Cutting Costly Codes Act of 2013

Monitor federal issues and legislation related to healthcare policy; Monitor implementation, P.L. 111-148; H.R. 460, Patients Access to Treatment Act of 2013; Extension, Section 3111, P.L. 111-148; H.R. 1701 / S. 972, Cutting Costly Codes Act; H.R. 1429 Scleroderma Research and Awareness Act; H.R. 2663 / S. 1422, To Amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013; H.R. 4282, Creating Access to Residency Education Act of 2014; H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under EHR incentive payment programs

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

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

S. 2839, Comprehensive Addiction and Recovery Act of 2014, all provisions S. 2645, Recovery Enhancement for Addiction Treatment (TREAT) Act, all provisions H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes, all provisions H.R. 1074, National Diabetes Clinical Care Commission Act, all provisions S. 539, National Diabetes Clinical Care Commission Act, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions Affordable Care Act - implementation Ebola Prescription requirements for OTC medications Electronic Health Records - Meaningful Use ICD-10 Repeal Prescription Drug Diversion Prescription drug abuse/pain management/prescriber education Telemedicine Sunshine Act Laboratory Developed Tests 21st Century Cures Initiative Narrow Networks Mental Health Diabetes Antibiotics and data collection Personalized medicine Coverage of lung cancer screening for high-risk patients Drug Quality and Security Act/Compounded and Repackaged Medications Federal scientists and researchers - academic and scientific conference travel restrictions Men who have sex with men/blood donor deferral policy

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

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

H.R. 83, Consolidated and Further Continuing Appropriations Act - ACA risk corridor program, expatriate plans, HHS appropriations 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 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;; 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; 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/formerly referred to as the web portal); financing for infectious disease such as Ebola; and other issues relating to health care reform implementation.

Client expense: $2,230,000 · 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, Treasury, Dept of, White House Office

H.R. 83, Consolidated and Further Continuing Appropriations Act - ACA risk corridor program, expatriate plans, HHS appropriations. 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Electronic Health Records (EHRs); Health IT Roadmap; HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing,administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. See following page on Health Care Reform issuesHR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

Client expense: $2,030,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmission, payment bundling, and potentially preventable events.Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) User Fee Program H.R.523-Protect Medical Innovation Act of 2013 S.232 - Medical Device Access and Innovation Protection Act Klobuchar / Hatch amendment #297 to S. Con. Res 8, the Senate FY 2014 Budget Resolution to support repeal of the medical device tax H.R.1701 / S.972 - Cutting Costly Codes Act H.R.2810 - Medicare Patient Access and Quality Improvement Act S.1871 - SGR Repeal and Medicare Beneficiary Access Act H.R.4302 - Protecting Access to Medicare Act H.R.5823 - Incentivizing Healthcare Quality Outcomes Act of 2014

Client expense: $1,500,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconcilation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmissions, payment bundling, and potentially preventable eventsComparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) H.R.1701 / S.972 - Cutting Costly Codes Act H.R.2810 - Medicare Patient Access and Quality Improvement Act S.1871 - SGR Repeal and Medicare Beneficiary Access Act H.R.4302 - Protecting Access to Medicare Act H.R.5823 - Incentivizing Healthcare Quality Outcomes Act of 2014

Client expense: $1,500,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

General issues relating to physicians to hospitals; Expanding Patients' Access to Quality Care Act of 2013 H.R.2027; Cutting Costly Codes Act of 2013 H.R.1701, S.972

