Health Care Price Transparency Promotion Act of 2013

S. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013 H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts S. 24, the Small Business Health Relief Act of 2013 H.R. 956, the Personal Health Investment Today Act of 2013 H.R. 1140, the Family Friendly HSA Improvement Act of 2013 H.R. 1342, the Helping American's Health Care Choices Act of 2013 H.R. 1326, the Health Care Price Transparency Promotion Act of 2013 S. 610/H.R. 1248, the Family Health Care Flexibility Act H.R. 1552, the Health Freedom for Seniors Act S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013 H.R. 2688, the PATIENT Health Care Act H.R. 2835, the Restoring Access to Medication Act of 2013 H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts

Client expense: $2,418,000 · Firm income: Not reported

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

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

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

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

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

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

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961 Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins(R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it.

Client expense: $4,270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE

Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act Supported S 2205, the Small Business Fairness in Health Care Act

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

H.R. 1326, Health Care Price Transparency Promotion Act (Burgess) - price transparency H.R. 1701, Cutting Costly Codes Act (Poe) - ICD-10 implementation H.R. 2853, Hospital Price Transparency and Disclosure Act (Lipinski) - transparency of hospital prices H.R. 3077, TELE-MED Act (Nunes-Pallone) - telemedicine H.R. 3750, Telehealth Modernization Act (Matsui-Johnson) - telemedicine H.R. 4302, Protecting Access to Medicare Act (Pitts) - ICD-10 Implementation S. 44, Medical Care Access Protection Act (Portman) - medical liability reform S. 972, Cutting Costly Codes Act (Coburn) - ICD-10 implementation S. 1897, Personal Data Privacy and Security Act (Leahy) - privacy, data security issues Labor, HHS, and Education Appropriations Bill (Harkin) - funding for HHS programs, ACA amendments HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; OPM data warehouse for FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment (commonly referred to as the 3 Rs); dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters for 2014; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, and issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to the federally-facilitated marketplaces (i.e., Exchanges) and other issues relating to health care reform implementation.

Client expense: $2,010,000 · Firm income: Not reported

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

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

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

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

H.R. 1326, Health Care Price Transparency Promotion Act (Burgess) - price transparency. H.R. 1701, Cutting Costly Codes Act (Poe) - ICD-10 implementation. H.R. 2853, Hospital Price Transparency and Disclosure Act (Lipinski) - transparency of hospital prices. H.R. 3077, TELE-MED Act (Nunes-Pallone) - telemedicine. H.R. 3750, Telehealth Modernization Act (Matsui-Johnson) - telemedicine. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ICD-10 Implementation. S. 44, Medical Care Access Protection Act (Portman) - medical liability reform. S. 972, Cutting Costly Codes Act (Coburn) - ICD-10 implementation. S. 1897, Personal Data Privacy and Security Act (Leahy) - privacy, data security issues. Labor, HHS, and Education Appropriations Bill (Harkin) - funding for HHS programs, ACA amendments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015

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

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

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015

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

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

See addendum.S. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013 H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts. S. 24, the Small Business Health Relief Act of 2013 H.R. 956, the Personal Health Investment Today Act of 2013 H.R. 1140, the Family Friendly HSA Improvement Act of 2013 H.R. 1342, the Helping American's Health Care Choices Act of 2013 H.R. 1326, the Health Care Price Transparency Promotion Act of 2013 S. 610/H.R. 1248, the Family Health Care Flexibility Act H.R. 1552, the Health Freedom for Seniors Act S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013 H.R. 2688, the PATIENT Health Care Act H.R. 2835, the Restoring Access to Medication Act of 2013 H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts.

Client expense: $2,560,000 · Firm income: Not reported

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act of 2014 Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins (R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 4067, to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it.

Client expense: $4,370,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE

H.R. 1326, Health Care Price Transparency Promotion Act (Burgess) price transparency16. Specific Lobbying Issues (continued): H.R. 1701, Cutting Costly Codes Act (Poe) ICD-10 implementation H.R. 2853, Hospital Price Transparency and Disclosure Act (Lipinski) transparency of hospital prices H.R. 3077, TELE-MED Act (Nunes-Pallone) telemedicine H.R. 4302, Protecting Access to Medicare Act (Pitts) ICD-10 Implementation S. 44, Medical Care Access Protection Act (Portman) medical liability reform S. 972, Cutting Costly Codes Act (Coburn) ICD-10 implementation S. 1897, Personal Data Privacy and Security Act (Leahy) privacy, data security issues Labor, HHS, and Education Appropriations Bill (Harkin) funding for HHS programs, ACA amendments Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; OPM data warehouse for FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; prescription drug pricing; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment (commonly referred to as the 3 Rs); dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters for 2014; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, and issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to the federally-facilitated marketplaces (i.e., Exchanges) and other issues relating to health care reform implementation.

Client expense: $2,530,000 · Firm income: Not reported

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

Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments Medicare and Medicaid paymentMedicaid Waivers Extension of Medicare Sustainable Growth Rate Medicare Evaluation and Management Reimbursement Reduction Proposal Issues related to waste, fraud, and abuse in Medicaid Medicare Disproportionate Share Hospital Payments H.R. 574 Medicare Physician Payment Innovation Act of 2013, all provisions H.R. 1853 Medicaid Accountability and Care Act, all provisions H.R. 574 Medicare Physician Payment Act, all provisions 5.577/H.R. 1180 Resident Physician Shortage Reduction Act, all provisions H.R. 1201 Training Tomorrow's Doctors Act, all provisions H.R. 1250/S.1012 Medicare Audit Improvement Act, all provisions H.R. 1487 Improved Healthcare at a Lower Cost Act, all provisions H.R. 1698 Stabilize Medicaid and CHIP Coverage, all provisions H.R. 1326 Health Care Price Transparency Promotion Act, all provisions H.R. 1920 DSH Reduction Relief Act, all provisions Issues related to Medicaid enrollment of newborns CMS FY2014 Hospital Inpatient Prospective Payment System Rule S.1555 DSH Reduction Relief Act of 2013, all provisions S.1871 SGR Repeal and Medicare Beneficiary Access Act, all sections H.R. 2810 Medicare Patient Access and Quality Improvement Act, all sections H.R. 4302 Protecting Access to Medicare Act, all sections H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act S. 1980 Medicaid and CHIP Continuous Quality Act H.R. 3678 Two-Midnight Rule Delay Act - all sections H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 2082 Two-Midnight Rule Coordination and Improvement Act S. 2501 Hospitals Readmissions Program Accuracy and Accountability Act, all sections Issues related to quality measures reporting in Medicaid S. 2461 CHIP Extension act of 2014, all provisions Issues related to Medicare payment for patients in "observation status" in hospitals CMS FY 2014 Outpatient Prospective Payment System Rule Issues related to Medicare Recovery Audit Contractors S. 2941 Medicare Protection Act, all Provisions Extension of SSA 1902 (a) (b) (c) - Medicaid Primary Care payment parity

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

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

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014

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

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

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014

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

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

H.R. 1326, Health Care Price Transparency Promotion Act (Burgess) - price transparency. H.R. 1701, Cutting Costly Codes Act (Poe) - ICD-10 implementation. H.R. 2853, Hospital Price Transparency and Disclosure Act (Lipinski) - transparency of hospital prices. H.R. 3077, TELE-MED Act (Nunes-Pallone) - telemedicine. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ICD-10 Implementation. S. 44, Medical Care Access Protection Act (Portman) - medical liability reform. S. 972, Cutting Costly Codes Act (Coburn) - ICD-10 implementation. S. 1897, Personal Data Privacy and Security Act (Leahy) - privacy, data security issues. Labor, HHS, and Education Appropriations Bill (Harkin) - funding for HHS programs, ACA amendments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See addendum.S. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013 H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts S. 24, the Small Business Health Relief Act of 2013 H.R. 956, the Personal Health Investment Today Act of 2013 H.R. 1140, the Family Friendly HSA Improvement Act of 2013 H.R. 1342, the Helping American's Health Care Choices Act of 2013 H.R. 1326, the Health Care Price Transparency Promotion Act of 2013 S. 610/H.R. 1248, the Family Health Care Flexibility Act H.R. 1552, the Health Freedom for Seniors Act S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013 H.R. 2688, the PATIENT Health Care Act H.R. 2835, the Restoring Access to Medication Act of 2013 H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts

Client expense: $1,960,000 · Firm income: Not reported

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

Supported the Senate confirmation of Sylvia Mathews Burwell to be the Secretary of Health and Human Services. Monitored the proposed health policy and funding changes included in the House Budget Resolution (H.Con. Res. 96). 340B Drug Discount Programs - Engaged in monitoring ongoing discussions about the program and possible regulatory changes in light of legal activity challenging newly-eligible providers allowed by the Affordable Care Act.Hospital group purchasing organizations - conducted outreach and education efforts related to the value provided by hospital group purchasing organizations. Hospital pricing transparency - monitored legislative proposals (H.R. 1326, H.R. 2853 ) related to hospital pricing transparency.

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached.Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored HR 4244, the Small Business Health Insurance Affordability Act of 2014 Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act

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

Government targets: Bureau of Land Management (BLM), HOUSE OF REPRESENTATIVES, SENATE, U.S. Forest Service

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support for Rep. Lynn Jenkins (R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank.

Client expense: $4,060,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), SENATE

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings.S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings.S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2668 - Fairness for American Families Act H.R. 2667 - Authority for Mandate Delay Act H.R.1326 - Health Care Price Transparency Promotion Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1932 - Better Care, Lower Cost Act H.R.3890 - Better Care, Lower Cost Act H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

See AddendumS. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013 H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts S. 24, the Small Business Health Relief Act of 2013 H.R. 956, the Personal Health Investment Today Act of 2013 H.R. 1140, the Family Friendly HSA Improvement Act of 2013 H.R. 1342, the Helping American's Health Care Choices Act of 2013 H.R. 1326, the Health Care Price Transparency Promotion Act of 2013 S. 610/H.R. 1248, the Family Health Care Flexibility Act H.R. 1552, the Health Freedom for Seniors Act S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013 H.R. 2688, the PATIENT Health Care Act H.R. 2835, the Restoring Access to Medication Act of 2013 H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts

Client expense: $1,730,000 · Firm income: Not reported

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R. 1326, Health Care Price Transparency Promotion Act (Burgess) price transparency16. Specific Lobbying Issues (continued): H.R. 1701, Cutting Costly Codes Act (Poe) ICD-10 implementation H.R. 2775, Continuing Appropriations Act (Black) ACA issues H.R. 2853, Hospital Price Transparency and Disclosure Act (Lipinski) transparency of hospital prices H.R. 3547, the Consolidated Appropriations Act (Smith) ACA issues, FY 2014 appropriations H.R. 4302, Protecting Access to Medicare Act (Pitts) ICD-10 Implementation S. 44, Medical Care Access Protection Act (Portman) medical liability reform S. 972, Cutting Costly Codes Act (Coburn) ICD-10 implementation S. 1897, Personal Data Privacy and Security Act (Leahy) privacy, data security issues U.S. Senate Special Committee on Aging Draft of Stop SCAMS Act (not yet introduced) - anti-fraud activities, including coding, Healthcare Fraud Prevention Partnership, and MEDPAC report Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; OPM data warehouse for FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters for 2014; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, and issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to the federally-facilitated marketplaces (i.e., Exchanges) and other issues relating to health care reform implementation. 18. Name of Lobbyists (continued): C. Lawrence: Assistant, Legislative Director for Rep. Bill Cassidy (LA-6); May 2008-July 200: Staff Assistant, Legislative Correspondent for Rep. Tom Price (GA-6)

