.R.4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act;S.2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014; Issues related to hospital and related provider reimbursement, disproportionate share hospitals, graduate medical education and delivery system reforms.

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

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

S.577/H.R.1180, Resident Physician Shortage Reduction Act of 2013. H.R.1201, Training Tomorrow's Doctors Today Act. H.R.3698, Two-Midnight Rule Delay Act of 2013/S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014. H.R.4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act.S.2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014. S.2553/H.R.4994, Improving Medicare Post-Acute Care Transformation Act of 2014. H.R.83, Consolidated and Further Continuing Appropriations Act, 2015. Medicare funding for graduate medical education. Medicare reimbursement for hospital outpatient services.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE