Accuracy in Medicare Physician Payment Act of 2013

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

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

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

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

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

The Patient Protection and Affordable Care Act, Pub. L. 111-148, Section 4104; Medicare sustainable growth rate reform; H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013; Colon cancer screening policies in Medicare; Medicare physician quality incentives; H.R. 1320/S. 608, the Supported Colorectal Examination and Education Now Act (SCREEN Act) of 2013; H.R. 1331, the Electronic Health Record Improvement Act; H.R. 2545, the Accuracy in Physician Payment Act of 2013; H.R. 4302, the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; Advancement of physician quality registries as they relate to Medicare physician payment reform; Transparency in valuation of medicare procedures under Medicare; Issues related to the Medicare physician fee schedule and payment policies for GI services.

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

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

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

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

The Patient Protection and Affordable Care Act, Pub. L. 111-148, Section 4104; Medicare sustainable growth rate reform; H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013; Colon cancer screening policies in Medicare; Medicare physician quality incentives; H.R. 1320/S. 608, the Supported Colorectal Examination and Education Now Act (SCREEN Act) of 2013; H.R. 1331, the Electronic Health Record Improvement Act; H.R. 2545, the Accuracy in Physician Payment Act of 2013; H.R. 4302, the Protecting Access to Medicare Act of 2014 (Pub. L. 113-93); S. 2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; Advancement of physician quality registries as they relate to Medicare physician payment reform; Transparency in valuation of medicare procedures under Medicare.

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

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

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

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

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

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

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

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

Patient Protection and Affordable Care Act, P.L. 111-148, Section 4104; Medicare sustainable growth rate reform: H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013; Colon cancer screening policies in Medicare; Medicare physician quality initiatives; H.R. 1320/S. 608, Supported Colorectal Examination and Educaiton Now Act (Screen Act) of 2013; H.R. 1331, Electronic Health Records Improvement Act; H.R. 2545, the Accuracy in Physician Payment Act of 2013;H.R. 4302, Protecting Access to Medicare Act of 2014 (P.L. 113-93); S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; Advancement of physician quality registries as they relate to Medicare physician payment reform; Transparency in valuation of medical procedures under Medicare.

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

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

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

Patient Protection and Affordable Care Act, P.L. 111-148, Section 4104; Medicare sustainable growth rate reform: H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013; Colon cancer screening policies in Medicare; Medicare physician quality initiatives; H.R. 1320/S. 608, Supported Colorectal Examination and Educaiton Now Act (Screen Act) of 2013; H.R. 1331, Electronic Health Records Improvement Act; H.R. 2545, the Accuracy in Physician Payment Act of 2013;H.R. 4302, Protecting Access to Medicare Act of 2014 (P.L. 113-93); S. 2110, Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; Advancement of physician quality registries as they relate to Medicare physician payment reform.

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

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

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

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

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

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

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

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

Client expense: $165,000 · Firm income: Not reported

Patient Protection and Affordable Care Act, P.L. 111-148, Section 4104; Medicare sustainable growth rate reform: H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013; Colon cancer screening policies in Medicare; Medicare physician quality initiatives; H.R. 1320/S. 608, Supported Colorectal Examination and Educaiton Now Act (Screen Act) of 2013; H.R. 1331, Electronic Health Records Improvement Act; H.R. 2545, the Accuracy in Physician Payment Act of 2013;S. 1871, Medicare Beneficiary Access Act of 2013 (SGR reform); P.L. 113-67, "Pathway for SGR Reform Act of 2013;" Advancement of physician quality registries as they relate to Medicare physician payment reform.

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

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 to sponsor bill. HR 1173, Personalize Your Care Act, Payment for discussion with patients of advance health care planning. HR 1184, Treat and Reduce Obesity Act, Payment for chronic obesity management.HR 1487, Improved Health Care at Lower Cost Act, Creation of exception to the physician self referral prohibition that would allow gain sharing arrangements with hospitals. HR 2545, Accuracy Medicare Physician Payment Act, Reform of CMS relationship to AMA Relative Value Scale Update Committee (RUC). HR 2775, Continuing Appropriations Act for 2014, Prevent cuts in primary care training grants and research. HR 2810, Repeal of Medicare SGR formula, Repeal of SGR to be replaced by a positive payment update and higher rate for primary care. HR 2817, Protect Patient Access to Quality Health Professionals Act, Remove the non -discrimination requirements relating to health care providers. HR 3204, Drug Supply Safety, followed the Compounding and Track and Trace legislation in both bodies. S. 1180, Medicare Data Access for Transparency and Accountability Act, Creation of database for public use of Medicare claims. S. 1238, Keep Student Loans Affordable Act, Extension of reduced interest rate for undergraduate Federal Direct Stafford Loans for medical students. S. 1284, Promoting Teaching Health Centers, AHRQ, Title VII primary care grants and NHSC appropriations, AAFP budget priorities, Title VII Sec 747, Teaching Health Center grants, NHSC, AHRQ. S. 1759, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medicare Education program. 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, Three month SGR patch, Urge Congress to pass budget deal which includes a three month SGR patch. No Bill Number, Corp Community Day Outreach, NHSC. No Bill Number, Urge sequestration be replaced, Protect funds for NHSC, CHC primary care research and training. No Bill Number, Met new director of the AHRQ, Primary care research. No Bill Number, Comprehensive Primary care, Medicare and private payments to primary care. No Bill Number, Medicare physician payment reform of the SGR, 2014 Proposed Medicare physician fee schedule. No Bill Number, Primary care payment, specialized Medicare codes for primary care. No Bill Number, Medicaid parity for primary care, Ensuring payments for true primary care physicians. No Bill Number, Primary care meeting, Medical Home and Health Care Reform. No Bill Number, E-Cigarettes, Urge FDA to regulate all tobacco products. No Bill Number, Independent nurse practitioners in the VA health system, Opposing designating Advanced practice nurses as independent in the VHA by means of amending the nursing handbook. No Bill Number, Access to Primary Care, Increase number of primary care physicians available to underserved areas such as loan repayment changes. No Bill Number, Emergency contraception availability, Support for emergency contraceptives more easily available. No Bill Number, Modernization of primary care graduate medical education, Support legislation to implement a budget neutral pilot project to test innovative models for distribution of GME funding.

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 to sponsor bill. HR 1173, Personalize Your Care Act, Payment for discussion with patients of advance health care planning. HR 1184, Treat and Reduce Obesity Act, Payment for chronic obesity management.HR 1487, Improved Health Care at Lower Cost Act, Creation of exception to the physician self referral prohibition that would allow gain sharing arrangements with hospitals. HR 2545, Accuracy Medicare Physician Payment Act, Reform of CMS relationship to AMA Relative Value Scale Update Committee (RUC). HR 2775, Continuing Appropriations Act for 2014, Prevent cuts in primary care training grants and research. HR 2810, Repeal of Medicare SGR formula, Repeal of SGR to be replaced by a positive payment update and higher rate for primary care. HR 2817, Protect Patient Access to Quality Health Professionals Act, Remove the non -discrimination requirements relating to health care providers. HR 3204, Drug Supply Safety, followed the Compounding and Track and Trace legislation in both bodies. HJRes59, Bipartisan Budget Act, Provide increased allocation for AAFP funding priorities in HHS. Oppose cuts or funding delays of ACA programs. S. 1238, Keep Student Loans Affordable Act, Extension of reduced interest rate for undergraduate Federal Direct Stafford Loans for medical students. S. 1284, Promoting Teaching Health Centers, AHRQ, Title VII primary care grants and NHSC appropriations, AAFP budget priorities, Title VII Sec 747, Teaching Health Center grants, NHSC, AHRQ. S. 1759, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medicare Education program. 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, Three month SGR patch, Urge Congress to pass budget deal which includes a three month SGR patch. No Bill Number, Corp Community Day Outreach, NHSC. No Bill Number, Urge sequestration be replaced, Protect funds for NHSC, CHC primary care research and training. No Bill Number, Met new director of the AHRQ, Primary care research. No Bill Number, Comprehensive Primary care, Medicare and private payments to primary care. No Bill Number, Medicare physician payment reform of the SGR, 2014 Proposed Medicare physician fee schedule. No Bill Number, Primary care payment, specialized Medicare codes for primary care. No Bill Number, Medicaid parity for primary care, Ensuring payments for true primary care physicians. No Bill Number, Primary care meeting, Medical Home and Health Care Reform. No Bill Number, E-Cigarettes, Urge FDA to regulate all tobacco products. No Bill Number, Independent nurse practitioners in the VA health system, Opposing designating Advanced practice nurses as independent in the VHA by means of amending the nursing handbook. No Bill Number, Access to Primary Care, Increase number of primary care physicians available to underserved areas such as loan repayment changes. No Bill Number, Emergency contraception availability, Support for emergency contraceptives more easily available. No Bill Number, Modernization of primary care graduate medical education, Support legislation to implement a budget neutral pilot project to test innovative models for distribution of GME funding.

