Medicare Patient Empowerment Act of 2013

HR713/S367 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) H.R. 3426/S.2818 Locum Tenens H.R. 1310 opt out

Client expense: $308,338 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H.R. 3662, the Mental Health Access Improvement Act of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762, the Medicare Transitional Care Act of 2014 H.R. 5353, the Medicaid Parity Act of 2014 H.R. 5136, the Breaking Addiction Act of 2014 H.R. 5339, the Expanding Opportunities for Recovery Act of 2014 H.R. 5587, the Opioid Abuse Prevention and Treatment Act of 2014 Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to Identifiable Data for the Center for Medicare and Medicaid Innovation Models & Other Revisions to Part B for CY 2015 (CMS-2014-0094-2364)

Client expense: $72,153 · Firm income: Not reported

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

S. 153, H.R. 274, the Mental Health First Aid Act of 2013 S. 195, H.R. 628, the Mental Health in Schools Act of 2013 H.R. 1100, the Mental Health on Campus Improvement Act S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act H.R. 1427, the Truth in Healthcare Marketing Act of 2013 S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 S. 265, Community-Based Mental Health Improvements Act S. 648, Helping Educators Support All Students Act S.162, Justice and Mental Health Collaboration Act of 2013; S. 649, Safe Communities, Safe Schools Act of 2013 S. 2461: The CHIP Extension Act of 2014 S. 2728: The Community Based Medical Education Act H.R. 1615, A bill to provide for a study by the Institute of Medicine on gaps in mental health services and how these gaps can increase the risk of violent acts. H.R. 2037, the Native American Psychiatric and Mental Health Care Improvement Act H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2775, No Subsidies Without Verification Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 2817, the Protect Patient Access to Quality Health Professionals Act of 2013 H.R. 2734, the Garrett Lee Smith Memorial Act Reauthorization of 2013 H.R. 2910, the Gun Violence Prevention and Reduction Act H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H Con Res 69, the Stop Harming Our Kids Resolution of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762, the Medicare Transitional Care Act of 2014 H.R. 4574, the Strengthening Mental Health in Our Communities Act H.R. 4783, the Promoting Healthy Minds for Safer Communities Act H.R. 4581, the Parental Control Act of 2014 H.R. 5353, the Medicaid Parity Act of 2014 H.R. 5136, the Breaking Addiction Act of 2014 H.R. 5587, the Opioid Abuse Prevention and Treatment Act of 2014 H.R. 5339, the Expanding Opportunities for Recovery Act of 2014 H.R. 5364: The CHIP Extension and Improvement Act of 2014

Client expense: $72,153 · Firm income: Not reported

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

1. H.R. 4035, S. 2046 to amend title XVIII of the Social Security Act to provide Medicare beneficiaries coordinated care and greater choice with regard to accessing hearing health services and benefits, specifically affording beneficiaries direct access to audiology services. 2. H.R. 1310, S. 236, Medicare Patient Empowerment Act, To amend title XVIII of the Social Security Act to establish a Medicare payment option for patients and physicians or practitioners (and specifically, audiologists) to freely contract, without penalty, for Medicare fee-for-service items and services, while allowing Medicare beneficiaries to use their Medicare benefits.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 236, Medicare Patient Empowerment Act: Private contracting for patients and physicians S. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB) S. 577, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training S. 972, Cutting Costly Codes Act Prohibit replacement of ICD-9 with ICD-10H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB)H.R. 574, Medicare Physician Payment Innovation Act of 2013: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 969, Medical Practice Freedom Act of 2013: Medical licensure H.R. 1180, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R.1201, Training Tomorrow's Doctors Today Act: Graduate medical education-residency training H.R. 1310, Medicare Patient Empowerment Act: Private contracting for patients and physicians H.R. 1333, Electronic Health Records Improvement Act: Electronic medical record penalties and incentive payments H.R.1701, Cutting Costly Codes Act Prohibit replacement of ICD-9 with ICD-10 H.R. 2810, Medicare Patient Access and Quality Improvement Act: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 4302, the Protecting Access to Medicare Act: Medicare physician payment-sustainable growth rate (SGR) reform H.R.4418: Expanding the Availability of Medicare Data Act: making Medicare data available for clinical data registries

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicare and Medicaid physician payments, comparative effectiveness research, quality reporting and improvement initiatives.Public Law 111-152, the Health Care and Education Reconciliation Act of 2010 - Implementation issues related to Medicare and Medicaid physician payments. Public Law 111-192 (H.R. 3962), the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Medicare physician payment issues. P.L. 112-096, the Middle Class Tax Relief and Job Creation Act of 2012 - issues related to Medicare and Medicaid physician payments. P.L. 112-240, the American Taxpayer Relief Act of 2012 - Medicare physician payment issues. S. 388, American Family Economic Protection Act of 2013 - sequestration issues affecting Medicare physician payments and drug reimbursement issues. H.R. 1310, Medicare Patient Empowerment Act of 2013, all provisions S. 236, Medicare Patient Empowerment Act, all provisions H.R. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, 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 The Medicare Payment Stability and Premium Security Act ( Draft bill) Medicare Program - Long term reform proposals for the Medicare physician payment system. Medicare Program - Regulatory and administrative issues with the Medicare physician formula. Medicare Program - Shared Savings/Accountable Care Organizations Medicare program - Value-based modifier Medicare program - Quality Reporting Programs Medicare program - New payment models/measuring quality performance Medicare and Medicaid programs - Burwell HHS nomination Medicaid program - Parity for primary care physician services Medicare program - Two-Midnight Rule Discussions concerning potential debt limit extension and deficit reduction legislation - physician payment issues. Public Law No: 113-46, Continuing Appropriations Act , 2014 - Medicare and Medicaid savings issues. Public Law 113-93 - The Protecting Access to Medicare Act of 2014 Discussions with congressional staff on misvalued coding issues.

Client expense: Not reported · Firm income: $75,000

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

S. 236, Medicare Patient Empowerment Act: Private contracting for patients and physicians S. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB) S. 577, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training S. 972, Cutting Costly Codes Act Prohibit replacement of ICD-9 with ICD-10H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB)H.R. 574, Medicare Physician Payment Innovation Act of 2013: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 969, Medical Practice Freedom Act of 2013: Medical licensure H.R. 1180, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R.1201, Training Tomorrow's Doctors Today Act: Graduate medical education-residency training H.R. 1310, Medicare Patient Empowerment Act: Private contracting for patients and physicians H.R. 1333, Electronic Health Records Improvement Act: Electronic medical record penalties and incentive payments H.R.1701, Cutting Costly Codes Act Prohibit replacement of ICD-9 with ICD-10 H.R. 2810, Medicare Patient Access and Quality Improvement Act: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 4302, the Protecting Access to Medicare Act: Medicare physician payment-sustainable growth rate (SGR) reform H.R.4418: Expanding the Availability of Medicare Data Act: making Medicare data available for clinical data registries

