Promoting Integrity in Medicare Act of 2013

Policies to enhance patient access to medicines in Medicaid; Policies to enhance patient access to medicines in Medicare; H.R. 2298, Medicare Patient Safety and Drug Abuse Prevention Act; H.R. 2914, Promoting Integrity in Medicare Act; H.R. 1190 & S. 141, Protecting Seniors' Access to Medicare Act of 2015; H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act; H.R. 3061 & S. 31, Medicare Prescription Drug Price Negotiation Act of 2015; H.R. 1102 & S. 117, Medicare Prescription Drug Price Negotiation Act; H.R. 2005 & S. 1083, Medicare Drug Savings Act; H. R. 3742, Access to Marketplace Insurance Act; Medicare payment proposals;

Client expense: $1,180,000 · 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), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR)

Medicare reimbursement related to the Physician Fee Schedule and Clinical Laboratory Fee Schedule (no specific bills), self-referral abuses relating to anatomic pathology (Promoting Integrity in Medicare Act of 2013, H.R. 2914), and Patient Protection and Affordable Care Act implementation.

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

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Policies to enhance patient access to medicines in Medicaid; Policies to enhance patient access to medicines in Medicare; H.R. 2298, Medicare Patient Safety and Drug Abuse Prevention Act; H.R. 2914, Promoting Integrity in Medicare Act; S. 141, Protecting Seniors' Access to Medicare Act of 2015 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act; S. 31, Medicare Prescription Drug Price Negotiation Act of 2015; H.R. 1102 & S. 117, Medicare Prescription Drug Price Negotiation Act; H.R. 2005 & S. 1083, Medicare Drug Savings Act;

Client expense: $930,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR)

Medicare reimbursement related to the Physician Fee Schedule and Clinical Laboratory Fee Schedule (no specific bills), self-referral abuses relating to anatomic pathology (Promoting Integrity in Medicare Act of 2013, H.R. 2914), and Patient Protection and Affordable Care Act implementation.

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

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Policies to enhance patient access to medicines in Medicaid; Policies to enhance patient access to medicines in Medicare; H.R. 2298, Medicare Patient Safety and Drug Abuse Prevention Act; H.R. 2914, Promoting Integrity in Medicare Act; S. 141, Protecting Seniors' Access to Medicare Act of 2015 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act; S. 31, Medicare Prescription Drug Price Negotiation Act of 2015; H.R. 1102 & S. 117, Medicare Prescription Drug Price Negotiation Act; H.R. 2005 & S. 1083, Medicare Drug Savings Act;

Client expense: $970,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR)

Medicare reimbursement related to the Physician Fee Schedule and Clinical Laboratory Fee Schedule (no specific bills), self-referral abuses relating to anatomic pathology (Promoting Integrity in Medicare Act of 2013, H.R. 2914), and Patient Protection and Affordable Care Act implementation.

Client expense: $150,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

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

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

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

HR 1309 - Health Information Technology Action of 2013 - Excludes pathologists from receiving incentives for purchasing electronic health records as well as being exempt from payment penalties under meaningful use standards. HR 1180, S 577, HR 2914 - GME legislation - proposed legislation to increase the number of federally funded residency slots HR 2914 - Stark Self-Referral Law HR 4250, S 2141 - Sunscreen Innovation Act.

Client expense: $277,572 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

In-office ancillary services exception (IOASE) / self-referral issue; H.R. 2914, Promoting Integrity in Medicare Act of 2013; meaningful use stage 2; ICD-10 delay; issues in the CY2015 CMS Physician Fee Schedule related to prostate biopsy and radiation therapy codes as well as transparency in coding