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicare and Medicaid physician payments, comparative effectiveness research, quality reporting and improvement initiatives.Public Law 111-152, the Health Care and Education Reconciliation Act of 2010 - Implementation issues related to Medicare and Medicaid physician payments. Public Law 111-192 (H.R. 3962), the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Medicare physician payment issues. P.L. 112-096, the Middle Class Tax Relief and Job Creation Act of 2012 - issues related to Medicare and Medicaid physician payments. P.L. 112-240, the American Taxpayer Relief Act of 2012 - Medicare physician payment issues. S. 388, American Family Economic Protection Act of 2013 - sequestration issues affecting Medicare physician payments and drug reimbursement issues. H.R. 1310, Medicare Patient Empowerment Act of 2013, all provisions S. 236, Medicare Patient Empowerment Act, all provisions H.R. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions H.R. 1179, Improving Access to Medicare Coverage Act of 2013, all provisions S. 569, Improving Access to Medicare Coverage Act of 2013, all provisions The Medicare Payment Stability and Premium Security Act ( Draft bill) Medicare Program - Long term reform proposals for the Medicare physician payment system. Medicare Program - Regulatory and administrative issues with the Medicare physician formula. Medicare Program - Shared Savings/Accountable Care Organizations Medicare program - Value-based modifier Medicare program - Quality Reporting Programs Medicare program - New payment models/measuring quality performance Medicare and Medicaid programs - Burwell HHS nomination Medicaid program - Parity for primary care physician services Medicare program - Two-Midnight Rule Discussions concerning potential debt limit extension and deficit reduction legislation - physician payment issues. Public Law No: 113-46, Continuing Appropriations Act , 2014 - Medicare and Medicaid savings issues. Public Law 113-93 - The Protecting Access to Medicare Act of 2014 Discussions with congressional staff on misvalued coding issues.

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

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

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center,including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing,administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor federal issues and legislation related to healthcare policy; Monitor implementation, P.L. 111-148; H.R. 460, Patients Access to Treatment Act of 2013; Extension, Section 3111, P.L. 111-148; H.R. 1701 / S. 972, Cutting Costly Codes Act; H.R. 1429 Scleroderma Research and Awareness Act; H.R. 2663 / S. 1422, To Amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013; H.R.4282, Creating Access to Residency Education Act of 2014; H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under EHR incentive payment programs

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

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

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmission, payment bundling, and potentially preventable events.Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) User Fee Program H.R.523-Protect Medical Innovation Act of 2013 S.232 - Medical Device Access and Innovation Protection Act Klobuchar / Hatch amendment #297 to S. Con. Res 8, the Senate FY 2014 Budget Resolution to support repeal of the medical device tax H.R.1701 / S.972 - Cutting Costly Codes Act H.R.2810 - Medicare Patient Access and Quality Improvement Act S.1871 - SGR Repeal and Medicare Beneficiary Access Act H.R.4302 - Protecting Access to Medicare Act

Client expense: $1,300,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconcilation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmissions, payment bundling, and potentially preventable eventsComparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) H.R.1701 / S.972 - Cutting Costly Codes Act H.R.2810 - Medicare Patient Access and Quality Improvement Act S.1871 - SGR Repeal and Medicare Beneficiary Access Act H.R.4302 - Protecting Access to Medicare Act

Client expense: $1,300,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

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

See attached addendum for General Lobbying Issue Area: HCR - HealthcareState-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. See following page on Health Care Reform issuesHR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General issues relating to physicians to hospitals HR 2027- Expanding Patients' Access to Quality Care Act of 2013 HR 1701 and S 972- Cutting Costly Codes Act of 2013

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. See following page on Health Care Reform issuesHR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

S. 2529, National All Schedules Prescription Electronic Reporting Reauthorization Act of 2014, all provisions S. 2645, Recovery Enhancement for Addiction Treatment (TREAT) Act, all provisions H.R. 3229, Indian Health Service Advance Appropriations Act of 2013, all provisions S. 1570, Indian Health Service Advance Appropriations Act of 2013, all provisionsH.R. 4843, Native Contract and Rate Expenditure Act of 2014, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions H.R. 3742, Antibiotic Development to Advance Patient Treatment (ADAPT) Act of 2013, all provisions ACA Implementation Prescription requirements for OTC medications Electronic Health Records Meaningful Use Regulations Opioid abuse, diversion control and treatment Prescription drug abuse/pain management/prescriber education Telemedicine ICD-10 Repeal CPT HIPAA Health Care Data Open Payments Regulations (Sunshine Act) Laboratory Developed Tests Personalized Medicine 21st Century Cures Initiative Mental Health Diabetes Nutrition Labeling Drug Compounding Biosimilars Clinical Data Registries Exchanges