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

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

H.R. 1326, Health Care Price Transparency Promotion Act (Burgess) - price transparency; H.R. 1701, Cutting Costly Codes Act (Poe) - ICD-10 implementation; H.R. 2775, Continuing Appropriations Act (Black) - ACA issues; H.R. 2853, Hospital Price Transparency and Disclosure Act (Lipinski) - transparency of hospital prices; H.R. 3547, the Consolidated Appropriations Act - (Smith) ACA issues, FY 2014 appropriations; H.R. 4302, Protecting Access to Medicare Act (Pitts) - ICD-10 Implementation; S. 44, Medical Care Access Protection Act (Portman) - medical liability reform; S. 972, Cutting Costly Codes Act (Coburn) - ICD-10 implementation; S. 1897, Personal Data Privacy and Security Act (Leahy) - privacy, data security issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments Medicare and Medicaid paymentMedicaid Waivers Extension of Medicare Sustainable Growth Rate Medicare Evaluation and Management Reimbursement Reduction Proposal Issues related to waste, fraud, and abuse in Medicaid Medicare Disproportionate Share Hospital Payments H.R. 574 Medicare Physician Payment Innovation Act of 2013, all provisions H.R. 1853 Medicaid Accountability and Care Act, all provisions H.R. 574 Medicare Physician Payment Act, all provisions 5.577/HR 1180 Resident Physician Shortage Reduction Act , all provisions H.R. 1201 Training Tomorrow's Doctors Act, all provisions H.R. 1250/5.1012 Medicare Audit Improvement Act, all provisions H.R. 1487 Improved Healthcare at a Lower Cost Act, all provisions H.R. 1698 Stabilize Medicaid and CHIP Coverage, all provisions H.R. 1326 Health Care Price Transparency Promotion Act, all provisions H.R. 1920 DSH Reduction Relief Act, all provisions Issues related to Medicaid enrollment of newborns CMS FY2014 Hospital Inpatient Prospective Payment System Rule Issues related to admission and medical review criteria for inpatient services ("two midnights rule") S.1555 DSH Reduction Relief Act of 2013, all provisions S.1871 SGR Repeal and Medicare Beneficiary Access Act - all sections H.R. 2810 Medicare Patient Access and Quality Improvement Act - all sections H.R. 4302 Protecting Access to Medicare Act - all sections H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act S. 1980 Medicaid and CHIP Continuous Quality Act H.R. 3678 Two-Midnight Rule Delay Act - all sections H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 2082 Two-Midnight Rule Coordination and Improvement Act

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

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

President's Budget, FY2015, Medicare and Medicaid hospital reimbursement issues. Health care reform, Hospital related issues and initiatives. Public Law 111-148, The Patient Protection and Affordable Care Act, Hospital related issues and initiatives. H.R.4872, Health Care and Education Reconciliation Act of 2010, Hospital related issues and initiatives. Sequestration and fiscal cliff issues generally. S.Con.Res.8, Concurrent Resolution on the Budget Fiscal Year 2014, Hospital related issues and initiatives. H.R.1250, Medicare Audit Improvement Act of 2013, Recovery Audit Contractors H.R.1326, Health Care Price Transparency Promotion Act of 2013, Pricing Transparency issues. H.R.1920, DSH Reduction Relief Act of 2013, Disproportionate Share Hospital payment H.R.1180, Resident Physician Shortage Reduction Act of 2013, Graduate Medical Expense (GME) Public Law 113-76, Consolidated Appropriations Act, FY2014, Hospital related issues. H.R.4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, SGR related issues. S.2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014, SGR related issues.

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

Government targets: HOUSE OF REPRESENTATIVES, 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