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See next page.Legislative: -Budget Sequestration Cuts (Senate, House, White House, CMS) -Medicare Physician Geographic Payment Locality Update (Senate, House, White House, CMS) -Medicare SGR and Alternative Physician Payment System (Senate, House) - Palliative Care Medical Home Authorization and Funding (Senate, House) -Graduate Medical Education: Expanding the number of residency positions (Senate, House) -H.R. Medicare Private Contracting -H.R. 2810 (Upton/Waxman) Medicare Patient Access and Quality Improvement Act of 2013 -H.R. 1310 (Price) Patient Empowerment Act -H.R. 1201 (Schock/Schwart) Training Tomorrows Doctors Today Act -S 577 (Nelson/Schumer/Reid) The Resident Physician Shortage Reduction Act of 2013 -H.R. 1180 (Crowley/Grimm) The Resident Physician Shortage Reduction Act of 2013 -H.R. 1761 (Terry/DeGette): Helping Ensure Life-and Limb-Saving Access to Podiatric Physicians Act -H.R. 4015/S. 2000 The SGR Repeal and Medicare Physician Payment Improvement Act -H.R. 4302 Protecting Access to Medicare Act of 2014 -H.R. 3402 The Protecting Access to Medicare Act of 2014 ICD-10 Coding System -S 2000/HR 4015 The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 -S 2694 (Murray & Brown) Ensuring Access to Primary Care for Women and Children Act -H.R. ## DRAFT Telehealth Promotion Act of 2014 (Thompson) -H.R. 3077 The Telemedicine for Medicare Act of 2013 Senate Finance Committee Legislation SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Reauthorization of the SCHIP State Childrens Health Insurance Program (Healthy Families in California). Regulatory: Medicare and Medicaid Part II Regulations-Hospital Conditions of Participation-Provisions to Promote Efficiency, Transparency and Burden Reduction. (Centers for Medicare and Medicaid Services -- CMS) Center for Medicare and Medicaid Services: Proposed 2014 Medicare Physician Payment Rule (CMS-1600-P). Methodological Changes for CY 2014 for Medicare Advantage Capitation Rates Medicare and Medicaid Part II, Provisions to Promote Program Efficiency, Transparency and Burden Reduction Medicaid Primary Care Rate Increase Implementation 2013-2014 Medicaid Payment Reduction - Federal & State Recoupment of the 10% Medicaid Physician Payment Rate Reduction (State Plan Amendment 11-009) Physicians Referrals to Health Care Entities with which they have Financial Relationships: Exception for certain Electronic Health Records Arrangements. (CMS-1454-F) Retroactive Recoupment of the State 10% Medi-Cal Physician Reimbursement Rate Cut. (CMS) 2015 Proposed Medicare Physician Payment Rule (CMS-1612-P)Medicaid, Childrens Health Insurance Programs and Exchanges: Essential Health Benefits in Alternate Benefit Programs, Eligibility Notices, Fair Hearing and Appeals Processes for Medicaid and Exchanges; Eligibility and Appeals and Other Provisions related to Enrollment and Medicaid Prevention and Cost Sharing (CMS). Medicaid Primary Care Rate Increase Implementation (CMS). Medicare-Medicaid Dual Eligibles Coordinated Care Demonstration Program (CMS). Medicare Contractor Transition from Palmetto to Noridian in California (CMS). Value Index Implementation (CMS). Two-Midnight Rule (CMS). Medicaid Primary Care Rate Increase Implementation Clarifications Verbal Orders clarification Medicare, Medicaid and SCHIP: Transparency Reports and Reporting Physician Ownership or Investment Interests -- (HHS). Modifications to the HIPAA Privacy Rules (HHS). -42 CFR Part 1001. Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor Under the Anti-Kickback Statute. (DOJ/OIG).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR713/S367 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) H.R. 3426/S.2818 Locum Tenens H.R. 1310 opt out

Client expense: $308,338 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 713/S. 367-Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) Payments to Physical Therapists under the Medicare Physician Fee Schedule Permanent Repeal of/alternatives to the Sustainable Growth Rate (SGR) Formula H.R. 574 Medicare Physician Payment Innovation ActOpposition of Multiple Procedure Payment Reduction for PT Services Physician Quality Reporting System H.R. 2914 Promoting Integrity in Medicare Act H.R. 1310 and S. 236 Medicare Patient Empowerment Act Prevention Initiatives for Fraud and Abuse in the Medicare program Accountable Care Organizations/Patient Centered Medical Homes Electronic Health Records/ Health Information Technology incentives for Physical Therapists Development of Alternatives to Medicare Therapy Cap Medicare Payment Reform Local Coverage Determinations NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National Priority for Research and Research Agenda Health Information Technology Medicare Physician Payment Innovation Act Functional Limitation Reporting Therapy Cap: Manual Medical Review Essential Health Benefits Sustainable Growth Rate Reform H.R. 1179/S. 569 Improving Access to Medicare Coverage Act Medicaid Essential Health Benefits EHR/LTPAC Settings: Transitions of Care Medicare Improvement Standards Bundled Payment Models Common assessment tool for Medicare post-acute care Medicare appeals process H.R. 3426 Prevent Interruptions in Physical Therapy Act/S.2818 H.R. 942 and S. 948 Ensuring Access to Quality Complex Rehabilitation Technology H.R. 2810 Medicare Patient Access and Quality Improvement Act Inclusion of physical therapists in quality programs in SGR Reform H.R. 4015 and S.2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 FTC Anti-competition Self-referral S.1871 SGR Repeal and Medicare Beneficiary Access Act S.2110 Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2157 Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act H.R.4302 Protecting Access to Medicare Act Statement for the record on Ways and Means Health Subcommittee Current Hospital Issues in Medicare H.R. 4755 Access to In-patient Rehabilitation Therapy Act H.R. 4994/S.2553 IMPACT Act Able Act Comments on CY2015 OPPS rule H.R. 5380 Medicare Telehealth Parity Act Comments on draft Fraud & Abuse Legislation

Client expense: $308,338 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

S. 153/H.R. 274 The Mental Health First Aid Act of 2013 S. 195/H.R. 628 The Mental Health in Schools Act of 2013 H.R. 1100 The Mental Health on Campus Improvement Act S. 264/H.R. 1263 The Excellence in Mental Health Act H.R. 794 To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574 The Medicare Physician Payment Innovation Act of 2013 S. 577/H.R. 1201 Training Tomorrows Doctors Today Act S. 236/H.R. 1310 the Medicare Patient Empowerment Act of 2013 H.R. 1331 The Electronic Health Records Improvement Act H.R. 1427 The Truth in Healthcare Marketing Act of 2013 S. 351/H.R. 351 The Protecting Seniors Access to Medicare Act of 2013 H.R. 297 The Childrens Hospital GME Support Reauthorization Act of 2013 S. 265 Community-Based Mental Health Improvements Act S. 648 Helping Educators Support All Students Act S.162 Justice and Mental Health Collaboration Act of 2013; S. 649 Safe Communities, Safe Schools Act of 2013 S. 2461 The CHIP Extension Act of 2014 S. 2728 The Community Based Medical Education Act H.R. 1615 A bill to provide for a study by the Institute of Medicine on gaps in mental health services and how these gaps can increase the risk of violent acts. H.R. 2037 The Native American Psychiatric and Mental Health Care Improvement Act H.R. 2545 The Accuracy in Medicare Physician Payment Act of 2013 S. 1064 Medicare Mental Health Access Act H.R. 2775 No Subsidies Without Verification Act H.R. 2810 The Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128 The Protect Patients Act of 2013 H.R. 2817 The Protect Patient Access to Quality Health Professionals Act of 2013 H.R. 2734 The Garrett Lee Smith Memorial Act Reauthorization of 2013 H.R. 2910 The Gun Violence Prevention and Reduction Act H.R. 3717 The Helping Families in Mental Health Crisis Act of 2013 H Con Res 69 The Stop Harming Our Kids Resolution of 2013 H.R. 4302 The Protecting Access to Medicare Act of 2014 H.R. 4015 The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 The Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 The Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762 The Medicare Transitional Care Act of 2014 H.R. 4574 The Strengthening Mental Health in Our Communities Act H.R. 4783 The Promoting Healthy Minds for Safer Communities Act H.R. 4581 The Parental Control Act of 2014 H.R. 5353 The Medicaid Parity Act of 2014 H.R. 5136 The Breaking Addiction Act of 2014 H.R. 5587 The Opioid Abuse Prevention and Treatment Act of 2014 H.R. 5339 The Expanding Opportunities for Recovery Act of 2014 H.R. 5364 The CHIP Extension and Improvement Act of 2014