Patient Protection and Affordable Care Act, P.L. 111-148, Section 4104; Medicare sustainable growth rate reform: H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013; Colon cancer screening policies in Medicare; Medicare physician quality initiatives; H.R. 1320/S. 608, Supported Colorectal Examination and Educaiton Now Act (Screen Act) of 2013; H.R. 1331, Electronic Health Records Improvement Act; H.R. 2545, the Accuracy in Physician Payment Act of 2013;Advancement of physician quality registries as they relate to Medicare physician payment reform.

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

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

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

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

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

Client expense: $111,382 · Firm income: Not reported

S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program.H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 H.R. 3128, the Protect Patients Act of 2013 Medicare and Medicaid Program: Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, and Other Revisions to Part B for CY2014- Proposed Rule. (CMS-2013-0155-0010) Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs for CY 2014- Proposed Rule. (CMS 1601-P)

Client expense: $111,382 · Firm income: Not reported

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps,provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Medicare Physician Payment Reform: Increase Medicare Fee Schedule payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged enactment of the Medicare Physician Payment Innovation Act (H.R. 574), as introduced in Feb. 2013 by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV). This legislation would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically, H.R. 574 would repeal the SGR formula, provide more than 5 years of stable physician payments, with positive increases for all physician services, and higher payments for primary care, preventive and care coordination services, and establishes a process for practices to transition to new, more effective, models of care by 2018.Advocated for the Patient-Centered Medical Home model should be scaled up for broad Medicare adoption, recognized, through the medical neighborhood concept, that specialty and subspecialty practices, hospitals, and other healthcare professionals and entities that provide treatment to the patient need to be recognized and provided with incentivesboth non-financial and financialfor engaging in patient-centered practices that complement and support the efforts of the PCMH to provide high quality, efficient, coordinated care; advocated for ACPs High Value, Cost-Conscious Care Initiative, which includes clinical, public policy, and educational components, designed to help physicians and patients understand the benefits, harms, and costs of an intervention and whether it provides good value, as well as to slow the unsustainable rate of health care cost increases while preserving high-value, high-quality care. Advocated for halting the nearly 25 percent cut in physician payments resulting from the flawed SGR formula, which is scheduled to take effect on January 1, 2014. Sequestration: Advocated strongly that Congress develop and pass a fiscally responsible, bipartisan agreement to prevent the implementation of across-the-board budget sequestration cuts that would endanger critical programs related to medical research, public health, workforce, food and drug safety, and health care for military families, as well as trigger cuts in Medicare payments to physicians and graduate medical education programs that will endanger patient access to care. Instead, policymakers should embrace an alternative approach that addresses the true cost drivers behind rising health care costs. They should work to improve the effectiveness of care provided, make necessary and appropriate changes in entitlement programs, including Medicare cost-sharing, reform payment and delivery systems, and support the proven value of primary care. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate Graduate Medical Education (GME) caps for residency programs in primary care, advocated for S. 1627, which would increase the number of Medicare-supported training positions for medical residents by 15 percent (approximately 15,000 slots) over five years, requiring at least 50 percent of the new positions to be allocated to specialties facing a current shortage. FY 2014 Budget: Recommended funding of $65 billion for discretionary public health and health research programs (Function 550) in the FY 2014 budget resolution; Urged the Administration to continue to prioritize investments in the nations health care workforce through Titles VII and VIII in the FY2014 budget. Urged appropriators to preserve full funding for the Health Resources and Services Administration (HRSA) Function 550) in the FY 2014 budget resolutions. FY2014 Appropriations: Advocated for the highest level of funding possible for the Labor-HHS-Education bill within the discretionary cap established by the Budget Control Act (BCA);; Supported funding to "improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services; Advocated for funding for AHRQ, the Health Resources and Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement; National Health Service Corps, Community Health Centers Fund, National Health Care Workforce Commission, the Centers for Medicare and Medicaid Services, Operations and Management of Exchanges, the National Institutes of Health (NIH), the Centers for Disease Control (CDC), GME; Urged Congress not to terminate AHRQ. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Advocated to federal health agencies that wellness programs must not be used as a means to discriminate against the sick and vulnerable. Wellness programs must be developed to encourage prevention and improve health rather than penalize those who are medically unable to meet wellness program goals; Advocated that employers and health plans should fund programs proven to be effective in reducing obesity, stopping smoking, deterring alcohol abuse, and promoting wellness and providing coverage or subsidies for individuals to participate in such programs. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services;and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Regarding the Essential Health Benefits Bulletin, issued by the Department of Health and Human Services (HHS) on December 16, 2011, the College advocated for striking a balance between comprehensiveness and affordability while giving States some freedom to determine a package that best serve the needs of residents. The College believes that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within and across categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Advocated to repeal the mandate that requires a prescription for over-the-counter medications purchased through a Health Savings Account. Advocated for legislation that would provide coverage under Medicare for voluntary consultations between doctors and patients to discuss advance care plans, as included in H.R. 1173, the Personalize Your Care Act of 2013. Essential Health Benefits: Commented on the proposed rule regarding essential benefits, actuarial value, and accreditation as issued by the U.S. Department of Health & Human Services on November 20, 2012; Advocated that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. National workforce policy to ensure sufficient numbers of primary care and other physicians: Urged support for a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Fully fund the commission at levels authorized in the Affordable Care Act; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine: Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury.Workforce: Advocated for H.R. 1201, The Training Tomorrow's Doctors Today Act, S. 577, the Resident Physician Shortage Reduction Act of 2013, H.R. 487, the Primary Care Workforce Access and Improvement Act of 2013, and legislation to permanently reauthorize the Conrad State 30 J-1 visa waiver program through S. 616, the Conrad State 30 and Physician Access Act. Chronic Care Management Codes/CPT 2014 Guidelines: expressed gratitude to CMS for its support of the Complex Chronic Care Management (CCCM) services and for proposing adoption of a number of provisions included in our multispecialty proposal and the CPT 2014 guidelines; made further recommendations. Additional legislation/policy: Supported the Medical Neutrality Protection Act of 2013 (H.R. 2033) which would establish the protection of medical neutrality as a policy priority of the United States, supported the intent of the Accuracy in Medicare Physician Payment (H.R. 2545) and requested changes/clarifications to ensure that it is consistent with the original MedPAC recommendation, particularly as it relates to the RUC, advocated that tobacco control measures and tobacco products are carved out of existing and future trade agreements, including the Trans-Pacific Partnership (TPP), a 12-nation agreement currently under negotiation.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps,provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act (111th Congress). Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Medicare Physician Payment Reform: Increase Medicare Fee Schedule payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Urged Congress to enact legislation that would provide stable payments for all physician specialties for at least five years while providing higher updates for undervalued evaluation and management services, require that different payment models (including Patient-Centered Medical Homes) be pilot-tested on a voluntary basis during the five year period of stable payments, and designate a specific transition period for broad adoption of the new models that have been shown to be the most effective based on the pilots. Urged enactment of the Medicare Physician Payment Innovation Act (H.R. 574), as introduced in Feb. 2013 by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV). This legislation would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically, H.R. 574 would repeal the SGR formula, provide more than 5 years of stable physician payments, with positive increases for all physician services, and higher payments for primary care, preventive and care coordination services, and establishes a process for practices to transition to new, more effective, models of care by 2018.Advocated for the Patient-Centered Medical Home model should be scaled up for broad Medicare adoption, recognized, through the medical neighborhood concept, that specialty and subspecialty practices, hospitals, and other healthcare professionals and entities that provide treatment to the patient need to be recognized and provided with incentivesboth non-financial and financialfor engaging in patient-centered practices that complement and support the efforts of the PCMH to provide high quality, efficient, coordinated care; advocated for ACPs High Value, Cost-Conscious Care Initiative, which includes clinical, public policy, and educational components, designed to help physicians and patients understand the benefits, harms, and costs of an intervention and whether it provides good value, as well as to slow the unsustainable rate of health care cost increases while preserving high-value, high-quality care. Advocated for halting the nearly 25 percent cut in physician payments resulting from the flawed SGR formula, which is scheduled to take effect on January 1, 2014. Sequestration: Advocated strongly that Congress develop and pass a fiscally responsible, bipartisan agreement to prevent the implementation of across-the-board budget sequestration cuts that would endanger critical programs related to medical research, public health, workforce, food and drug safety, and health care for military families, as well as trigger cuts in Medicare payments to physicians and graduate medical education programs that will endanger patient access to care. Instead, policymakers should embrace an alternative approach that addresses the true cost drivers behind rising health care costs. They should work to improve the effectiveness of care provided, make necessary and appropriate changes in entitlement programs, including Medicare cost-sharing, reform payment and delivery systems, and support the proven value of primary care. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate Graduate Medical Education (GME) caps for residency programs in primary care, advocated for S. 1627, which would increase the number of Medicare-supported training positions for medical residents by 15 percent (approximately 15,000 slots) over five years, requiring at least 50 percent of the new positions to be allocated to specialties facing a current shortage. FY 2014 Budget: Recommended funding of $65 billion for discretionary public health and health research programs (Function 550) in the FY 2014 budget resolution; Urged the Administration to continue to prioritize investments in the nations health care workforce through Titles VII and VIII in the FY2014 budget. Urged appropriators to preserve full funding for the Health Resources and Services Administration (HRSA) Function 550) in the FY 2014 budget resolutions. FY2014 Appropriations: Advocated for the highest level of funding possible for the Labor-HHS-Education bill within the discretionary cap established by the Budget Control Act (BCA);; Supported funding to "improve health care quality, enhance consumer choice, advance patient safety, improve efficiency, reduce medical errors, and broaden access to essential services; Advocated for funding for AHRQ, the Health Resources and Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement; National Health Service Corps, Community Health Centers Fund, National Health Care Workforce Commission, the Centers for Medicare and Medicaid Services, Operations and Management of Exchanges, the National Institutes of Health (NIH), the Centers for Disease Control (CDC), GME; Urged Congress not to terminate AHRQ. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Advocated to federal health agencies that wellness programs must not be used as a means to discriminate against the sick and vulnerable. Wellness programs must be developed to encourage prevention and improve health rather than penalize those who are medically unable to meet wellness program goals; Advocated that employers and health plans should fund programs proven to be effective in reducing obesity, stopping smoking, deterring alcohol abuse, and promoting wellness and providing coverage or subsidies for individuals to participate in such programs. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services;and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Regarding the Essential Health Benefits Bulletin, issued by the Department of Health and Human Services (HHS) on December 16, 2011, the College advocated for striking a balance between comprehensiveness and affordability while giving States some freedom to determine a package that best serve the needs of residents. The College believes that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within and across categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Advocated to repeal the mandate that requires a prescription for over-the-counter medications purchased through a Health Savings Account. Advocated for legislation that would provide coverage under Medicare for voluntary consultations between doctors and patients to discuss advance care plans, as included in H.R. 1173, the Personalize Your Care Act of 2013. Essential Health Benefits: Commented on the proposed rule regarding essential benefits, actuarial value, and accreditation as issued by the U.S. Department of Health & Human Services on November 20, 2012; Advocated that strong oversight is needed when determining the initial benchmark plan (and whether it reflects the coverage requirements of the Affordable Care Act) and how the package will be updated, particularly if insurers are given the ability to substitute benefits within categories. State and the federal government must work in concert with physicians, health care providers and payers to determine and promote use of clinically effective and cost-effective services that result in improved patient health while bending the cost curve. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. National workforce policy to ensure sufficient numbers of primary care and other physicians: Urged support for a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Fully fund the commission at levels authorized in the Affordable Care Act; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine: Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury.Workforce: Advocated for H.R. 1201, The Training Tomorrow's Doctors Today Act, S. 577, the Resident Physician Shortage Reduction Act of 2013, H.R. 487, the Primary Care Workforce Access and Improvement Act of 2013, and legislation to permanently reauthorize the Conrad State 30 J-1 visa waiver program through S. 616, the Conrad State 30 and Physician Access Act. Chronic Care Management Codes/CPT 2014 Guidelines: expressed gratitude to CMS for its support of the Complex Chronic Care Management (CCCM) services and for proposing adoption of a number of provisions included in our multispecialty proposal and the CPT 2014 guidelines; made further recommendations. Additional legislation/policy: Supported the Medical Neutrality Protection Act of 2013 (H.R. 2033) which would establish the protection of medical neutrality as a policy priority of the United States, supported the intent of the Accuracy in Medicare Physician Payment (H.R. 2545) and requested changes/clarifications to ensure that it is consistent with the original MedPAC recommendation, particularly as it relates to the RUC, advocated that tobacco control measures and tobacco products are carved out of existing and future trade agreements, including the Trans-Pacific Partnership (TPP), a 12-nation agreement currently under negotiation.