H.R. 1326, Health Care Price Transparency Promotion Act (Burgess) price transparency16. Specific Lobbying Issues (continued): H.R. 1701, Cutting Costly Codes Act (Poe) ICD-10 implementation H.R. 2775, Continuing Appropriations Act (Black) ACA issues H.R. 2853, Hospital Price Transparency and Disclosure Act (Lipinski) transparency of hospital prices S. 44, Medical Care Access Protection Act (Portman) medical liability reform S. 972, Cutting Costly Codes Act (Coburn) ICD-10 implementation S. 1284, Labor, HHS, and Education Appropriations Bill (Harkin) funding for HHS programs and agencies; amendment to block implementation of ACA individual mandate Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets, identifiers including the health plan identifier, enforcement; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues relating to similarly sized subscriber group (SSSG) and MLR requirements under the FEHBP; OPM data warehouse for FEHBP; implementation of the health savings account provisions of the Medicare Act; issues related to Medicare Secondary Payer requirements; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital consolidation; issues relating to quality improvement; issues related to potential priority research topics for the effective health care program; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to data breach requirements; issues relating to "meaningful use" requirements for health information technology; issues related to the collection of race and ethnicity data; issues related to medical loss ratios; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; accountable care organizations; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues relating to the annual fee on health insurance providers; health plan automatic enrollment requirements; health insurance web portal requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters for 2014; essential health benefits, actuarial value, and accreditation; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, and issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to the federally-facilitated marketplaces (i.e., Exchanges) and other issues relating to health care reform implementation.

Client expense: $3,630,000 · Firm income: Not reported

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

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Support S 1143 and HR 2801 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Supporting the Health Care Price Transparency Promotion Act of 2013 to require States to have or establish requirements for disclosure of information on hospital charges for certain services and require insurers to provide enrollees with information on out-of-pocket expenditures upon request; Support 340B Drug Program; Support for Rep. Lynn Jenkins (R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank.

Client expense: $4,560,000 · Firm income: Not reported

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

Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt paymentsMedicaid Waivers Extension of Medicare Sustainable Growth Rate Medicare Evaluation and Management Reimbursement Reduction Proposal Issues related to waste, fraud, and abuse in Medicaid Medicare Disproportionate Share Hospital Payments H.R. 574 Medicare Physician Payment Innovation Act of 2013, all provisions H.R. 1853 Medicaid Accountability and Care Act, all provisions H.R. 574 Medicare Physician Payment Act, all provisions 5.577/HR 1180 Resident Physician Shortage Reduction Act , all provisions H.R. 1201 Training Tomorrow's Doctors Act, all provisions H.R. 1250/5.1012 Medicare Audit Improvement Act, all provisions H.R. 1487 Improved Healthcare at a Lower Cost Act, all provisions H.R. 1698 Stabilize Medicaid and CHIP Coverage, all provisions H.R. 1326 Health Care Price Transparency Promotion Act, all provisions H.R. 1920 DSH Reduction Relief Act, all provisions Issues related to Medicaid enrollment of newborns CMS FY2014 Hospital Inpatient Prospective Payment System Rule Issues related to admission and medical review criteria for inpatient services ("two midnights rule") S.1555 DSH Reduction Relief Act of 2013, all provisions S.1871 SGR Repeal and Medicare Beneficiary Access Act - all sections H.R. 2810 Medicare Patient Access and Quality Improvement Act - all sections

Client expense: $200,000 · Firm income: Not reported

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

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 933 - Department of Defense, Military Construction, and Veterans Affairs and Full-Year Continuing Appropriations Act of 2013S. Con. Res. 8 - The Senate Concurrent Budget Resolution for FY 2014 H. Con. Res. 25 - The House Concurrent Budget Resolution for FY 2014 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings H.R. 574 - Medicare Physician Payment Innovation Act of 2013 H.R. 2667 - Authority for Mandate Delay Act H.R. 2668 - Fairness for American Families Act S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013 S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. H.R.1326 - Health Care Price Transparency Promotion Act of 2013 H.J. Res. 59 - Continuing Appropriations Resolution, 2014 H.R. 2775 - The Continuing Appropriations Act, 2014 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R. 351 - Protecting Seniors' Access to Medicare Act of 2013 S. 351 - Protecting Seniors' Access to Medicare Act of 2013 H.R. 933 - Department of Defense, Military Construction, and Veterans Affairs and Full-Year Continuing Appropriations Act of 2013S. Con. Res. 8 - The Senate Concurrent Budget Resolution for FY 2014 H. Con. Res. 25 - The House Concurrent Budget Resolution for FY 2014 H.R. 2663 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings H.R. 574 - Medicare Physician Payment Innovation Act of 2013 H.R. 2667 - Authority for Mandate Delay Act H.R. 2668 - Fairness for American Families Act S. 1193 - Data Security and Breach Notification Act of 2013 H.R. 2810 - Medicare Patient Access and Quality Improvement Act of 2013 S. 1422 - A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. H.R.1326 - Health Care Price Transparency Promotion Act of 2013 H.J. Res. 59 - Continuing Appropriations Resolution, 2014 H.R. 2775 - The Continuing Appropriations Act, 2014 H.R. 3547 - Consolidated Appropriations Act, 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 S.1685 - Behavioral Health Information Technology Coordination Act of 2013