Client expense: $4,230,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Veterans Affairs, Dept of (VA), White House Office

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; ; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; Medicare Cost Contract Extension MLR Broker Fees:Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purpos

Client expense: $43,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1331 the Electronic Health Records Improvements Act H.R. 1201 Training Tomorrow's Doctors Today Act H.R. 1701 Cutting Costly Codes Act of 2013 H.R. 1827 The Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R.2545 Accuracy in Medicare Physician Payment Act of 2013 H.R. 2720 The Alexis Agin Identity Theft Protection Act H.R. 2810 Medicare Patient Access and Quality Improvement Act H.R. 1473 Standard of Care Protection Act H.R. 36/S. 961 Health Care Safety Net Enhancement Act of 2013 H.R. 1733/S. 2196 Good Samaritan Health Professionals Act of 2014 S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act S. 577 The Resident Physician Shortage Act S. 1180 Medicare Data Access for Transparency and Accountability Act S. 1360 The Improper Payments Agency Cooperation Enhancement Act S. 1871 SGR Repeal and Medicare Beneficiary Access Act of 2013 Medicare Physician Fee Schedule, Inpatient Prospective Payment System, Affordable Care Act implementation, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, Sustainable Growth Rate, Medicare Physician Payment Reform, Independent Payment Advisory Board, Resident work hours, patient centered outcomes research institute, MEDCAC, Centers for Medicare and Medicaid Innovation, Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ-USPSTF, Graduate Medical Education, Medical Loss Ratio, Electronic cigarette regulation, surgical global payments

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Monitor federal issues and legislation related to healthcare policy; Monitor implementation, P.L. 111-148; H.R. 460, Patients Access to Treatment Act of 2013; Extension, Section 3111, P.L. 111-148; H.R. 1701 / S. 972, Cutting Costly Codes Act; H.R. 1429 Scleroderma Research and Awareness Act; H.R. 2663 / S. 1422 To Amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013; H.R.4282, Creating Access to Residency Education Act of 2014

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

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

please see addendumH.R. 1331 the Electronic Health Records Improvements Act H.R. 1201 Training Tomorrow's Doctors Today Act H.R. 1701 Cutting Costly Codes Act of 2013 H.R. 1827 The Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R.2545 Accuracy in Medicare Physician Payment Act of 2013 H.R. 2720 The Alexis Agin Identity Theft Protection Act H.R. 2810 Medicare Patient Access and Quality Improvement Act H.R. 1473 Standard of Care Protection Act H.R. 36/S. 961 Health Care Safety Net Enhancement Act of 2013 H.R. 1733/S. 2196 Good Samaritan Health Professionals Act of 2014 S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act S. 577 The Resident Physician Shortage Act S. 1180 Medicare Data Access for Transparency and Accountability Act S. 1360 The Improper Payments Agency Cooperation Enhancement Act S. 1871 SGR Repeal and Medicare Beneficiary Access Act of 2013 Medicare Physician Fee Schedule, Inpatient Prospective Payment System, Affordable Care Act implementation, health care reform, health care quality improvement, physician workforce, comparative effectiveness research, health information technology, EHR meaningful use, Sustainable Growth Rate, Medicare Physician Payment Reform, Independent Payment Advisory Board, Resident work hours, patient centered outcomes research institute, MEDCAC, Centers for Medicare and Medicaid Innovation, Medicare claims data, Social Security Death Master File, lung cancer screenings, AHRQ-USPSTF, Graduate Medical Education, Medical Loss Ratio, Electronic cigarette regulation