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to in office ancillary services exception; colonoscopy/endoscopy reimbursement issues; H.R. 2914, Promoting Integrity in Medicare Act of 2013; S. 2348/H.R. 1070, Removing Barriers to Colorectal Cancer Screening Act of 2014; appropriate use criteria for medical imaging; ICD-10 delay; issues in the CY2015 CMS Physician Fee Schedule Proposed Rule related to transparency in misvalued codes and the inclusion of anesthesia in colonoscopy screenings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support legislation to eliminate the Independent Payment Advisory Board (S.351, H.R. 351, Protecting Seniors' Access to Medicare Act of 2013). Support legislation to increase residency slots for Graduate Medical Education (H.R. 1201, Training Tomorrow's Doctors Today Act). Lobby in support of legislation to enact a permanent repeal to the Medicare sustainable growth rate (S.2000/H.R. 4015; SGR Repeal and Medicare Provider Payment Modernization Act of 2014 ). Lobby in support of a cap on the amount CMS can decrease payment to physician services in a given year. (related provision included in S.2000/H.R. 4015; SGR Repeal and Medicare Provider Payment Modernization Act of 2014 and H.R. 4302, Protecting Access to Medicare Act). Lobby Congress in opposition to proposed legislation to repeal in-office ancillary and physician services for anatomic pathology services (H.R. 2914, Promoting Integrity in Medicare Act of 2013, FY 15 President's Budget). Lobby Congress on impact of Health Information Technology. Lobby Congress to stop sequestration cuts to Medicare physician payments (Bipartisan Budget Act of 2013). Lobby in support of increased transparency and adequate response time from CMS when setting values for misvalued codes. Oppose legislation allowing non-physician providers direct access to Medicare patients without a referral (H.R. 5304, Audiology Patient Choice Act of 2014). Advocate on issues related to waste, fraud and abuse in Medicare. Lobby in support of legislation to extend the 90 day reporting period for demonstration meaningful use in 2015 (H.R. 5481, Flexibility in Health IT Reporting (Flex-IT) Act) Lobby Congress to rescind or delay policy in the 2015 Final Medicare Physician Fee Schedule Rule to transition 10- and 90-day global period codes to 0-day global period codes in 2017 and 2018. Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage and health insurance exchange networks (S. 2552/H.R. 4998, Medicare Advantage Participant Bill of Rights Act of 2014). Lobby Congress on issues related to telemedicine (H.R. 5380, the Medicare Telehealth Parity Act).

Client expense: $307,164 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for legislation to rebase the Medicare physician payment formula to stabilize physician payments. Support for legislation to insure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services.Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act (HR 1146). Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Support for preserving access to radiation therapy services under the Medicare Physician Fee Schedule. Support for repeal of Medicare sequestration cuts under the Budget Control Act of 2011. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Support for H.R. 2914, Promoting Integrity in Medicare Act of 2013, which amends title XVIII (Medicare) of the Social Security Act (SSA) with respect to the general exceptions to both ownership and compensation arrangement prohibitions against physician self-referrals of Medicare patients to the entity with which a physician has a certain financial relationship. Support for H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) repeal sustainable growth rate (SGR) methodology from the determination of annual conversion factors in the formula for payment for physicians' services; and (2) prescribe an update to the single conversion factor for 2014 through 2018, as well as 2019 all subsequent years, of 0.5%. Support the SGR repeal and Medicare Beneficiary Access Improvement Act of 2013.

Client expense: $134,144 · 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Nuclear Regulatory Commission (NRC), SENATE

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

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

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

Issues related to anatomic pathology and the "in-office ancillary" services exception to the Ethics in Patient Referrals Act; H.R. 2914; Policies impacting Medicare reimbursement for anatomic pathology services.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare physician payment; Medicare coverage; Medicare hospital payment; physician and hospital quality; medical liability reform; electronic health record incentive program; clinical data registries; graduate medical education; health care quality; medical imaging and prior authorization; in-office ancillary services exception. HR 2914, Promoting Integrity in Medicare Act; SGR Repeal and Beneficiary Access Improvement Act; HR 4015/S 2000, SGR Repeal and Medicare Provider Payment Modernization Act; S 2501, Hospital Readmission Accuracy and Accountability Act; S 1932/HR 3890, Better Care, Lower Cost Act; Facilitating Participation in Clinical Data Registries Act; IMPACT Act; S 2552, Medicare Advantage Participant Bill of Rights Act; HR 4282, CARE Act; HR 4930, Advancing Care for Exceptional Kids Act; S 961/HR 36, Health Care Safety Net Enhancement Act; HR 5215, to provide for recommendations for the development and use of clinical data registries; HR 5481, FLEX-IT Act; HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act; HR 4857, Ensuring Equal Access to Treatments Act; S 1758, Quality Data, Quality Healthcare Act; HR 4418, Expanding the Availability of Medicare Data Act; Hospital Improvements for Payment (HIP) Act of 2014; Protecting Integrity in Medicare Act of 2014 (PIMA); HR 647, ABLE Act; S 2461/HR 5364, CHIP Extension and Improvement Act of 2014.