Client expense: $71,176 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

S. 264/H.R. 1263 The Excellence in Mental Health Act H.R. 794 To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574 The Medicare Physician Payment Innovation Act of 2013 S. 577/H.R. 1201 Training Tomorrows Doctors Today Act S. 236/H.R. 1310 The Medicare Patient Empowerment Act of 2013 H.R. 1331 The Electronic Health Records Improvement Act S. 351/H.R. 351 The Protecting Seniors Access to Medicare Act of 2013 H.R. 297 The Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545 The Accuracy in Medicare Physician Payment Act of 2013 S. 1064 Medicare Mental Health Access Act H.R. 2810 The Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128 The Protect Patients Act of 2013 H.R. 3717 The Helping Families in Mental Health Crisis Act of 2013 H.R. 3662 The Mental Health Access Improvement Act of 2013 H.R. 4302 The Protecting Access to Medicare Act of 2014 H.R. 4015 The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 The Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 The Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762 The Medicare Transitional Care Act of 2014 H.R. 5353 The Medicaid Parity Act of 2014 H.R. 5136 The Breaking Addiction Act of 2014 H.R. 5339 The Expanding Opportunities for Recovery Act of 2014 H.R. 5587 The Opioid Abuse Prevention and Treatment Act of 2014 Proposed Rule for Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY 2015 (CMS-1612-P)

Client expense: $71,176 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

See next page.Legislative: -Budget Sequestration Cuts (Senate, House, White House, CMS) -Medicare Physician Geographic Payment Locality Update (Senate, House, White House, CMS) -Medicare SGR and Alternative Physician Payment System (Senate, House) - Palliative Care Medical Home Authorization and Funding (Senate, House) -Graduate Medical Education: Expanding the number of residency positions (Senate, House) -H.R. Medicare Private Contracting -H.R. 2810 (Upton/Waxman) Medicare Patient Access and Quality Improvement Act of 2013 -H.R. 1310 (Price) Patient Empowerment Act -H.R. 1201 (Schock/Schwart) Training Tomorrows Doctors Today Act -S 577 (Nelson/Schumer/Reid) The Resident Physician Shortage Reduction Act of 2013 -H.R. 1180 (Crowley/Grimm) The Resident Physician Shortage Reduction Act of 2013 -H.R. 1761 (Terry/DeGette): Helping Ensure Life-and Limb-Saving Access to Podiatric Physicians Act -H.R. 4015/S. 2000 The SGR Repeal and Medicare Physician Payment Improvement Act -H.R. 4302 Protecting Access to Medicare Act of 2014 -H.R. 3402 The Protecting Access to Medicare Act of 2014 ICD-10 Coding System Senate Finance Committee Legislation SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Regulatory: Medicare and Medicaid Part II Regulations-Hospital Conditions of Participation-Provisions to Promote Efficiency, Transparency and Burden Reduction. (Centers for Medicare and Medicaid Services -- CMS) Center for Medicare and Medicaid Services: Proposed 2014 Medicare Physician Payment Rule (CMS-1600-P). Methodological Changes for CY 2014 for Medicare Advantage Capitation Rates Medicare and Medicaid Part II, Provisions to Promote Program Efficiency, Transparency and Burden Reduction Medicaid Primary Care Rate Increase Implementation 2013-2014 Medicaid Payment Reduction - Federal & State Recoupment of the 10% Medicaid Physician Payment Rate Reduction (State Plan Amendment 11-009) Physicians Referrals to Health Care Entities with which they have Financial Relationships: Exception for certain Electronic Health Records Arrangements. (CMS-1454-F) Retroactive Recoupment of the State 10% Medi-Cal Physician Reimbursement Rate Cut. (CMS) Medicaid, Childrens Health Insurance Programs and Exchanges: Essential Health Benefits in Alternate Benefit Programs, Eligibility Notices, Fair Hearing and Appeals Processes for Medicaid and Exchanges; Eligibility and Appeals and Other Provisions related to Enrollment and Medicaid Prevention and Cost Sharing (CMS). Medicaid Primary Care Rate Increase Implementation (CMS). Medicare-Medicaid Dual Eligibles Coordinated Care Demonstration Program (CMS). Medicare Contractor Transition from Palmetto to Noridian in California (CMS). Value Index Implementation (CMS). Two-Midnight Rule (CMS). Medicare, Medicaid and SCHIP: Transparency Reports and Reporting Physician Ownership or Investment Interests -- (HHS). Modifications to the HIPAA Privacy Rules (HHS). -42 CFR Part 1001. Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor Under the Anti-Kickback Statute. (DOJ/OIG).

Client expense: $75,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

SGR/physician payment reform, IPAB repeal (S. 351/HR. 351), medical liability reform, electronic health records meaningful use reform (HR. 1331), private contracting for Medicare beneficiaries and their physicians (S. 236/HR. 1310), graduate medical education (S. 1152/HR. 1180/HR. 1201), clinical data registry reporting, combatting false advertising in health care (HR. 1427), insurance coverage for children with congenital deformities

Client expense: $145,000 · Firm income: Not reported

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

Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicare and Medicaid physician payments, comparative effectiveness research, quality reporting and improvement initiatives.Public Law 111-152, the Health Care and Education Reconciliation Act of 2010 - Implementation issues related to Medicare and Medicaid physician payments. Public Law 111-192 (H.R. 3962), the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Medicare physician payment issues. P.L. 112-096, the Middle Class Tax Relief and Job Creation Act of 2012 - issues related to Medicare and Medicaid physician payments. P.L. 112-240, the American Taxpayer Relief Act of 2012 - Medicare physician payment issues. S. 388, American Family Economic Protection Act of 2013 - sequestration issues affecting Medicare physician payments and drug reimbursement issues. H.R. 1310, Medicare Patient Empowerment Act of 2013, all provisions S. 236, Medicare Patient Empowerment Act, all provisions H.R. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, 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 The Medicare Payment Stability and Premium Security Act ( Draft bill) Medicare Program - Long term reform proposals for the Medicare physician payment system. Medicare Program - Regulatory and administrative issues with the Medicare physician formula. Medicare Program - Shared Savings/Accountable Care Organizations Medicare program - Value-based modifier Medicare program - Quality Reporting Programs Medicare program - New payment models/measuring quality performance Medicare and Medicaid programs - Burwell HHS nomination Medicaid program - Parity for primary care physician services Medicare program - Two-Midnight Rule Discussions concerning potential debt limit extension and deficit reduction legislation - physician payment issues. Public Law No: 113-46, Continuing Appropriations Act , 2014 - Medicare and Medicaid savings issues. P.L 113-67, Continuing Appropriations Resolution for 2014 - Medicare physician payments S.2000 - The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R.4015 -The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 Public Law 113-93 - The Protecting Access to Medicare Act of 2014