S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program.H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act Medicare Program: Request for Information on Use of Clinical Quality Measures Reported under Physician Quality Reporting System, etc. (CMS-2013-0020-0001) Medicare and Medicaid Programs: Part II - Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction (CMS-2013-0019-0001) Medicare Programs: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Long Term Care Hospital Prospective Payment System, etc. (CMS-2013-0084-0002)

Client expense: $146,735 · Firm income: Not reported

S. 153, H.R. 274, the Mental Health First Aid Act of 2013 S. 195, H.R. 628, the Mental Health in Schools Act of 2013H.R. 1100, the Mental Health on Campus Improvement Act S. 264, H.R. 1263, the Excellence in Mental Health Act H.R. 794, To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 574, the Medicare Physician Payment Innovation Act of 2013 S. 577, H.R. 1201, Training Tomorrows Doctors Today Act S. 236, H.R. 1310, the Medicare Patient Empowerment Act of 2013 H.R. 1331, the Electronic Health Records Improvement Act H.R. 1427, the Truth in Healthcare Marketing Act of 2013 S. 351, H.R. 351, the Protecting Seniors Access to Medicare Act of 2013 H.R. 297, the Childrens Hospital GME Support Reauthorization Act of 2013 S. 265, Community-Based Mental Health Improvements Act S. 648, Helping Educators Support All Students Act S.162, Justice and Mental Health Collaboration Act of 2013; S. 649, Safe Communities, Safe Schools Act of 2013 H.R. 1615, A bill to provide for a study by the Institute of Medicine on gaps in mental health services and how these gaps can increase the risk of violent acts. H.R. 2037, the Native American Psychiatric and Mental Health Care Improvement Act H.R. 2545, the Accuracy in Medicare Physician Payment Act of 2013 S. 1064, Medicare Mental Health Access Act Advancing Interoperability and Health Information Exchange: Request for Information- ONC (CMS-2013-0044-0001) HIPAA Privacy Rule and the National Instant Criminal Background Check System Proposed Rule- HHS (HHS-OCR-2013-0002-0001)

Client expense: $146,735 · Firm income: Not reported