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

S. 1031/H.R. 2194, the Family and Retirement Health Investment Act of 2013; H.R. 207, a bill to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts; S. 24, the Small Business Health Relief Act of 2013; H.R. 956, the Personal Health Investment Today Act of 2013; H.R. 1140, the Family Friendly HSA Improvement Act of 2013;H.R. 1342, the Helping American's Health Care Choices Act of 2013; H.R. 1326, the Health Care Price Transparency Promotion Act of 2013; S. 610/H.R. 1248, the Family Health Care Flexibility Act; H.R. 1552, the Health Freedom for Seniors Act; S. 728/H.R. 2499, the Tax Parity for Health Plan Beneficiaries Act of 2013; H.R. 2688, the PATIENT Health Care Act; H.R. 2835, the Restoring Access to Medication Act of 2013; H.R. 3498, a bill to allow individuals to choose to opt out of the Medicare part A benefit and to allow individuals opting out of such benefit to be eligible for health savings accounts.

Client expense: $2,140,000 · Firm income: Not reported

Government targets: Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

President's Budget, FY2014, Medicare and Medicaid hospital reimbursement issues. Health care reform, Hospital related issues and initiatives. Public Law 111-148, The Patient Protection and Affordable Care Act, Hospital related issues and initiatives. H.R.4872, Health Care and Education Reconciliation Act of 2010, Hospital related issues and initiatives. Sequestration and fiscal cliff issues generally. S.Con.Res.8, Concurrent Resolution on the Budget Fiscal Year 2014, Hospital related issues and initiatives. H.R.1250, Medicare Audit Improvement Act of 2013, Recovery Audit Contractors H.R.1326, Health Care Price Transparency Promotion Act of 2013, Pricing Transparency issues. H.R.1920, DSH Reduction Relief Act of 2013, Disproportionate Share Hospital payment H.R.1180, Resident Physician Shortage Reduction Act of 2013, Graduate Medical Expense (GME) H.J.Res.59, Continuing Appropriations Resolutions, FY2014, Hospital related issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2775 Continuing Appropriations Act, 2014 H.J. Res 59 Bipartisan Budget Act of 2013 H.R. 2810 The Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3077 TELE-MED Act of 2013H.R. 3303 Sensible Oversight for Technology which Advances Regulatory Efficiency (SOFTWARE) Act H.R. 2725 FDA Safety Over Sequestration Act H.R. 3204 Drug Quality and Security Act H.R. 2651 Critical Care Assessment and Improvement Act of 2013 S. 1439 Care Planning Act of 2013 S. 1193 Data Security and Breach Notification Act of 2013 S.1927 The Data Security Act of 2014 H.R. 3696 National Cybersecurity and Critical Infrastructure Protection Act of 2013 H.R. 3811 Healthcare Exchange Security and Transparency Act of 2014 S.1897 Personal Data Privacy and Security Act of 2014 H.R. 1326 Health Care Price Transparency Promotion Act of 2013 H.R. 2651 Critical Care Assessment and Improvement Act of 2013 H.R. 2843 Medicare Data Access for Transparency and Accountability Act S. 1180 Medicare Data Access for Transparency and Accountability Act S. 1758 Quality Data, Quality Healthcare Act of 2013 H.R.3367 To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 1037 Occupational Therapy in Mental Health Act H.R. 3120 Comprehensive Dental Reform Act of 2013 H.R. 3306 Telehealth Enhancement Act of 2013 H.R. 3507 21st Century Care for Military and Veterans Act H.R. 487 Primary Care Workforce Access Improvement Act of 2013 H.R. 574 Medicare Physician Payment Innovation Act of 2013 H.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. 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. 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. 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. 244 Physician Availability 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. 2801 Protecting Access to Rural Therapy Services (PARTS) 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 ActH.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. 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. 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. 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. 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. 755 Enhanced Access to Medicaid Services Act of 2013 S. 945 Access to Quality Diabetes Education Act of 2013 S.577 Resident Physician Shortage Reduction Act of 2013 S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act H.R. 2663 Preventive Health Savings Act S. 1422 Preventive Health Savings Act S. 1228 Medicare Better Health Rewards Program Act S. 1184 Treat and Reduce Obesity Act H.R. 2415 Treat and Reduce Obesity Act H.R. 2810 Medicare Patient Access and Quality Improvement Act H.R. 2642 Federal Agriculture Reform and Risk Management (FARRM) Act S. 954 Agriculture Reform, Food and Jobs Act