Client expense: Not reported · Firm income: $75,000

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

S. 236, Medicare Patient Empowerment Act: Private contracting for patients and physicians S. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB) S. 577, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training S. 972, Cutting Costly Codes Act Prohibit replacement of ICD-9 with ICD-10H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB)H.R. 574, Medicare Physician Payment Innovation Act of 2013: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 969, Medical Practice Freedom Act of 2013: Medical licensure H.R. 1180, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R.1201, Training Tomorrow's Doctors Today Act: Graduate medical education-residency training H.R. 1310, Medicare Patient Empowerment Act: Private contracting for patients and physicians H.R. 1333, Electronic Health Records Improvement Act: Electronic medical record penalties and incentive payments H.R.1701, Cutting Costly Codes Act Prohibit replacement of ICD-9 with ICD-10 H.R. 2810, Medicare Patient Access and Quality Improvement Act: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 4302, the Protecting Access to Medicare Act: Medicare physician payment-sustainable growth rate (SGR) reform H.R.4418: Expanding the Availability of Medicare Data Act: making Medicare data available for clinical data registries

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 236, Medicare Patient Empowerment Act: Private contracting for patients and physicians S. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB) S. 577, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training S. 972, Cutting Costly Codes Act Prohibit replacement of ICD-9 with ICD-10H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB)H.R. 574, Medicare Physician Payment Innovation Act of 2013: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 969, Medical Practice Freedom Act of 2013: Medical licensure H.R. 1180, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R.1201, Training Tomorrow's Doctors Today Act: Graduate medical education-residency training H.R. 1310, Medicare Patient Empowerment Act: Private contracting for patients and physicians H.R. 1333, Electronic Health Records Improvement Act: Electronic medical record penalties and incentive payments H.R.1701, Cutting Costly Codes Act Prohibit replacement of ICD-9 with ICD-10 H.R. 2810, Medicare Patient Access and Quality Improvement Act: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 4302, the Protecting Access to Medicare Act: Medicare physician payment-sustainable growth rate (SGR) reform H.R.4418: Expanding the Availability of Medicare Data Act: making Medicare data available for clinical data registries

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 153, H.R. 274, the Mental Health First Aid Act of 2013 S. 195, H.R. 628, the Mental Health in Schools Act of 2013 H.R. 1100, the Mental Health on Campus Improvement Act S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act H.R. 1427, the Truth in Healthcare Marketing Act of 2013 S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 S. 265, Community-Based Mental Health Improvements Act S. 648, Helping Educators Support All Students Act S.162, Justice and Mental Health Collaboration Act of 2013; S. 649, Safe Communities, Safe Schools Act of 2013 H.R. 1615, A bill to provide for a study by the Institute of Medicine on gaps in mental health services and how these gaps can increase the risk of violent acts. H.R. 2037, the Native American Psychiatric and Mental Health Care Improvement Act H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2775, No Subsidies Without Verification Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 2817, the Protect Patient Access to Quality Health Professionals Act of 2013 H.R. 2734, the Garrett Lee Smith Memorial Act Reauthorization of 2013 H.R. 2910, the Gun Violence Prevention and Reduction Act H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H Con Res 69, the Stop Harming Our Kids Resolution of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762, the Medicare Transitional Care Act of 2014 H.R. 4574, the Strengthening Mental Health in Our Communities Act H.R. 4783, the Promoting Healthy Minds for Safer Communities Act H.R. 4581, the Parental Control Act of 2014

Client expense: Not reported · Firm income: $196,673

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H.R. 3662, the Mental Health Access Improvement Act of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4762, the Medicare Transitional Care Act of 2014 Proposed Rule: Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System - Update for the Fiscal Year Beginning October 1, 2014 (FY 2015)(Vol. 79, Federal Register No. 87, 26040, May 6, 2014) Docket No. CMS-1606-P

Client expense: Not reported · Firm income: $196,673

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Protecting Seniors' Access to Medicare Act (HR 351/S 351) Medicare Physician Reimbursement Reform Medicare Patient Empowerment Act (HR 1310/S 236) Medicare Patient Access and Quality Improvement Act (HR 2810)

Client expense: $112,893 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR713/S367 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) H.R. 3426 Locum Tenens H.R. 1310 opt out

Client expense: $492,169 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 713/S. 367-Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) Payments to Physical Therapists under the Medicare Physician Fee Schedule Permanent Repeal of/alternatives to the Sustainable Growth Rate (SGR) Formula H.R. 574 Medicare Physician Payment Innovation ActOpposition of Multiple Procedure Payment Reduction for PT Services Physician Quality Reporting System H.R. 2914 Promoting Integrity in Medicare Act H.R. 1310 and S. 236 Medicare Patient Empowerment Act Prevention Initiatives for Fraud and Abuse in the Medicare program Accountable Care Organizations/Patient Centered Medical Homes Electronic Health Records/ Health Information Technology incentives for Physical Therapists Development of Alternatives to Medicare Therapy Cap Local Coverage Determinations NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National Priority for Research and Research Agenda Health Information Technology Medicare Physician Payment Innovation Act Functional Limitation Reporting Therapy Cap: Manual Medical Review Essential Health Benefits H.R. 1179/S. 569 Improving Access to Medicare Coverage Act Medicaid Essential Health Benefits EHR/LTPAC Settings: Transitions of Care Medicare Improvement Standards Bundled Payment Models Post-Acute Care Reform Common assessment tool for Medicare post-acute care Medicare appeals process H.R. 3426 Prevent Interruptions in Physical Therapy Act H.R. 942 and S. 948 Ensuring Access to Quality Complex Rehabilitation Technology H.R. 2810 Medicare Patient Access and Quality Improvement Act Inclusion of physical therapists in MIPS H.R. 4015 and S.2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 Post-Acute Care Reform Bill FTC Anti-competition Self-referral S.1871 SGR Repeal and Medicare Beneficiary Access Act S.2110 Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2157 Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act H.R.4302 Protecting Access to Medicare Act Medicare Advantage 2015 Call Letter Comment letter for FY 2015 IPPS: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals. 2-midnight criteria, short stays, observation status. FY 2015 LTCH Long Term Care Hospital Prospective Payment Systems proposed rule. 2-midnight criteria, short stays, observation status Improving Medicare Post Acute Care Transformation Act (IMPACT) H.R. 4994/S.2553 Comments on RFI Provider Non-discrimination Statement for the record on Ways and Means Health Subcommittee Current Hospital Issues in Medicare Exchange and Insurance Market Standards for 2015 and Beyond Comments: 90 day grace period and network adequecy Letter of Support for Medicare coverage of functional electrical stimulation (FES) devices for post-stroke foot drop Prior authorization for DME Locum tenens SNF&IRF PPS F2015

Client expense: $492,169 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 1310, S. 236, Medicare Patient Empowerment Act, To amend title XVIII of the Social Security Act to establish a Medicare payment option for patients and physicians or practitioners (and specifically, audiologists) to freely contract, without penalty, for Medicare fee-for-service items and services, while allowing Medicare beneficiaries to use their Medicare benefits.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicare and Medicaid physician payments, comparative effectiveness research, quality reporting and improvement initiatives.Public Law 111-152, the Health Care and Education Reconciliation Act of 2010 - Implementation issues related to Medicare and Medicaid physician payments. Public Law 111-192 (H.R. 3962), the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Medicare physician payment issues. P.L. 112-096, the Middle Class Tax Relief and Job Creation Act of 2012 - issues related to Medicare and Medicaid physician payments. P.L. 112-240, the American Taxpayer Relief Act of 2012 - Medicare physician payment issues. S. 388, American Family Economic Protection Act of 2013 - sequestration issues affecting Medicare physician payments and drug reimbursement issues. H.R. 1310, Medicare Patient Empowerment Act of 2013, all provisions S. 236, Medicare Patient Empowerment Act, all provisions H.R. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, 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 The Medicare Payment Stability and Premium Security Act ( Draft bill) Medicare Program - Long term reform proposals for the Medicare physician payment system. Medicare Program - Regulatory and administrative issues with the Medicare physician formula. Medicare Program - Shared Savings/Accountable Care Organizations Medicare program - Value-based modifier Medicare program - Quality Reporting Programs Medicare program - New payment models/measuring quality performance Medicare and Medicaid programs - Tavenner CMS nomination Medicaid program - Primary care bonus Discussions concerning potential debt limit extension and deficit reduction legislation - physician payment issues. Public Law No: 113-46, Continuing Appropriations Act , 2014 - Medicare and Medicaid savings issues. P.L 113-67, Continuing Appropriations Resolution for 2014 - Medicare physician payments S.2000 - The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R.4015 -The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 Public Law 113-93 - The Protecting Access to Medicare Act of 2014

Client expense: Not reported · Firm income: $75,000

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

H.R. 713/S. 367-Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) Payments to Physical Therapists under the Medicare Physician Fee Schedule Permanent Repeal of/alternatives to the Sustainable Growth Rate (SGR) Formula H.R. 574 Medicare Physician Payment Innovation ActOpposition of Multiple Procedure Payment Reduction for PT Services Physician Quality Reporting System H.R. 2914 Promoting Integrity in Medicare Act H.R. 1310 and S. 236 Medicare Patient Empowerment Act Locum Tenens Prevention Initiatives for Fraud and Abuse in the Medicare program Accountable Care Organizations/Patient Centered Medical Homes Electronic Health Records/ Health Information Technology incentives for Physical Therapists Development of Alternatives to Medicare Therapy Cap Medicare Payment Reform Local Coverage Determinations NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National Priority for Research and Research Agenda Health Information Technology :EHR Comments Medicare Physician Payment Innovation Act PFS PPS - Functional Limitation Reporting Therapy Cap: Manual Medical Review Essential Health Benefits Medicare Physician Fee Schedule Final Rule 2013 Sustainable Growth Rate Reform H.R. 1179/S. 569 Improving Access to Medicare Coverage Act Medicaid Essential Health Benefits EHR/LTPAC Settings: Transitions of Care Medicare Improvement Standards Bundled Payment Models Post-Acute Care Reform Common assessment tool for Medicare post-acute care Medicare appeals process H.R. 3426 Prevent Interruptions in Physical Therapy Act H.R. 942 and S. 948 Ensuring Access to Quality Complex Rehabilitation Technology H.R. 2810 Medicare Patient Access and Quality Improvement Act IRF setting proposed measures related to function based on the CARE PAC Tool elements comments Proposed LTCH Quality measures for patient function based on the CARE PAC data items for the LTCH setting. Inclusion of physical therapists in MIPS H.R. 4015 and S.2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 Post-Acute Care Reform Bill FTC Anti-competition Self-referral S.1871 SGR Repeal and Medicare Beneficiary Access Act S.2110 Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2157 Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act H.R.4302 Protecting Access to Medicare Act Medicare Advantage 2015 Call Letter

Client expense: $454,968 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

HR713/S367 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) H.R. 3426 Locum Tenens H.R. 1310 opt out

Client expense: $454,968 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

See next page.Legislative: -Budget Sequestration Cuts (Senate, House, White House, CMS) -Medicare Physician Geographic Payment Locality Update (Senate, House, White House, CMS) -Medicare SGR and Alternative Physician Payment System (Senate, House) - Palliative Care Medical Home Authorization and Funding (Senate, House) -Graduate Medical Education: Expanding the number of residency positions (Senate, House) -H.R. Medicare Private Contracting -H.R. 2810 (Upton/Waxman) Medicare Patient Access and Quality Improvement Act of 2013 -H.R. 1310 (Price) Patient Empowerment Act -H.R. 1201 (Schock/Schwart) Training Tomorrows Doctors Today Act -S 577 (Nelson/Schumer/Reid) The Resident Physician Shortage Reduction Act of 2013 -H.R. 1180 (Crowley/Grimm) The Resident Physician Shortage Reduction Act of 2013 -H.R. 1761 (Terry/DeGette): Helping Ensure Life-and Limb-Saving Access to Podiatric Physicians Act -H.R. 4015/S. 2000 The SGR Repeal and Medicare Physician Payment Improvement Act -H.R. 4302 Protecting Access to Medicare Act of 2014 ICD-10 Coding System Senate Finance Committee Legislation SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Regulatory: Medicare and Medicaid Part II Regulations-Hospital Conditions of Participation-Provisions to Promote Efficiency, Transparency and Burden Reduction. (Centers for Medicare and Medicaid Services -- CMS) Center for Medicare and Medicaid Services: Proposed 2014 Medicare Physician Payment Rule (CMS-1600-P). Methodological Changes for CY 2014 for Medicare Advantage Capitation Rates Medicare and Medicaid Part II, Provisions to Promote Program Efficiency, Transparency and Burden Reduction Medicaid Primary Care Rate Increase Implementation 2013-2014 Medicaid Payment Reduction - Federal & State Recoupment of the 10% Medicaid Physician Payment Rate Reduction (State Plan Amendment 11-009) Physicians Referrals to Health Care Entities with which they have Financial Relationships: Exception for certain Electronic Health Records Arrangements. (CMS-1454-F) Retroactive Recoupment of the State 10% Medi-Cal Physician Reimbursement Rate Cut. (CMS) Medicaid, Childrens Health Insurance Programs and Exchanges: Essential Health Benefits in Alternate Benefit Programs, Eligibility Notices, Fair Hearing and Appeals Processes for Medicaid and Exchanges; Eligibility and Appeals and Other Provisions related to Enrollment and Medicaid Prevention and Cost Sharing (CMS). Medicaid Primary Care Rate Increase Implementation (CMS). Medicare-Medicaid Dual Eligibles Coordinated Care Demonstration Program (CMS). Medicare Contractor Transition from Palmetto to Noridian in California (CMS). Value Index Implementation (CMS). Two-Midnight Rule (CMS). Medicare, Medicaid and SCHIP: Transparency Reports and Reporting Physician Ownership or Investment Interests -- (HHS). Modifications to the HIPAA Privacy Rules (HHS). -42 CFR Part 1001. Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor Under the Anti-Kickback Statute. (DOJ/OIG).

Client expense: $75,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

S. 236, Medicare Patient Empowerment Act: Private contracting for patients and physicians S. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB) S. 577, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB)H.R. 1180, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R.1201, Training Tomorrow's Doctors Today Act: Graduate medical education-residency training H.R. 1310, Medicare Patient Empowerment Act: Private contracting for patients and physicians H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 4302, the Protecting Access to Medicare Act of 2014: Medicare physician payment-sustainable grwoth rate (SGR) reform; ICD-10 delay; misvalued physician services No Bill: Preservation of in-office ancillary exception to Stark laws for ownership of imaging equipment

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 236, Medicare Patient Empowerment Act: Private contracting for patients and physicians S. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB) S. 577, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB)H.R. 1180, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R.1201, Training Tomorrow's Doctors Today Act: Graduate medical education-residency training H.R. 1310, Medicare Patient Empowerment Act: Private contracting for patients and physicians H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 4302, the Protecting Access to Medicare Act of 2014: Medicare physician payment-sustainable grwoth rate (SGR) reform; ICD-10 delay; misvalued physician services No Bill: Preservation of in-office ancillary exception to Stark laws for ownership of imaging equipment

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program.H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 3717, The Helping Families in Mental Health Crisis Act of 2013 H.R. 3662, the Mental Health Access Improvement Act of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 Final Rule for Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY 2014 ID #: CMS-2013-0155-10181 Proposals for Revising the Part D Classes of Clinical Concern and Revoking Physicians Medicare Enrollment ID#: CMS-4159 P