Client expense: $410,000 · Firm income: Not reported

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

Medicare reimbursement related to the Physician Fee Schedule and Clinical Laboratory Fee Schedule (no specific bills), self-referral abuses relating to anatomic pathology (Promoting Integrity in Medicare Act of 2013, H.R. 2914), and Patient Protection and Affordable Care Act implementation.

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

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

HR 3509: Patient Protection and Affordable Care Act of 2010 - various provisions including: Medical Device Excise Tax, various reimbursement cuts and policy proposals for medical imaging; remote monitoring technology in the context of accountable care organizations, medical homes and post acute bundling; transparency HR 3692: The Affordable Health Care for America Act: Imaging cuts, device tax transparency and remote monitoringHR 4695 Medicare OSA Sleep Testing Bill HR 1932 Better Care, Lower Cost Act PL 110-275: "Medicare Improvements for Patient and Providers Act" (sec. 135) - Medical imaging accreditations program; medical imaging clinical appropriateness demonstration program Decline in growth rate of Medicare non-hospital imaging services S 596 - The FITT Act of 2013 (Fostering Independence Through Technology Act) - specifically the telehealth provisions HR 2914 - Imaging self-referral HR 1717 - The Medicare DMEPOS - Marketing Pricing Program Act of 2013 HR 8 - "American Tax Payer Relief Act of 2012" - Medicare Imaging Cuts & Sustainable Growth Rate Extension Site-neutrality in payments (no bill number yet) HR 2375 - The Transparency and Accountability in Medicare Bidding Act of 2013 HR 4015 - Long-term Sustainable Growth Rate (SGR) replacement legislation Appropriate Use Criteria CT Dose Optimization HR 6179 - "The Telehealth Promotion Act of 2012" HR 6626 - "The Health Care Innovation and Marketplace Technologies Act of 2012" - Telemedicine provisions. Drafts in the House and Senate addressing the SGR formula - potential telehealth provisions. HR 4920 - The Medicare DMEPOS Competitive Bidding Improvement Act of 2014 HR 5083 The Medicare DMEPOS Audit Improvement and Reform Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE

Radiation oncology reimbursement. Radiation oncology treatment safety. In office ancillary services exception to Stark laws. H.R. 2914, Promoting Integrity in Medicare Act of 2013. Medicare Physician Payment Reform.

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

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

Medicare reimbursement for radiation oncology, patient safety, quality improvement. Medicare fraud and abuse. In-office ancillary services exception to Stark law. H.R. 2914, Promoting Integrity in Medicare Act of 2013. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Support for preserving access to radiation therapy services under the Medicare Physician Fee Schedule. Medicare Physician Payment Reform.

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

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

Medicare reimbursement related to the Physician Fee Schedule and Clinical Laboratory Fee Schedule (no specific bills). Self-referral abuses relating to anatomic pathology (H.R.2914, Promoting Integrity in Medicare Act of 2013). Patient Protection and Affordable Care Act (P.L. 111-148) implementation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Reimbursement and coverage issues related to the Medicare Clinical Laboratory Fee Schedule and the Physician Fee Schedule, including implementation of the Protecting Access to Medicare Act (P.L. 113-93), misvalued codes, CMS billing practices, and appropriate test utilization; narrowing the in-office ancillary services to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, and H.R. 2914, the Promoting Integrity in Medicare Act of 2014.

Client expense: $191,813 · Firm income: Not reported

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

Reimbursement and coverage issues related to the Medicare Clinical Laboratory Fee Schedule and the Physician Fee Schedule, including implementation of the Protecting Access to Medicare Act (P.L. 113-93), misvalued codes, CMS billing practices, and appropriate test utilization; narrowing the in-office ancillary services to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, H.R. 2914, the Promoting Integrity in Medicare Act of 2014; 21st Century Cures Initiative; and the regulation and oversight of clinical laboratories.

Client expense: $191,813 · Firm income: Not reported

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

Reimbursement and coverage issues related to the Medicare Clinical Laboratory Fee Schedule and the Physician Fee Schedule, including implementation of the Protecting Access to Medicare Act (P.L. 113-93), misvalued codes, CMS billing practices, and appropriate test utilization; narrowing the in-office ancillary services to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, H.R. 2914, the Promoting Integrity in Medicare Act of 2014; 21st Century Cures Initiative; and the regulation and oversight of clinical laboratories.

Client expense: $191,813 · Firm income: Not reported

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

HR 1309 - Health Information Technology Action of 2013 - Excludes pathologists from receiving incentives for purchasing electronic health records as well as being exempt from payment penalties under meaningful use standards. HR 1180, S 577, HR 2914 - GME legislation - proposed legislation to increase the number of federally funded residency slots HR 2914 - Stark Self-Referral Law HR 4250, S 2141 - Sunscreen Innovation Act.

Client expense: $292,496 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1070 / S. 2348 - Support "Removing Barriers to Colorectal Cancer Screening Act." Bill would waive Medicare beneficiary coinsurance for a screening colonoscopy with polyp removal. Preserve the Medicare In-Office Ancillary Services Exception under the Stark Self-Referral Law / Oppose H.R. 2914 Support increased transparency and improved process for Medicare rate setting under the Medicare Physician Fee Schedule

Client expense: Not reported · Firm income: $21,000

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

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

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

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

Medicare reimbursement related to the Physician Fee Schedule and Clinical Laboratory Fee Schedule (no specific bills), self-referral abuses relating to anatomic pathology (Promoting Integrity in Medicare Act of 2013, H.R. 2914), and Patient Protection and Affordable Care Act implementation.

Client expense: $150,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Support legislation to eliminate the Independent Payment Advisory Board (S.351, H.R. 351, Protecting Seniors' Access to Medicare Act of 2013). Support legislation to increase residency slots for Graduate Medical Education (H.R. 1201, Training Tomorrow's Doctors Today Act). Lobby in support of legislation to enact a permanent repeal to the Medicare sustainable growth rate (S.2000/H.R. 4015; SGR Repeal and Medicare Provider Payment Modernization Act of 2014 ). Lobby in support of a cap on the amount CMS can decrease payment to physician services in a given year. (related provision included in S.2000/H.R. 4015; SGR Repeal and Medicare Provider Payment Modernization Act of 2014 and H.R. 4302, Protecting Access to Medicare Act). Lobby Congress in opposition to proposed legislation to repeal in-office ancillary and physician services for anatomic pathology services (H.R. 2914, Promoting Integrity in Medicare Act of 2013, FY 15 President's Budget). Lobby Congress on impact of Health Information Technology. Lobby Congress to stop sequestration cuts to Medicare physician payments (Bipartisan Budget Act of 2013). Lobby in support of increased transparency and adequate response time from CMS when setting values for misvalued codes. Oppose legislation allowing non-physician providers direct access to Medicare patients without a referral (H.R. 5304, Audiology Patient Choice Act of 2014). Advocate on issues related to waste, fraud and abuse in Medicare. Advocate regarding use and release of Medicare data regarding services provide by physicians. Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage networks (S. 2552/H.R. 4998, Medicare Advantage Participant Bill of Rights Act of 2014). Lobby Congress on issues related to telemedicine (H.R. 5380, the Medicare Telehealth Parity Act).

Client expense: $410,421 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Reimbursement and coverage issues related to both the Medicare Clinical Laboratory Fee Schedule and the Physician Fee Schedule, including implementation of the Protecting Access to Medicare Act of 2014 (P.L. 113-93, misvalued codes, pricing for molecular diagnostic tests by CMS, billing practices, and appropriate test utilization. Issues related to the draft guidance released by FDA to regulate laboratory-developed tests (LDTs). Narrowing the In-Office Ancillary Services Exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, H.R. 2914, the Promoting Integrity in Medicare Act of 2013. 21st Century Cures Initiative.

Client expense: $383,688 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Reimbursement and coverage issues related to both the Medicare Clinical Laboratory Fee Schedule and the Physician Fee Schedule, including implementation of the Protecting Access to Medicare Act of 2014 (P.L. 113-93, misvalued codes, pricing for molecular diagnostic tests by CMS, billing practices, and appropriate test utilization. Issues related to the draft guidance released by FDA to regulate laboratory-developed tests (LDTs). Narrowing the In-Office Ancillary Services Exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, H.R. 2914, the Promoting Integrity in Medicare Act of 2013. 21st Century Cures Initiative.

Client expense: $383,688 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Reimbursement and coverage issues related to both the Medicare Clinical Laboratory Fee Schedule and the Physician Fee Schedule, including implementation of the Protecting Access to Medicare Act of 2014 (P.L. 113-93, misvalued codes, pricing for molecular diagnostic tests by CMS, billing practices, and appropriate test utilization. Issues related to the draft guidance released by FDA to regulate laboratory-developed tests (LDTs). Narrowing the In-Office Ancillary Services Exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, H.R. 2914, the Promoting Integrity in Medicare Act of 2013. 21st Century Cures Initiative.

Client expense: $383,688 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Reimbursement and coverage issues related to both the Medicare Clinical Laboratory Fee Schedule and the Physician Fee Schedule, including implementation of the Protecting Access to Medicare Act of 2014 (P.L. 113-93, misvalued codes, pricing for molecular diagnostic tests by CMS, billing practices, and appropriate test utilization. Issues related to the draft guidance released by FDA to regulate laboratory-developed tests (LDTs). Narrowing the In-Office Ancillary Services Exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy, H.R. 2914, the Promoting Integrity in Medicare Act of 2013. 21st Century Cures Initiative.

Client expense: $383,688 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, White House Office

Medicare reimbursement related to the Physician Fee Schedule and Clinical Laboratory Fee Schedule (no specific bills). Self-referral abuses relating to anatomic pathology (H.R.2914, Promoting Integrity in Medicare Act of 2013). Patient Protection and Affordable Care Act (P.L. 111-148) implementation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

In-office ancillary services exception (IOASE) / self-referral issue; H.R. 2914, Promoting Integrity in Medicare Act of 2013; meaningful use stage 2; payment reforms for pathology services contained in 2014 CMS proposed physician fee schedule rule; radiation oncology payment reforms contained in 2014 CMS proposed physician fee schedule rule

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

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

Issues related to in office ancillary services exception; colonoscopy/endoscopy reimbursement issues; H.R. 2914, Promoting Integrity in Medicare Act of 2013; S. 2348/H.R. 1070, Removing Barriers to Colorectal Cancer Screening Act of 2014; appropriate use criteria for medical imaging

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for legislation to rebase the Medicare physician payment formula to stabilize physician payments. Support for legislation to insure patient safety and preserve the integrity of the Medicare program by ending abuses of the physician self-referral law for radiation therapy services.Support for structural changes that lead to delivering high-quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers. Support for Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act (HR 1146). Support for ensuring radiation oncologists participation in the Medicare electronic health record incentive program. Support for preserving access to radiation therapy services under the Medicare Physician Fee Schedule Support for repeal of Medicare sequestration cuts under the Budget Control Act of 2011 Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Support for H.R. 2914, Promoting Integrity in Medicare Act of 2013, which amends title XVIII (Medicare) of the Social Security Act (SSA) with respect to the general exceptions to both ownership and compensation arrangement prohibitions against physician self-referrals of Medicare patients to the entity with which a physician has a certain financial relationship. Support for H.R. 2810, the Medicare Patient Access and Quality Improvement Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) repeal sustainable growth rate (SGR) methodology from the determination of annual conversion factors in the formula for payment for physicians' services; and (2) prescribe an update to the single conversion factor for 2014 through 2018, as well as 2019 all subsequent years, of 0.5%. Support the SGR repeal and Medicare Beneficiary Access Improvement Act of 2013 Printed

Client expense: $157,732 · 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), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Nuclear Regulatory Commission (NRC), SENATE

Issues related to anatomic pathology and the "in-office ancillary" services exception to the Ethics in Patient Referrals Act; H.R. 2914; Policies impacting Medicare reimbursement for anatomic pathology services.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare physician payment; clinical data registries; graduate medical education; health care quality; medical imaging and prior authorization; in-office ancillary services exception; HR 2914, Promoting Integrity in Medicare Act; SGR Repeal and Beneficiary Access Improvement Act of 2014; HR 4015/S 2000, SGR Repeal and Medicare Provider Payment Modernization Act; S 2501, Hospital Readmission Accuracy and Accountability Act; S 1932/HR 3890, Better Care, Lower Cost Act; IMPACT Act;S 2552, Medicare Advantage Participant Bill of Rights Act; HR 4282, CARE Act; HR 4930, Advancing Care for Exceptional Kids Act; S 961/HR 36, Health Care Safety Net Enhancement Act; Facilitating Participation in Clinical Data Registries Act; HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act; HR 4857, Ensuring Equal Access to Treatments Act; S 1758, Quality Data, Quality Healthcare Act; HR 4418, Expanding the Availability of Medicare Data Act.

Client expense: $850,000 · Firm income: Not reported

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

Support legislation to eliminate the Independent Payment Advisory Board (S.351, H.R. 351, Protecting Seniors' Access to Medicare Act of 2013). Support legislation to increase residency slots for Graduate Medical Education (H.R. 1201, Training Tomorrow's Doctors Today Act).Lobby in support of legislation to enact a permanent repeal to the Medicare sustainable growth rate (S.2000/H.R. 4015; SGR Repeal and Medicare Provider Payment Modernization Act of 2014 ). Lobby in support of a cap on the amount CMS can decrease payment to physician services in a given year. (related provision included in S.2000/H.R. 4015; SGR Repeal and Medicare Provider Payment Modernization Act of 2014 and H.R. 4302, Protecting Access to Medicare Act). Lobby Congress in opposition to proposed legislation to repeal in-office ancillary and physician services for anatomic pathology services (H.R. 2914, Promoting Integrity in Medicare Act of 2013, FY 15 President's Budget). Lobby Congress on impact of Health Information Technology. Lobby Congress to stop sequestration cuts to Medicare physician payments (Bipartisan Budget Act of 2013). Lobby in support of increased transparency and adequate response time from CMS when setting values for misvalued codes. Oppose legislation allowing non-physician providers direct access to Medicare patients without a referral (H.R. 5304, Audiology Patient Choice Act of 2014). Advocate on issues related to waste, fraud and abuse in Medicare.

Client expense: $416,696 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Radiation oncology reimbursement. Radiation oncology treatment safety. In office ancillary services exception to Stark laws. H.R. 2914, Promoting Integrity in Medicare Act of 2013. See continuation page.Medicare Physician Payment Reform. S. 1871, SGR Repeal and Medicare Beneficiary Improvement Act of 2013. H.R. 2810, SGR Repeal and Medicare Beneficiary Access Act of 2013. Pathway for SGR Reform Act. S. 2110, The Medicare SGR Repeal and Beneficiary Access Improve Act of 2014 (Wyden). S. 2122, The Responsible Medicare SGR Real and Beneficiary Access Improvement Act of 2014 (Hatch). S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 (Wyden). S. 2000, H.R. 4015, The SGR Repeal and Medicare Provider Payment Modernization Act of 2014. H.R. 4302, The Protecting Access to Medicare Act (Became Public Law 113-93).

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

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

Medicare reimbursement for radiation oncology, patient safety, quality improvement. Medicare fraud and abuse. In-office ancillary services exception to Stark law. H.R. 2914, Promoting Integrity in Medicare Act of 2013. Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value. Support for preserving access to radiation therapy services under the Medicare Physician Fee Schedule. See continuation page.Medicare Physician Payment Reform. S. 1871, SGR Repeal and Medicare Beneficiary Improvement Act of 2013. H.R. 2810, SGR Repeal and Medicare Beneficiary Access Act of 2013. Pathway for SGR Reform Act. S. 2110, The Medicare SGR Repeal and Beneficiary Access Improve Act of 2014 (Wyden). S. 2122, The Responsible Medicare SGR Real and Beneficiary Access Improvement Act of 2014 (Hatch). S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 (Wyden). S. 2000, H.R. 4015, The SGR Repeal and Medicare Provider Payment Modernization Act of 2014. H.R. 4302, The Protecting Access to Medicare Act (Became Public Law 113-93). H.R. 2914, The Promoting Integrity in Medicare Act.

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

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

HR 3509: Patient Protection and Affordable Care Act of 2010 - various provisions including: Medical Device Excise Tax, various reimbursement cuts and policy proposals for medical imaging; remote monitoring technology in the context of accountable care organizations, medical homes and post acute bundling; transparency HR 3692: The Affordable Health Care for America Act: Imaging cuts, device tax transparency and remote monitoringHR 4695 Medicare OSA Sleep Testing Bill HR 1932 Better Care, Lower Cost Act PL 110-275: "Medicare Improvements for Patient and Providers Act" (sec. 135) - Medical imaging accreditations program; medical imaging clinical appropriateness demonstration program Decline in growth rate of Medicare non-hospital imaging services S 596 - The FITT Act of 2013 (Fostering Independence Through Technology Act) - specifically the telehealth provisions HR 2914 - Imaging self-referral HR 1717 - The Medicare DMEPOS - Marketing Pricing Program Act of 2013 HR 8 - "American Tax Payer Relief Act of 2012" - Medicare Imaging Cuts & Sustainable Growth Rate Extension Site-neutrality in payments (no bill number yet) HR 2375 - The Transparency and Accountability in Medicare Bidding Act of 2013 HR 4015 - Long-term Sustainable Growth Rate (SGR) replacement legislation Appropriate Use Criteria CT Dose Optimization HR 6179 - "The Telehealth Promotion Act of 2012" HR 6626 - "The Health Care Innovation and Marketplace Technologies Act of 2012" - Telemedicine provisions. Drafts in the House and Senate addressing the SGR formula - potential telehealth provisions. HR 4920 - The Medicare DMEPOS Competitive Bidding Improvement Act of 2014 HR 5083 The Medicare DMEPOS Audit Improvement and Reform Act

Client expense: $350,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE

H.R. 1070 / S. 2348 - Support "Removing Barriers to Colorectal Cancer Screening Act." Bill would waive Medicare beneficiary coinsurance for a screening colonoscopy with polyp removal. Preserve the Medicare In-Office Ancillary Services Exception under the Stark Self-Referral Law / Oppose H.R. 2914 Support increased transparency and improved process for Medicare rate setting under the Medicare Physician Fee Schedule

Client expense: Not reported · Firm income: $21,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Medicare reimbursement related to the Physician Fee Schedule and Clinical Laboratory Fee Schedule (no specific bills), self-referral abuses relating to anatomic pathology (Promoting Integrity in Medicare Act of 2013, H.R. 2914), and Patient Protection and Affordable Care Act implementation.

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

Government targets: Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, SENATE