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), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

See attached.Monitored HR 344, the Competitive Health Insurance Act Monitored HR 1254, to repeal a requirement that new employees of certain employers be automatically enrolled in their employers health benefit plans Monitored HR 1326, the Health Care Price Transparency Act Monitored HR 1342, to Helping Save Americans Health Care Choices Act Monitored HR 1558, to lower health premiums and increase choice for small business Monitored HR 1990/S 983, the Keep the IRS Off Your Health Care Act Monitored HR 2667, the Authority for Mandate Delay Act Monitored HR 2700, the Health Care Waiver Fairness Act Monitored HR 3046, the Small Business Health Care Tax Credit Improvement Act Monitored S 24, the Small Business Health Relief Act Monitored S 479, the Health Insurance Rate Review Act Monitored S 560, to construe the Individual Mandate of the Patient Protection and Affordable Care Act as a tax Monitored S 610, the Family Health Care Flexibility Act Monitored S 603, the Jobs and Premium Protection Act Monitored S 701, modifying the definition of full time employee for the purposes of the Patient Protection and Affordable Care Act Monitored HR 762, the Health Care Choice Act Monitored S 1154/HR 2938, the Exchange Sunset Act Monitored HR 3350, the Keep Your Health Plan Act Monitored S 1735/HR 3462, the Self-insurance Protection Act Monitored HR 3522, the Employee Health Care Protection Act Monitored S 1894, the Health Insurance Accountability Act

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

Government targets: Bureau of Land Management (BLM), HOUSE OF REPRESENTATIVES, SENATE, U.S. Forest Service

H.R. 1326, Health Care Price Transparency Promotion Act (Burgess) - price transparency. H.R. 1701, Cutting Costly Codes Act (Poe) - ICD-10 implementation. H.R. 2775, Continuing Appropriations Act (Black) - ACA issues. H.R. 2853, Hospital Price Transparency and Disclosure Act (Lipinski) - transparency of hospital prices. S. 44, Medical Care Access Protection Act (Portman) - medical liability reform. S. 972, Cutting Costly Codes Act (Coburn) - ICD-10 implementation. S. 1284, Labor, HHS, and Education Appropriations Bill (Harkin) - funding for HHS programs and agencies; amendment to block implementation of ACA individual mandate.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Support S 1143 and HR 2801 Protecting Access to Rural Therapy Services (PARTS) Act, a bill to amend title XVIII of the Social Security Act with respect to physician supervision of therapeutic hospital outpatient services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Supporting the Health Care Price Transparency Promotion Act of 2013 to require States to have or establish requirements for disclosure of information on hospital charges for certain services and require insurers to provide enrollees with information on out-of-pocket expenditures upon request; Support 340B Drug Program; Support for Rep. Lynn Jenkins (R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system;

Client expense: $3,750,000 · Firm income: Not reported

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