PRIME Act of 2013

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay. H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders . H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program. H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies. H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding. Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders. S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud. S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks. S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussion of transportation issues for the reauthorization of MAP-21. AARP interests include increasing funding for public transit and special needs para-transit services, promotion of older driver and pedestrian safety, expanding adoption of planning and design features to better accommodate all roadway users and strengthening connections between transportation and land use planning.Discussed legislation regarding roadway design and policy enhancements to promote safety for older drivers and pedestrians and increased access to specialized and public transportation for older adults. (no bill) S. 2004, The Safe Streets Act of 2014 - Discussed legislation to ensure that new or improved federally-funded roadways are planned, designed, operated, and maintained to safely accomodate all roadway users. H.R. 2468, The Safe Streets Act of 2013 - Discussed legislation to ensure that new or improved federally-funded roadways are planned, designed, operated, and maintained to safely accomodate all roadway users. Discussed the need to improve human services transportation coordination. H.R. 83, Consolidated Appropriations Act and Further Continuing Appropriation, 2015 - Lobbied to protect funding levels for senior housing and transportation programs, and related community development aid. H.R. 4507, the Pedestrian Fatalities Reduction Act - Sent a letter of support and discussed with Congressional staff members. S. 2284, the Pedestrian Safety Act - Sent a letter of support. Submitted a comment letter to the Department of Transportation regarding a proposed rule for Highway Safety Improvement Performance Management expressing the need for separate performance measures for non-motorized travel. H.R. 4745/S.2438, Transportation and HUD Appropriations bill, 2015 - Lobbied to protect housing and transportation programs serving seniors. H.R. 2468, Safe Streets Act of 2014 - Discussed legislation with staff. H.R. 4726, Innovation in Surface Transportation Act of 2014 - Sent letter of support. Discussed with Congressional staff. H.R. 2305/S. 1123, Preventing and Reducing Improper Medicare Expenditures (PRIME Act) - Discussed legislation with Hill staff. H.R. 1953, Senior Fraud Prevention Act - Discussed legislation with staff.

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

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

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

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

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

General Medicare Protection, Repeal of Sustainable Growth Rate: H.R. 574, Prevention of Fraud, Waste, and Abuse: H.R. 2305 and H.R. 3090 and S. 1123 and S. 1019 and H.R. 4998 and S. 2552, Savings on Medical Expenses: H.R. 4104 and H.R. 1179 and S. 569, Workforce Advancements: S. 2251 and H.R. 4445.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal Sustainable Growth Rate formula; Monitor implementation, P.L. 111-148; Extend Section 3111, P.L. 111-148; H.R. 4015 / S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act; S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013; H.R. 1416, Cancer Patient Protection Act; H.R. 2305 / S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act; H.R. 2810, Medicare Patient Access and Quality Improvement Act; H.R. 4302, Protecting Access to Medicare Act; 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; H.R. 800, To exclude prompt pay discounts from ASP formula

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

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

Medicare Recovery Audit Contractor (RAC) program and RAC reform proposals including H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; H.R. 2305/S. 1123 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013; H.R. 2329 - Administrative Relief and Accurate Medicare Payments Act of 2013; S.1871, the SGR Repeal and Medicare Beneficiary Access Act of 2013; and draft legislation, Protecting Integrity in Medicare Act of 2014 (PIMA)

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

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

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; 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

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

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

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

H.R. 3124, the Investing in Permanency for Youth in Foster Care Act S. 1511, the Removing Barriers to Adoption and Supporting Families Act S. 1518, the Improving Outcomes for Youth at Risk for Sex Trafficking Act S. 1732, the Strengthening the Child Welfare Response to Human Trafficking ActS. 1876, the Strengthening and Finding Families for Children Act H.R. 2305, the Promoting Adoption and Legal Guardianship for Children in Foster Care Act H.R. 4909, the Permanent Families for All Children Act H.R. 4980, the Preventing Sex Trafficking and Strengthening Families Act

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

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Library of Congress (LOC), Natl Security Agency (NSA), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), White House Office

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay. H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders. H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program. H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies. H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding. Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer). S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders. S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud. S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks. S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General Medicare Protection, Repeal of Sustainable Growth Rate: H.R. 574, Prevention of Fraud, Waste, and Abuse: H.R. 2305 and H.R. 3090 and S. 1123 and S. 1019 and H.R. 4998 and S. 2552, Savings on Medical Expenses: H.R. 4104 and H.R. 1179 and S. 569, Workforce Advancements: S. 2251 and H.R. 4445.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General Medicare Protection, Repeal of Sustainable Growth Rate: H.R. 574; Prevention of Waste, Fraud, and Abuse: H.R. 2305, H.R. 3090, H.R. 4998, S. 1123, S. 1019, and S. 2552; Savings on Medical Expenses: H.R. 4104, H.R. 1179, and S. 569; Workforce Advancements: H.R. 4445 and S. 2251.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General Medicare Protection, Repeal of Sustainable Growth Rate: H.R. 574; Prevention of Waste, Fraud, and Abuse: H.R. 2305, H.R. 3090, H.R. 4998, S. 1123, S. 1019, and S. 2552; Savings on Medical Expenses: H.R. 4104, H.R. 1179, and S. 569; Workforce Advancements: H.R. 4445 and S. 2251.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation related to medical licensure, telemedicine, medical regulations, license portability, and other matters that might affect state-based health regulation. Development of state compact for licensure S.1123 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013 (PRIME ACT) H.R.2305 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013 (PRIME ACT) H.R. 3077 - The TELE-MED Act of 2013 S. 1277 - Combating Prescription Drug Abuse Act H.R. 2484 - Conrad State 30 and Physician Access Act H.R. 3750 - Telehealth Modernization Act of 2013 potential legislation: Telehealth Promotion Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal Sustainable Growth Rate formula; Monitor implementation, P.L. 111-148; Extend Section 3111, P.L. 111-148; H.R. 4015 / S. 2000 SGR Repeal and Medicare Provider Payment Modernization Act; S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013; H.R. 1416 Cancer Patient Protection Act; H.R. 2305 / S. 1123 Preventing and Reducing Improper Medicare and Medicaid Expenditures Act; H.R. 2810 Medicare Patient Access and Quality Improvement Act; H.R. 4302 Protecting Access to Medicare Act; H.R. 800 Exclude prompt pay discounts from ASP formula

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

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

HR 487, Primary Care Workforce Access Improvement Act, Urge House to cosponsor bill that would create GME pilot project to train primary care doctors, urge Senate offices to sponsor bill; urge W&M offices to discuss during March 2014 budget hearing, GME reform increase primary care physician training, pilot test alternatives to GME payment to increase PCP training.HR 2305, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2810, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2867, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2969, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 3306, Telehealth Enhancement Act, Defining the home base for telehealth reimbursement to incluse family medicine offices. HR 4015, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4209, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4302, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. HR 4418, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4543, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1123, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1184, Treat and Reduce Obesity Act, Seeking House and Senate cosponsors for obesity legislation. S. 1318, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1759, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 1769, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1871, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1978, Increasing Primary Care Access Act, Family physician workforce, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medical Education program, increase family physician workforce. S. 2000, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. S. 2110, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. S. 2122, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 2229, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 2415, Seeking House and Senate cosponsors for obesity legislation. No Bill Number, SGR Repeal and Replacement process, Advocate for SGR repeal and new physician payment system that pays for value and primary care. No Bill Number, Medicaid Primary Care Bonus, Advocate for extension of the Medicaid bonus which expires at the end of 2014. No Bill Number, Medicare Primary Care Incentive Payment, Urge Ways and Means members to discuss at annual MedPac hearing. No Bill Number, Telemedicine,advocate for AAFP policies to be included in a potential bipartisan telehealth bill. No Bill Number, Medicare Site Neutral Payments; advocate for AAFP policies to be included in conncection with MedPac hearing. No Bill Number, Extend Medicare/medicare parity for primary care services, Extend increase in Medicaid payments for primary care services to Medicare levels beyond 2015. No Bill Number, Direct Primary Care, Primary care model of retainer-based practice. No Bill Number, Medicare physician payment reform of the SGR, 2014 converstion factor. No Bill Number, Repeal SGR, Positive update and higher rate for primary care.No Bill Number, Site-neutral payment for medical services, Support site-neutral payment by CMS for medical services. No Bill Number, First Fridays Meetings, Provider outreach group for Affordable Care Act, provider and open enrollment issues.

Client expense: $1,257,519 · 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), SENATE, Veterans Affairs, Dept of (VA)

HR 487, Primary Care Workforce Access Improvement Act, Urge House to cosponsor bill that would create GME pilot project to train primary care doctors, urge Senate offices to sponsor bill; urge W&M offices to discuss during March 2014 budget hearing, GME reform increase primary care physician training, pilot test alternatives to GME payment to increase PCP training.HR 2305, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2810, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2867, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 2969, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 3306, Telehealth Enhancement Act, Defining the home base for telehealth reimbursement to incluse family medicine offices. HR 4015, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4209, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4302, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. HR 4418, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. HR 4543, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1123, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1184, Treat and Reduce Obesity Act, Seeking House and Senate cosponsors for obesity legislation. S. 1318, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1759, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 1769, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1871, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 1978, Increasing Primary Care Access Act, Family physician workforce, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medical Education program, increase family physician workforce. S. 2000, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. S. 2110, Medicare Payment Reform, Repeal SGR. Positive update and higher rate for primary care. S. 2122, Medicare Payment Reform, Repeal SGR, Positive update and higher rate for primary care. S. 2229, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 2415, Seeking House and Senate cosponsors for obesity legislation. No Bill Number, SGR Repeal and Replacement process, Advocate for SGR repeal and new physician payment system that pays for value and primary care. No Bill Number, Medicaid Primary Care Bonus, Advocate for extension of the Medicaid bonus which expires at the end of 2014. No Bill Number, Medicare Primary Care Incentive Payment, Urge Ways and Means members to discuss at annual MedPac hearing. No Bill Number, Telemedicine,advocate for AAFP policies to be included in a potential bipartisan telehealth bill. No Bill Number, Medicare Site Neutral Payments; advocate for AAFP policies to be included in conncection with MedPac hearing. No Bill Number, Extend Medicare/medicare parity for primary care services, Extend increase in Medicaid payments for primary care services to Medicare levels beyond 2015. No Bill Number, Direct Primary Care, Primary care model of retainer-based practice. No Bill Number, Medicare physician payment reform of the SGR, 2014 converstion factor. No Bill Number, Repeal SGR, Positive update and higher rate for primary care.No Bill Number, Site-neutral payment for medical services, Support site-neutral payment by CMS for medical services. No Bill Number, First Fridays Meetings, Provider outreach group for Affordable Care Act, provider and open enrollment issues.

Client expense: $1,257,519 · 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), SENATE, Veterans Affairs, Dept of (VA)

Medicare Recovery Audit Contractor (RAC) program and RAC reform proposals including H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; H.R. 2305/S. 1123 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013; H.R. 2329 - Administrative Relief and Accurate Medicare Payments Act of 2013; and S.1871, the SGR Repeal and Medicare Beneficiary Access Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits16. Specific Lobbying Issues (continued): H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) MA payment and enrollment issues, wellness incentives H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) SGR repeal, quality- and value-based payment reforms H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) MA plan provider networks H.Con.Res. 96, Budget Resolution (Ryan) Medicare, Medigap, Medicaid, ACA issues S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 25 (Hatch) extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- CHIP reauthorization S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) MA plan provider networks16. Specific Lobbying Issues (continued): Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation. 17. Houses of Congress and Federal Agencies (continued): Medicaid and CHIP Payment and Access Commission (MACPAC)

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

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

Issues relating to Medicaid and Sustainable Growth Rate (SGR) reform. HR 2305 "Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act of 2013," all provisions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3124, the Investing in Permanency for Youth in Foster Care Act S. 1511, the Removing Barriers to Adoption and Supporting Families Act S. 1518, the Improving Outcomes for Youth at Risk for Sex Trafficking Act S. 1732, the Strengthening the Child Welfare Response to Human Trafficking ActS. 1876, the Strengthening and Finding Families for Children Act H.R. 2305, the Promoting Adoption and Legal Guardianship for Children in Foster Care Act H.R. 4909, the Permanent Families for All Children Act H.R. 4980, the Preventing Sex Trafficking and Strengthening Families Act

Client expense: $260,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Natl Security Agency (NSA), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits. H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi). H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes. H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care. H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations. H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs. H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse. H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules. H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives. H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives. H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) - SGR repeal, quality- and value-based payment reforms. H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review. H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period. H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions. H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule. H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders." H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans. H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks. H.Con.Res. 96, Budget Resolution (Ryan) - Medicare, Medigap, Medicaid, ACA issues. S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues. S. 25 (Hatch) - extension of Medicare sequestration cuts. S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations. S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes. S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse. S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives. S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations. S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs. S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions. S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment. S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms. S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders." S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal. S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- CHIP reauthorization. S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation related to medical licensure, telemedicine, medical regulations, license portability, and other matters that might affect state-based health regulation. Development of state compact for licensureS.1123 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013 (PRIME ACT) H.R.2305 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013 (PRIME ACT) H.R. 3077 - The TELE-MED Act of 2013 S. 1277 - Combating Prescription Drug Abuse Act H.R. 2484 - Conrad State 30 and Physician Access Act H.R. 3750 - Telehealth Modernization Act of 2013 potential legislation: Telehealth Promotion Act of 2014