Client expense: $130,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicare and Medicaid physician payments, comparative effectiveness research, quality reporting and improvement initiatives.Public Law 111-152, the Health Care and Education Reconciliation Act of 2010 - Implementation issues related to Medicare and Medicaid physician payments. Public Law 111-192 (H.R. 3962), the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Medicare physician payment issues. P.L. 112-096, the Middle Class Tax Relief and Job Creation Act of 2012 - issues related to Medicare and Medicaid physician payments. P.L. 112-240, the American Taxpayer Relief Act of 2012 - Medicare physician payment issues. S. 388, American Family Economic Protection Act of 2013 - sequestration issues affecting Medicare physician payments and drug reimbursement issues. H.R. 1310, Medicare Patient Empowerment Act of 2013, all provisions S. 236, Medicare Patient Empowerment Act, all provisions H.R. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 351, Protecting Seniors' Access to Medicare Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions H.R. 1179, Improving Access to Medicare Coverage Act of 2013, all provisions S. 569, Improving Access to Medicare Coverage Act of 2013, all provisions The Medicare Payment Stability and Premium Security Act ( Draft bill) Medicare Program - Long term reform proposals for the Medicare physician payment system. Medicare Program - Regulatory and administrative issues with the Medicare physician formula. Medicare Program - Shared Savings/Accountable Care Organizations Medicare program - Value-based modifier Medicare program - Quality Reporting Programs Medicare program - New payment models/measuring quality performance Medicare and Medicaid programs - Burwell HHS nomination Medicaid program - Parity for primary care physician services Medicare program - Two-Midnight Rule Discussions concerning potential debt limit extension and deficit reduction legislation - physician payment issues. Public Law No: 113-46, Continuing Appropriations Act , 2014 - Medicare and Medicaid savings issues. P.L 113-67, Continuing Appropriations Resolution for 2014 - Medicare physician payments S.2000 - The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R.4015 -The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 Public Law 113-93 - The Protecting Access to Medicare Act of 2014

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

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

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Deliver System Reforms. State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database. Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees. Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health BEnefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851, 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue and governance. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health an Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified b health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (T-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD-9) with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the elecronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient PRotection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate th health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), 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. 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

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconcilation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmissions, payment bundling, and potentially preventable eventsComparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) H.R.1701 / S.972 - Cutting Costly Codes Act H.R.2810 - Medicare Patient Access and Quality Improvement Act S.1871 - SGR Repeal and Medicare Beneficiary Access Act H.R.4302 - Protecting Access to Medicare Act

Client expense: $1,400,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

Implementation of the Patient Protection and Affordable Care Act (PL 111-148) and the Health Care and Education Reconciliation Act (PL 111-152) Medicare and Medicaid reimbursement policies related to healthcare associated conditions, healthcare associated infections, readmission, payment bundling, and potentially preventable events.Comparative effectiveness research and policies Accountable Care Organizations (ACO) Policy Competitive Bidding Policy Regulations and legislation related to the Adoption of International Classification of Diseases, version 10 (ICD-10) Implementation of the Physician Payments Sunshine Act (PL 111-152, Section 6002) Implementation of the Food and Drug Administration Safety and Innovation Act (FDASIA) User Fee Program H.R.523-Protect Medical Innovation Act of 2013 S.232 - Medical Device Access and Innovation Protection Act Klobuchar / Hatch amendment #297 to S. Con. Res 8, the Senate FY 2014 Budget Resolution to support repeal of the medical device tax H.R.1701 / S.972 - Cutting Costly Codes Act H.R.2810 - Medicare Patient Access and Quality Improvement Act S.1871 - SGR Repeal and Medicare Beneficiary Access Act H.R.4302 - Protecting Access to Medicare Act

Client expense: $1,400,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Federal Highway Administration (FHA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Securities & Exchange Commission (SEC), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. International Trade Commission (ITC), U.S. Trade Representative (USTR)

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts.

Client expense: $1,820,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

H.R. 1701, Cutting Costly Codes Act of 2013, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions H.R. 3750, Telehealth Modernization Act of 2013, all provisions H.R. 4341, Truth in Advertising Act of 2014, all provisionsH.R. 2027, Expanding Patients' Access to Quality Care Act of 2013, all provisions H.R. 4707, To authorize the appropriation of funds to the Centers for Disease Control and Prevention for conducting or supporting research on firearms safety or gun violence prevention, all provisions S. 2373, A bill to authorize the appropriation of funds to the Centers for Disease Control and Prevention for conducting or supporting research on firearms safety or gun violence prevention, all provisions Food and Drugs Administration Safety and Innovation Act (FDASIA) Prescription Drug Abuse and Diversion DEA Registration and Registration Fees Telemedicine Prescription Drug Monitoring Program (PDMP) ICD-10 Repeal Prescriber education and mandatory/voluntary CME training Sunshine Act - Reprints Meaningful Use of EHRs/Health Information Technology EHR Patient Safety Prescription requirements for OTC medications Continuity of Care Hydrocodone Rescheduling Mental health care Diabetes Prevention Hospital Consolidation HIPAA Follow-on Biologics Access to care ACA Implementation Physician Consortium for Performance Improvement (PCPI) Compounding Laboratory developed tests Genetics

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

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

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts.

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

Government targets: HOUSE OF REPRESENTATIVES, 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 attached addendum for general issue area code: HCR - Health IssuesAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums .

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy.Draft, House Departments of Labor, Health and Human Services and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. H.R. 1701, Cutting Costly Codes Act of 2013. S. 972, Cutting Costly Codes Act of 2013. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4302, Protecting Access to Medicare Act. H.R. 4241, Act to Ban Zohydro. S. 2134, Act to Ban Zohydro.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy.Draft, House Departments of Labor, Health and Human Services and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. H.R. 1701, Cutting Costly Codes Act of 2013. S. 972, Cutting Costly Codes Act of 2013. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4302, Protecting Access to Medicare Act. H.R. 4241, Act to Ban Zohydro. S. 2134, Act to Ban Zohydro.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy.Draft, House Departments of Labor, Health and Human Services and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. H.R. 1701, Cutting Costly Codes Act of 2013. S. 972, Cutting Costly Codes Act of 2013. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4302, Protecting Access to Medicare Act. H.R. 4241, Act to Ban Zohydro. S. 2134, Act to Ban Zohydro.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy.Draft, House Departments of Labor, Health and Human Services and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. H.R. 1701, Cutting Costly Codes Act of 2013. S. 972, Cutting Costly Codes Act of 2013. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4302, Protecting Access to Medicare Act. H.R. 4241, Act to Ban Zohydro. S. 2134, Act to Ban Zohydro.

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

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

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148). Monitor federal issues and legislation associated with health care policy. Draft, House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015.H.R. 460, Patients Access to Treatment Act of 2013. H.R. 1416, Cancer Patient Protection Act of 2013. H.R. 1429, Scleroderma Research and Awareness Act of 2013. H.R. 1701, Cutting Costly Codes Act of 2013. S. 972, Cutting Costly Codes Act of 2013. H.R.2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures 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. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4302, Protecting Access to Medicare Act. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148). Monitor federal issues and legislation associated with health care policy. Draft, House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015.H.R. 460, Patients Access to Treatment Act of 2013. H.R. 1416, Cancer Patient Protection Act of 2013. H.R. 1429, Scleroderma Research and Awareness Act of 2013. H.R. 1701, Cutting Costly Codes Act of 2013. S. 972, Cutting Costly Codes Act of 2013. H.R.2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures 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. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4302, Protecting Access to Medicare Act. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor federal and legislative activity related to health care and reauthorization of National All Schedules Prescription Electronic Reporting Act (NASPER) (P.L. 109-60). Monitor federal and legislative activity related to Medicare Reimbursement. Monitor federal issues and legislation associated with health care policy.Draft, House Departments of Labor, Health and Human Services and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. H.R. 1701, Cutting Costly Codes Act of 2013. S. 972, Cutting Costly Codes Act of 2013. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013. H.R. 4302, Protecting Access to Medicare Act. H.R. 4241, Act to Ban Zohydro. S. 2134, Act to Ban Zohydro.

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

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