Client expense: $120,576 · Firm income: Not reported

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

S. 153, H.R. 274, the Mental Health First Aid Act of 2013 S. 195, H.R. 628, the Mental Health in Schools Act of 2013H.R. 1100, the Mental Health on Campus Improvement Act S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act H.R. 1427, the Truth in Healthcare Marketing Act of 2013 S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 S. 265, Community-Based Mental Health Improvements Act S. 648, Helping Educators Support All Students Act S.162, Justice and Mental Health Collaboration Act of 2013; S. 649, Safe Communities, Safe Schools Act of 2013 H.R. 1615, A bill to provide for a study by the Institute of Medicine on gaps in mental health services and how these gaps can increase the risk of violent acts. H.R. 2037, the Native American Psychiatric and Mental Health Care Improvement Act H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2775, No Subsidies Without Verification Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 2817, the Protect Patient Access to Quality Health Professionals Act of 2013 H.R. 2734, the Garrett Lee Smith Memorial Act Reauthorization of 2013 H.R. 2910, the Gun Violence Prevention and Reduction Act H.R. 3717, The Helping Families in Mental Health Crisis Act of 2013 H. Con Res 69, the Stop Harming Our Kids Resolution of 2013 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122, the Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

Client expense: $120,576 · Firm income: Not reported

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

Protecting Seniors' Access to Medicare Act (HR 351/S 351) Medicare Physician Reimbursement Reform Medicare Patient Empowerment Act (HR 1310/S 236) Medicare Patient Access and Quality Improvement Act (HR 2810)

Client expense: $26,518 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 2019 Gabriella Miller Kids First Research Act H.R. 1037 Occupational Therapy in Mental Health Act H.R. 1178 Creating Access to Residency Education Act of 2013H.R. 1180 Resident Physician Shortage Reduction Act of 2013 H.R. 1201 Training Tomorrow's Doctors Act H.R. 1252 Physical Therapist Workforce and Patient Access Act of 2013 H.R. 1274 Access to Quality Diabetes Education Act of 2013 H.R. 1326 Health Care Price Transparency Promotion Act of 2013 H.R. 1339 Palliative Care and Hospice Education and Training Act H.R. 1427 Truth in Healthcare Marketing Act of 2013 H.R. 1790 Health IT Modernization for Underserved Communities Act of 2013 H.R. 1814 Equitable Access to Care and Health (EACH) Act H.R. 1821 Registered Nurse Safe Staffing Act of 2013 H.R. 1827 Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 1838 Enhanced Access to Medicaid Services Act of 2013 H.R. 1874 Pro-Growth Budgeting Act H.R. 1907 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2013 H.R. 1976 Access to Certified Professional Midwives Act of 2013 H.R. 2131 Supplying Knowledge-based Immigrants and Lifting Levels of STEM (SKILLS) Visas Act of 2013 H.R. 235 Veteran Emergency Medical Technician Support Act of 2013 H.R. 2415 Treat and Reduce Obesity Act H.R. 244 Physician Availability Act of 2013 H.R. 2453 Medicare Beneficiary Preservation of Choice Act of 2013 H.R. 2484 Conrad State 30 and Physician Access Act H.R. 2619 Medicare Repiratory Therapist Access Act of 2013 H.R. 2651 Critical Care Assessment and Improvement Act of 2013 H.R. 2663 Preventive Health Savings Act H.R. 2801 Protecting Access to Rural Therapy Services (PARTS) Act H.R. 2810 Medicare Patient Access and Quality Improvement Act of 2013 H.R. 2843/S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 2867 Medicare Hospice Care Access Act of 2013 H.R. 2969 Medicare Patient Access to Hospice Act of 2013 H.R. 297 Children's Hospital GME Support Reauthorization Act of 2013 H.R. 2986 Protecting Access to Primary Care Act H.R. 3077 TELEmedicine for MEDicare Act of 2013 or TELE-MED Act of 2013 H.R. 3120 Comprehensive Dental Reform Act of 2013 H.R. 3303 Sensible Oversight for Technology which Advances Regulatory Efficiency (SOFTWARE) Act H.R. 3306 Telehealth Enhancement Act of 2013 H.R. 3362, Exchange Information Disclosure Act H.R. 3392 Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013 H.R. 3474 Hire More Heroes Act of 2013 H.R. 3507 21st Century Care for Military and Veterans Act H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H.R. 3811, Health Exchange Security and Transparency Act H.R. 3979 Protecting Volunteer Firefighters and Emergency Responders Act of 2014 H.R. 4106, Barr-Bera Saving Lives, Saving Costs Act H.R. 4118, The SIMPLE Fairness Act H.R. 4160 - the "Keep the Promise to Seniors Act of 2014." H.R. 4177: a bill to amend the Internal Revenue Code of 1986 to Allow Medicare beneficiaries participating in a Medicare Advantage MSA to contribute their own money to their MSA. H.R. 4180: a bill to amend the Internal Revenue Code of 1986 to permit rollovers from health savings accounts to Medicare Advantage MSAs H.R. 4196: Seniors' Fairness Act of 2014H.R. 4201: Seniors' Rights to Know Act H.R. 487 Primary Care Workforce Access Improvement Act of 2013 H.R. 574 Medicare Physician Payment Innovation Act of 2013 H.R. 7, No Taxpayer Funding for Abortion Act H.R. 794 To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 962 Medicare Diabetes Prevention Act H.R. 2575, the "Save American Workers Act of 2014," H.R. 4064, FAIR ACT of 2014 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.RES.356 A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States. H.R.1024 The Medication Therapy Management Empowerment Act IMPACT Act of 2014 (Improving Medicare Post-Acute Care Transformation Act of 2014) S. 1060 Veterans to Paramedics Transition Act S. 1061 Veterans Access to Care Act S. 1064 Medicare Mental Health Access Act S. 1143 Protecting Access to Rural Therapy Services (PARTS) Act S. 1152 Building a Health Care Workforce for the Future Act S. 1184 Treat and Reduce Obesity Act S. 1193 Data Security and Breach Notification Act of 2013 S. 1228 Medicare Better Health Rewards Program Act S. 1422 Preventive Health Savings Act S. 1439 Care Planning Act of 2013 S. 1444 Medicare Access to Rural Anesthesiology Act of 2013 S. 1445 National Health Service Corps Improvement Act of 2013 S. 1475 National Nurse Act of 2013 S. 1517 Behavioral Health Information Technology Act of 2013 S. 1522 Comprehensive Dental Reform Act of 2013 S. 1557 Children's Hospital GME Support Reauthorization Act of 2013 S. 1685 Behavioral Health Information Technology Coordination Act of 2013 S. 1729 - Expanded Consumer Choice Act S. 1758 Quality Data, Quality Healthcare Act of 2013 S. 1871, SGR Repeal and Medicare Beneficiary Improvement Act of 2013 S. 2000/H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2007, Preventing Regulatory Overreach To Enhance Care Technology Act of 2014 (PROTECT Act) S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2166 Treating Families Fairly Act S. 2168 amends the definition from 50 100 employees for the purposes of the employer mandate S. 2173 the CHOICE Act S. 2175 Enhancing Access to Agents and Brokers Act S. 2240 The Medicare Choices Empowerment and Protection Act S. 236 Medicare Patient Empowerment Act S. 328 Strengthening Rural Access to Emergency Services Act S. 382 A bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs.S. 452 Medicare Diabetes Prevention Act S. 557 The Medication Therapy Management Empowerment Act S. 577 The Resident Physician Shortage Reduction Act of 2013 S. 602 Physical Therapist Workforce and Patient Access Act of 2013 S. 616 Conrad State 30 and Physician Access Act S. 641 Palliative Care and Hospice Education and Training Act S. 739 National Nursing Shortage Reform and Patient Advocacy Act S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act S. 755 Enhanced Access to Medicaid Services Act of 2013 S. 945 Access to Quality Diabetes Education Act of 2013 S.1067 Innovation Inspiration School Grant Program Act S.1897 Personal Data Privacy and Security Act of 2014 S.1927 The Data Security Act of 2014 S.1932/H.R. 3890 The Better Care, Lower Cost Act S.1976 Data Security and Breach Notification Act of 2014 S.1995 Personal Data Protection and Breach Accountability Act S.2106, FAIR Act of 2014 S.236 / H.R. 1310 - Medicare Patient Empowerment Act of 2013 S.577 Resident Physician Shortage Reduction Act of 2013 S.RES.26 A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.

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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S.236 / H.R. 1310 - Medicare Patient Empowerment Act of 2013 S. 755 Enhanced Access to Medicaid Services Act of 2013 S. 641 Palliative Care and Hospice Education and Training Act S. 452 Medicare Diabetes Prevention ActS. 2240 The Medicare Choices Empowerment and Protection Act S. 236 Medicare Patient Empowerment Act S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.1932/H.R. 3890 The Better Care, Lower Cost Act S. 2000/H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 1871, SGR Repeal and Medicare Beneficiary Improvement Act of 2013 S. 1439 Care Planning Act of 2013 S. 1444 Medicare Access to Rural Anesthesiology Act of 2013 S. 1228 Medicare Better Health Rewards Program Act S. 1064 Medicare Mental Health Access Act IMPACT Act of 2014 (Improving Medicare Post-Acute Care Transformation Act of 2014) H.R. 4302, the Protecting Access to Medicare Act of 2014 H.R. 962 Medicare Diabetes Prevention Act H.R. 574 Medicare Physician Payment Innovation Act of 2013 H.R. 4160 - the "Keep the Promise to Seniors Act of 2014." H.R. 3392 Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013 H.R. 3077 TELEmedicine for MEDicare Act of 2013 (TELE-MED Act of 2013) H.R. 2810 Medicare Patient Access and Quality Improvement Act of 2013 H.R. 2843/S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 2867 Medicare Hospice Care Access Act of 2013 H.R. 2969 Medicare Patient Access to Hospice Act of 2013 H.R. 2619 Medicare Repiratory Therapist Access Act of 2013 H.R. 1838 Enhanced Access to Medicaid Services Act of 2013 S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicare and Medicaid physician payments, comparative effectiveness research, quality reporting and improvement initiatives.Public Law 111-152, the Health Care and Education Reconciliation Act of 2010 - Implementation issues related to Medicare and Medicaid physician payments. Public Law 111-192 (H.R. 3962), the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Medicare physician payment issues. P.L. 112-096, the Middle Class Tax Relief and Job Creation Act of 2012 - issues related to Medicare and Medicaid physician payments. P.L. 112-240, the American Taxpayer Relief Act of 2012 - Medicare physician payment issues. H. Con. Res. 25, Establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023; and S.Con.Res. 8, An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023 - Medicare physician payment and drug reimbursement issues. S. 388, American Family Economic Protection Act of 2013 - sequestration issues affecting Medicare physician payments and drug reimbursement issues. H.R. 1310, Medicare Patient Empowerment Act of 2013, all provisions S. 236, Medicare Patient Empowerment Act, all provisions H.R. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, 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 The Medicare Payment Stability and Premium Security Act ( Draft bill) Medicare Program - Long term reform proposals for the Medicare physician payment system. Medicare Program - Regulatory and administrative issues with the Medicare physician formula. Medicare Program - Shared Savings/Accountable Care Organizations Medicare program - Value-based modifier Medicare program - Quality Reporting Programs Medicare program - New payment models/measuring quality performance Medicare and Medicaid programs - Tavenner CMS nomination Medicaid program - Primary care bonus Discussions concerning potential debt limit extension and deficit reduction legislation - physician payment issues. Public Law No: 113-46, Continuing Appropriations Act , 2014 - Medicare and Medicaid savings issues. P.L 113-67, Continuing Appropriations Resolution for 2014 - Medicare physician payments S. 1871, the SGR Repeal and Medicare Beneficiary Access Act - Medicare physician payment issues. H.R. 2810, the Medicare Patient Access and Quality Improvement Act - Medicare physician payment issues. Meetings with CMS staff concerning reimbursement for anesthesiology and pediatric subspecialty services under the 2014 physician fee schedule rule.

Client expense: Not reported · Firm income: $75,000

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

S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program.H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 3717, The Helping Families in Mental Health Crisis Act of 2013 H.R. 3662, the Mental Health Access Improvement Act of 2013

Client expense: $294,640 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 153, H.R. 274, the Mental Health First Aid Act of 2013 S. 195, H.R. 628, the Mental Health in Schools Act of 2013H.R. 1100, the Mental Health on Campus Improvement Act S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act H.R. 1427, the Truth in Healthcare Marketing Act of 2013 S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 S. 265, Community-Based Mental Health Improvements Act S. 648, Helping Educators Support All Students Act S.162, Justice and Mental Health Collaboration Act of 2013; S. 649, Safe Communities, Safe Schools Act of 2013 H.R. 1615, A bill to provide for a study by the Institute of Medicine on gaps in mental health services and how these gaps can increase the risk of violent acts. H.R. 2037, the Native American Psychiatric and Mental Health Care Improvement Act H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2775, No Subsidies Without Verification Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 H.R. 2817, the Protect Patient Access to Quality Health Professionals Act of 2013 H.R. 2734, the Garrett Lee Smith Memorial Act Reauthorization of 2013 H.R. 2910, the Gun Violence Prevention and Reduction Act H.R. 3717, The Helping Families in Mental Health Crisis Act of 2013 H. Con Res 69, the Stop Harming Our Kids Resolution of 2013

Client expense: $294,640 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to improving healthcare policy, including relevant provisions in H.R. 1310/S. 236, the Medicare Patient Empowerment Act of 2013.

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

S. 236, Medicare Patient Empowerment Act: Private contracting for patients and physicians S. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB) S. 577, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB)H.R. 574, Medicare Physician Payment Innovation Act of 2013: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 969, Medical Practice Freedom Act of 2013: Medical licensure H.R. 1180, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R.1201, Training Tomorrow's Doctors Today Act: Graduate medical education-residency training H.R. 1310, Medicare Patient Empowerment Act: Private contracting for patients and physicians H.R. 1333, Electronic Health Records Improvement Act H.R. 2810, Medicare Patient Access and Quality Improvement Act, Medicare physician payment-sustainable growth rate (SGR) reform

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 236, Medicare Patient Empowerment Act: Private contracting for patients and physicians S. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB) S. 577, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R. 351, Protecting Seniors' Access to Medicare Act of 2013: Repeal of the Independent Payment Advisory Board (IPAB)H.R. 574, Medicare Physician Payment Innovation Act of 2013: Medicare physician payment-sustainable growth rate (SGR) reform H.R. 969, Medical Practice Freedom Act of 2013: Medical licensure H.R. 1180, Resident Physician Shortage Reduction Act of 2013: Graduate medical education-residency training H.R.1201, Training Tomorrow's Doctors Today Act: Graduate medical education-residency training H.R. 1310, Medicare Patient Empowerment Act: Private contracting for patients and physicians H.R. 1333, Electronic Health Records Improvement Act: Electronic medical record penalties and incentive payments H.R. 2810, Medicare Patient Access and Quality Improvement Act: Medicare physician payment-sustainable growth rate (SGR) reform

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013 , all provisions S. 1871, SGR Repeal and Medicare Beneficiary Access 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 provisionsH.R. 1701, Cutting Costly Codes Act of 2013, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, 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 H.R. 1310, Medicare Patient Empowerment Act of 2013, all provisions S. 236, Medicare Patient Empowerment Act, all provisions H.R. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions Medicare program - Sustainable Growth Rate (SGR) Repeal Medicare program - Private Contracting Medicare program - Graduate Medical Education Medicare program - Independent Payment Advisory Board (IPAB) Repeal Medicare program - 2014 Physician Fee Schedule Medicare program - Value-Based Modifier Medicare program - Medicare Quality Improvement Medicare program - ICD-10 Repeal Medicare program - Relative Value Scale Update Committee (RUC) Medicare program - Program Integrity Medicare program - Enrollment Medicare program - Payment Models Medicare program - Funding for quality measure development Medicare program - Delivery and payment reform Medicare program - Accountable Care Organizations exclusivity Medicare program - In-Office Ancillary Services Exception Medicare program - Medicare Advantage narrow networks Medicare program - Regulatory Reform Medicare program - Recovery Audit Contractors (RACs) Medicare program - Sunshine Act Medicare program - Data Medicare program - Cost of care measures Medicare program - Care Coordination Medicare program - Physician Compare Medicare program - Registries Medicare program - HIPAA Medicare program - PQRS Medicare program - Two Midnight policy Medicare program - Administrative Simplification/HIPAA issues Medicare program - HIPAA privacy/security/breach notification and accounting for disclosures Medicare program - EHR usability/certification Medicare program - MoPath Codes Medicare program - Network adequacy issues Medicare and Medicaid programs - Mental Health Reform Medicare and Medicaid programs - Electronic Health Records - Meaningful Use Regulations Medicaid program - Primary care bonus

Client expense: $4,240,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), President of the U.S., SENATE, U.S. Trade Representative (USTR), White House Office

H.R. 713/S. 367-Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) Payments to Physical Therapists under the Medicare Physician Fee Schedule Permanent Repeal of/alternatives to the Sustainable Growth Rate (SGR) Formula H.R. 574 Medicare Physician Payment Innovation ActOpposition of Multiple Procedure Payment Reduction for PT Services Physician Quality Reporting System H.R. 2914 Promoting Integrity in Medicare Act H.R. 1310 and S. 236 Medicare Patient Empowerment Act Locum Tenens Prevention Initiatives for Fraud and Abuse in the Medicare program Accountable Care Organizations/Patient Centered Medical Homes Electronic Health Records/ Health Information Technology incentives for Physical Therapists Development of Alternatives to Medicare Therapy Cap Medicare Payment Reform Local Coverage Determinations NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National Priority for Research and Research Agenda Health Information Technology :EHR Comments Medicare Physician Payment Innovation Act PFS PPS - Functional Limitation Reporting Therapy Cap: manual Medical Review Essential Health Benefits Medicare Physician Fee Schedule Final Rule 2013 Sustainable Growth Rate Reform H.R. 1179/S. 569 Improving Access to Medicare Coverage Act Medicaid Essential Health Benefits EHR/LTPAC Settings: Transitions of Care Medicare Part B Inpatient Billing Proposed Rule Comments Nerve Conduction Studies and EMG LCD Comments for various MACs 2013 EMG Payment Reductions Medicare Improvement Standards Bundled Payment Models Post-Acute Care Reform Common assessment tool for Medicare post-acute care Manual Medical Review Medicare appeals process H.R. 3426 Prevent Interruptions in Physical Therapy Act Debt ceiling package 2014 OPPS Rule 2014 IPPS rule NCD to add CHF to cardiac rehabilitation H.R. 942 and S. 948 Ensuring Access to Quality Complex Rehabilitation Technology H.R. 2810 Medicare Patient Access and Quality Improvement Act

Client expense: $455,858 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

HR713/S367 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) H.R. 3426 Locum Tenens H.R. 1310 opt out

Client expense: $455,858 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

See next page.Legislative: -Budget Sequestration Cuts (Senate, House, White House, CMS) -Medicare Physician Geographic Payment Locality Update (Senate, House, White House, CMS) -Medicare SGR and Alternative Physician Payment System (Senate, House) - Palliative Care Medical Home Authorization and Funding (Senate, House) -Graduate Medical Education: Expanding the number of residency positions (Senate, House) -H.R. Medicare Private Contracting -H.R. 2810 (Upton/Waxman) Medicare Patient Access and Quality Improvement Act of 2013 -H.R. 1310 (Price) Patient Empowerment Act -H.R. 1701 (Roe)/ S 954 (Coburn) ICD-10 Coding System -H.R. 1201 (Schock/Schwart) Training Tomorrows Doctors Today Act -S 577 (Nelson/Schumer/Reid) The Resident Physician Shortage Reduction Act of 2013 -H.R. 1180 (Crowley/Grimm) The Resident Physician Shortage Reduction Act of 2013 -H.R. 1761 (Terry/DeGette): Helping Ensure Life-and Limb-Saving Access to Podiatric Physicians Act Senate Finance Committee Legislation SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Regulatory: Medicare and Medicaid Part II Regulations-Hospital Conditions of Participation-Provisions to Promote Efficiency, Transparency and Burden Reduction. (Centers for Medicare and Medicaid Services -- CMS) Center for Medicare and Medicaid Services: Proposed 2014 Medicare Physician Payment Rule (CMS-1600-P). Methodological Changes for CY 2014 for Medicare Advantage Capitation Rates Medicare and Medicaid Part II, Provisions to Promote Program Efficiency, Transparency and Burden Reduction Medicaid Primary Care Rate Increase Implementation 2013-2014 Medicaid Payment Reduction - Federal & State Recoupment of the 10% Medicaid Physician Payment Rate Reduction (State Plan Amendment 11-009) Physicians Referrals to Health Care Entities with which they have Financial Relationships: Exception for certain Electronic Health Records Arrangements. (CMS-1454-F) Retroactive Recoupment of the State 10% Medi-Cal Physician Reimbursement Rate Cut. (CMS) Medicaid, Childrens Health Insurance Programs and Exchanges: Essential Health Benefits in Alternate Benefit Programs, Eligibility Notices, Fair Hearing and Appeals Processes for Medicaid and Exchanges; Eligibility and Appeals and Other Provisions related to Enrollment and Medicaid Prevention and Cost Sharing -- (CMS). Medicaid Primary Care Rate Increase Implementation (CMS). Medicare-Medicaid Dual Eligibles Coordinated Care Demonstration Program (CMS). Medicare Contractor Transition from Palmetto to Noridian in California (CMS). Medicare, Medicaid and SCHIP: Transparency Reports and Reporting Physician Ownership or Investment Interests -- (HHS). Modifications to the HIPAA Privacy Rules (HHS). -42 CFR Part 1001. Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor Under the Anti-Kickback Statute. (DOJ/OIG).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 2810 Medicare Patient Access and Quality Improvement Act; Draft, Senate bill to reform sustainable growth rate and Medicare physician payment formu; Monitor implementation, P.L. 111-148; Extension, Section 3111, P.L. 111-148; H.R. 1416 Cancer Patient Protection Act; H.R. 351 / S. 351 Protecting Access to Medicare Act; H.R. 800 Exclude prompt pay discounts; H.R. 1310 / S. 236 Medicare Patient Empowerment Act; H.R. 2305 / S. 1123 Preventing and Reducing Improper Medicare Expenditures Act

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

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