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

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 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

General Medicare Protection, Repeal of Sustainable Growth Rate: H.R. 574, Prevention of Fraud, Waste, and Abuse: H.R. 2305 and H.R. 3090 and S. 1123 and S. 1019, Savings on Medical Expenses: H.R. 4104 and H.R. 1179 and S. 569, Workforce Advancements: S. 2251 and H.R. 4445.

Client expense: $40,000 · 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 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: $60,000

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: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General Medicare Protection, Repeal of Sustainable Growth Rate: H.R. 574; Prevention of Waste, Fraud and Abuse: H.R. 2305 and H.R. 3090, and S. 1123 and S. 1019; Savings on Medical Expenses: H.R. 4104 and H.R. 1179 and S. 569; Workforce Advancements: H.R. 4445 and S. 2251.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal Sustainable Growth Rate formula; Monitor implementation, P.L. 111-148; Extend Section 3111, P.L. 111-148; H.R. 4015 / S. 2000 SGR Repeal and Medicare Provider Payment Modernization Act; H.R. 1416 Cancer Patient Protection Act; H.R. 2305 / S. 1123 Preventing and Reducing Improper Medicare and Medicaid Expenditures Act; H.R. 2810 Medicare Patient Access and Quality Improvement Act; H.R. 4302 Protecting Access to Medicare Act; H.R. 800 Exclude prompt pay discounts from ASP formula

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

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

Medicare Recovery Audit Contractor (RAC) program and RAC reform proposals including H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; H.R. 2305/S. 1123 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013; H.R. 2329 - Administrative Relief and Accurate Medicare Payments Act of 2013; S.1871, the SGR Repeal and Medicare Beneficiary Access Act of 2013; and H.R. 4302, the Protecting Access to Medicare Act (Public Law No: 113-93).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3124, the Investing in Permanency for Youth in Foster Care Act S. 1511, the Removing Barriers to Adoption and Supporting Families Act S. 1518, the Improving Outcomes for Youth at Risk for Sex Trafficking Act S. 1732, the Strengthening the Child Welfare Response to Human Trafficking ActS. 1876, the Strengthening and Finding Families for Children Act H.R. 2305, the Promoting Adoption and Legal Guardianship for Children in Foster Care Act

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

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Legal Services Corporation, Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Copyright Office, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

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

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

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

H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits16. Specific Lobbying Issues (continued): H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) MA payment and enrollment issues, wellness incentives H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) SGR repeal, quality- and value- based payment reforms H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.J.Res. 59, Bipartisan Budget Act (Rogers) MA Special Needs Plans, Cost Plans, Medicare physician payment, QI and TMA programs S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 25 (Hatch) extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Baucus) SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Baucus) SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal U.S. Senate Special Committee on Aging Draft of Stop SCAMS Act (not yet introduced) - anti-fraud activities, including coding, Healthcare Fraud Prevention Partnership, and MEDPAC report16. Regulatory Issues (continued): Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation. 17. Houses of Congress and Federal Agencies (continued): Medicaid and CHIP Payment and Access Commission (MACPAC) 18. Name of Lobbyists (con't): C. Lawrence: Assistant, Legislative Director for Rep. Bill Cassidy (LA-6); May 2008-July 200: Staff Assistant, Legislative Correspondent for Rep. Tom Price (GA-6)

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

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

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148). Monitor federal issues and legislation associated with health care policy. Monitor passage of FY 2014 omnibus appropriations bill (P.L. 113-76). 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: $60,000

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. Monitor passage of FY 2014 omnibus appropriations bill (P.L. 113-76). 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: $60,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits; H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi); H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes; H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care; H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations; H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs; H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse; H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules; H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives; H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives; H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) - SGR repeal, quality- and value-based payment reforms; H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review; H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period; H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions; H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay; H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule; H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders; H.J.Res. 59, Bipartisan Budget Act (Rogers) - MA Special Needs Plans, Cost Plans, Medicare physician payment, QI and TMA programs; S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues; S. 25 (Hatch) - extension of Medicare sequestration cuts; S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations; S. 324, Puerto Rico Medicare Part B Equity Act (Schumer); S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes; S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care; S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse; S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives; S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations; S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Baucus) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs; S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions; S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment; S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Baucus) - SGR repeal, quality- and value-based payment reform; S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders; S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2305, H.R.2810, H.R.2867, H.R.2969, H.R.4015, S.1123, S.1318, S.1405, S.2000, S.2110, S.2122, S.2157, legislation reforming Medicare's Sustainable Growth Rate, regarding all provisions.

Client expense: $520,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General Medicare Protection, Repeal of Sustainable Growth: HR 574; Prevention of Fraud, Waste and Abuse: HR 2305 and HR 3090, and S. 1123 and S. 1019; Savings on Medical Expenses: HR 4104

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation related to medical licensure, telemedicine, medical regulations, license portability, and other matters that might affect state-based health regulation. S.1123 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013 (PRIME ACT) H.R.2305 - Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013 (PRIME ACT)H.R. 3077 - The TELE-MED Act of 2013 S. 1277 - Combating Prescription Drug Abuse Act H.R. 2484 - Conrad State 30 and Physician Access Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General Medicare Protection, Repeal of Sustainable Growth Rate: H.R. 574, Prevention of Fraud, Waste, and Abuse: H.R. 2305 and H.R. 3090 and S. 1123 and S. 1019, Savings on Medical Expenses: H.R. 4104.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.Con.Res. 25, House Budget Resolution (Ryan) public program issues, deficit reduction proposals16. Specific Lobbying Issues (continued): S.Con.Res. 8, Senate Budget Resolution (Murray) public program issues, deficit reduction proposals H.R. 162, Medicaid Integrity Act (Bachmann) Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) Medicare Part D changes H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) MA payment and enrollment issues, wellness incentives H.R. 2810, Medicare Patient Access and Quality Improvement Act (Burgess/Camp) SGR repeal, quality- and value-based payment reforms H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) MA open enrollment period H.J.Res. 59, Bipartisan Budget Act (Rogers) MA Special Needs Plans, Cost Plans, Medicare physician payment, QI and TMA programs S. 11, Fiscal Sustainability Act (Corker) Medicare, Medigap, Medicaid issues S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Baucus) SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues; Medicare creditable drug coverage reporting requirements; implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative;Regulatory Issues (con't): issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage; issues relating to "meaningful use" requirements for health information technology; and other issues relating to health care reform implementation. 17. Houses of Congress and Federal Agencies (con't): Medicaid and CHIP Payment and Access Commission (MACPAC)

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

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

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148). Monitor federal issues and legislation associated with health care policy. Monitor passage of Continuing Appropriations Act, 2014 (P.L. 113-46). Monitor passage of The Bipartisan Budget Act of 2013 (P.L. 113-67).Draft, FY 2014 omnibus appropriations bill. Draft, House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013. S. 1284, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2014. H.R. 460, Patients Access to Treatment Act of 2013. H.R. 1416, Cancer Patient Protection Act of 2013 (Ellmers). H.R. 1429, Scleroderma Research and Awareness Act of 2013 (Capps). H.R. 1701, Cutting Costly Codes Act of 2013 (Poe). S. 972, Cutting Costly Codes Act of 2013 (Coburn). 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 (Burgess). S. 1422, A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (Cardin). H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013 (Burgess). S. 1871, Senate bill to amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians services, and for other purposes. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013.

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

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. Monitor passage of Continuing Appropriations Act, 2014 (P.L. 113-46). Monitor passage of The Bipartisan Budget Act of 2013 (P.L. 113-67).Draft, FY 2014 omnibus appropriations bill. Draft, House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2013. S. 1284, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2014. H.R. 460, Patients Access to Treatment Act of 2013. H.R. 1416, Cancer Patient Protection Act of 2013 (Ellmers). H.R. 1429, Scleroderma Research and Awareness Act of 2013 (Capps). H.R. 1701, Cutting Costly Codes Act of 2013 (Poe). S. 972, Cutting Costly Codes Act of 2013 (Coburn). 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 (Burgess). S. 1422, A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings (Cardin). H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013 (Burgess). S. 1871, Senate bill to amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians services, and for other purposes. S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE