Two-Midnight Rule Delay Act of 2013

21st Century Cures Act (H.R. 6) and Senate HELP Committee provisions related to interoperability and information blocking Urging release of funding for Ebola preparedness and treatment Support for Protecting Seniors Access to Medicare Act of 2015 (H.R. 1190 and S.141) Support for Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Support for Critical Access Hospital Relief Act of 2015 (H.R. 169/S. 258) Support for Protecting Access to Rural Therapies Act (H.R. 1611/S. 257) Support for Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) Support for Flexibility in Health IT Reporting Act of 2015 (H.R. 270) Support for Resident Physician Shortage Reduction Act of 2015 (H.R. 2124/ S. 1148) Support for Medicare Audit Improvement Act of 2015 (H.R. 2156) Support for Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Support for Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Support for Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Protecting 340B Drug Pricing Program in regulatory and legislative proposals Opposing Medicare and Medicaid Payment reductions, including those to Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) payments, CAH payments, IPPS coding offset, rural hospital payments, hospital outpatient department (HOPD) clinics, and sequestration. Support for finalizing Medicare and Medicaid Electronic Health Record Incentive Payment Programs (Meaningful Use) 2015-2017 Modifications Rule; support for delaying of Stage 3 Rule Urging Release of New York State Medicaid Vital Access Provider Program Funding Support for changes to liver transplant allocation system

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

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

Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) 21st Century Cures Act (H.R. 6) Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) Funding for Ebola preparedness and treatment Protecting Seniors Access to Medicare Act of 2015 (H.R. 1190 and S.141) Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Critical Access Hospital Relief Act of 2015 (H.R. 169/S. 258) Protecting Access to Rural Therapies Act (H.R. 1611/S. 257) Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) Flexibility in Health IT Reporting Act of 2015 (H.R. 270) Resident Physician Shortage Reduction Act of 2015 (H.R. 2124/ S. 1148) Medicare Audit Improvement Act of 2015 (H.R. 2156) Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Medicare physician fee schedule fix Medicare and Medicaid Recovery Audit Contractor (RAC) Programs 340B Drug Pricing Program Funding for National Institutes of Health Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) Payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, hospital outpatient department (HOPD) clinics, and sequestration. Medicare and Medicaid Electronic Health Record Incentive Payment Programs Medicaid, New York State Medicaid Vital Access Provider Program Liver transplant allocation system FFY 2015 Inpatient Prospective Payment System Proposed Rule (CMS-1607-P) - Two-Midnight Policy

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

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

Medicare Access and CHIP Reauthorization Act of 2015 (H.R. 2) Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) Funding for Ebola preparedness and treatment Protecting Seniors Access to Medicare Act of 2015 (H.R. 1190 and S.141) Rural Hospital Access Act of 2015 (H.R. 663/S. 332) Critical Access Hospital Relief Act of 2015 (H.R. 169/S. 258) Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 1343/S. 688) Flexibility in Health IT Reporting Act of 2015 (H.R. 270) Resident Physician Shortage Reduction Act of 2013 (H.R. 1180/ S. 577) Medicare Audit Improvement Act of 2013 (H.R. 1250/ S.1012) Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Medicare physician fee schedule fix Medicare and Medicaid Recovery Audit Contractor (RAC) Programs Funding for National Institutes of Health Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) Payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, hospital outpatient department (HOPD) clinics, and sequestration. Medicare and Medicaid Electronic Health Record Incentive Payment Programs Medicaid, New York State Medicaid Vital Access Provider Program Liver transplant allocation system FFY 2015 Inpatient Prospective Payment System Proposed Rule (CMS-1607-P) - Two-Midnight Policy

Client expense: $220,000 · Firm income: Not reported

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

Inpatient and outpatient hospital payments Issues and Legislation related to the Medicare Sustainable Growth Rate H.R.3698, Two-Midnight Rule Delay Act of 2013 S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 Issues Related to 340B Program Changes Issues Related to Telehealth

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

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

HR 3698/ S. 2082: The Two Midnight Rule Coordination & Improvement Act HR 3993/ S. 2037: Critical Access Hospital Relief Act HR 1250/ S. 1012: Medicare Audit Improvement Act - Legislation to improve the system of hospital payment audits conducted by Medicare Recovery Audit contractors. HR 1920/ S. 1555: DSH Reduction Relief Act - Legislation to delay the Medicare & Medicaid disproportionate share hospital (DSH) cuts contained in the Affordable Care Act for two years until fiscal year 2016. HR 2801/S. 842: Protecting Access to Rural Therapy Services Act - Legislation to protect access to outpatient therapeutic services in small & rural and critical access hospitals. HR 4302: Protecting Access to Medicare Act of 2014 - Sustainable growth rate - doc. fix. HR 1201: Training Tomorrow's Doctors Act - Legislation to revise the distribution of resident positions and the calculation of payments for direct medical education costs. HR 2810/ S. 2000: Permant Sustainable Growth Rate for Medicare Physicians HR 1787/ S. 842: Rural Hospital Access Act HR 5481: Continue 3 - month quarter reporting in 2015 under Medicare & Medicaid EHR Site Neutral Payments Medicaid & Medicare Funding in the Federal Budget Medicare Payment Penalties for Hospital Aquired Conditions (HACs)

Client expense: $190,000 · Firm income: Not reported

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

Health and Human Services Appropriations - In support of increased funding for the Department of Health and Human Services including National Institutes of Health research programs and Title VII and Title VIII funding; Poison Control Centers and programs for teaching and research at academic medical centers. In support of report language regarding the National Pediatric Research Network. In support of extension for 340B Program. In opposition to cuts to GME/IME. In support of the Two Midnights Amendment to SGR Repeal & Medicare Beneficiary Access Improvement Act of 2013 (Casey). In support of the Two Midnight Rule Delay Act of 2013 (HR 3698). In Support of HR4188, Establishing Beneficiary Equity in the hospital Readmission Program Act. In Support of HR1250, Medicare Audit Improvement Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1012 / H.R. 1250: Medicare Audit Improvement Act S. 183 / H.R. 2053: Hospital Payment Fairness Act H.R. 2329: Administrative Relief and Accurate Medicare Payments Act H.R. 3698: Two Midnight Rule Delay Act S. 2082: Two-Midnight Rule Coordination and Improvement Act S. 1143 / H.R. 2801: Protecting Access to Rural Therapy Services Act H.R. 3769: Delays enforcement of physician supervision requirements for CAHs S. 2037 / H.R. 3991: Critical Access Hospital Relief Act S. 2187: Rural Community Hospital Demonstration Extension Act S. 2359: Craig Thomas Rural Hospital and Provider Equity Act H.R. 5227: Making the Education of Nurses Dependable for Schools Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1201 "Training Tomorrow's Doctors Today Act" All Provisions S 577 "Resident Physician Shortage Act of 2013" All Provisions HR 574 "Medicare Physician Payment Innovation Act" All Provisions H.R. 4302 Protecting Access to Medicare Act of 2014 All Provisions P.L. 111-148 and P.L. 111-152 Affordable Care Act. All provisions related to implementation of health care reform including the Medicare and Medicaid programs, tax and insurance policies, graduate medical education, biomedical research, public and preventative health measures, and other policies concerning hospitals, physicians, health plans, employers and individuals. H.R. 1180 The Resident Physician Shortage Reduction Act of 2013. All Provisions. H.R. 1920 DSH Reduction Relief Act of 2013. All Provisions. S. 1012 The Medicare Audit Improvement Act of 2013. All Provisions. H.R. 1250 The Medicare Audit Improvement Act of 2013. All Provisions. H. R. 2810 Medicare Patient Access and Quality Improvement Act of 2013. All Provisions. Senate Finance Committee: The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. All Provisions. The SGR Repeal and Medicare Beneficiary Accesst Improvement Act of 2013, offered as a substitute amendment to H.R.2810 Medicare Patient Access and Quality Improvement Act of 2013. All Provisions. H.J. Res.59 Continuing Appropriations Resolution, 2014 Short Title: Bipartisan Budget Act of 2013 and Pathway for SGR Reform Act of 2013. All Provisions related to the Medicare Physican Payment H.R. 3698 Two-Midnight Rule Relay Act, All provision Medicare Advantage 2015 Advance Notice of Methodological Changes for Calendar Year 2015 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2015 Call Letter. All Provisions S.1932 Medicare Better Care Program. All provisions. H.R. 3890 Medicare Better Care Program. All provisions. H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act. All provisions. H.R. 1920 DSH Reduction Relief Act of 2013. All provisions. S. 2082 Two-Midnight Rule Coordination and Improvement Act of 2014. All provisions. H.R. 4673 Bundling and Coordinating Post-Acute Care Act of 2014. All provisions. H.R. 4994 Impact Act of 2014 - Improving Medicare Post-Acute Care Transformation Act of 2014. All provisions. H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act. All provisions. Medicare Shared Savings Program/Accountable Care Organizations: Potential Regulatory Reforms H.R. 5481 To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes. Hospital Improvements for Payment Act of 2014 Discussion Draft - All Provisions H.R. 5771 Tax Increase Prevention Act of 2014. All Provisions CMMI Demonstration Project

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

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

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support. General discussions of graduate medical education.

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support. General discussions about graduate medical education.

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support. General discussions of graduate medical education.

Client expense: Not reported · Firm income: $15,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1143/HR 2801 -- PARTS Act to modify physician supervision rules for therapeutic services delivered in a hospital outpatient department. Support. S 2037/HR 3991 -- Modify critical access hospital length-of-stay requirements to average annual length-of-stay. Support S 2082/HR 3698 -- Require Centers for Medicare & Medicaid Services to change two-midnights rule used to determine whether a patient is inpatient or outpatient. Support.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for an additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments;AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered,and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 and S. 2037 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Support HR 3991 and S 2037 Critical Access Hospital Relief Act of 2014, amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital; Support HR 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act, to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support H.R. 2801 and S1143 Protecting Access to Rural Therapy Services (PARTS) Act of 2013, a bill to adopt a default standard of general supervision for outpatient therapeutic services, develop a reasonable exceptions process with provider input to identify specific procedures that require direct supervision, ensure that, for CAHs, the definition of direct supervision is consistent with the CAH conditions of participation that allow a physician or NPP to present within 30 minutes of being called and prohibit enforcement of CMSs retroactive reinterpretation that the direct supervision requirements applied to services furnished since January 1, 2001; S.1932/H.R. 3890 Better Care, Lower Cost Act , AHA has not taken position on the bill, but did establish an AHA working group to analyze the legislation to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions; requested that the increasing number of hospital compliance reviews performed by the Office of Inspector General (OIG) Office of Audit Services in which the OIG has extrapolated audit findings to estimate Medicare overpayments to the hospitals and the hospitals Medicare Administrative Contractors (MACs)have sought to recover the extrapolated overpayment amounts be halted without delay; Support HR 5481, The Flexibility in Health IT Reporting (Flex-It) Act, a bill to continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs. Senate briefing on legal barriers to providers' ability to manage risk, particularly with respect to Medicare ACO programs. Support HR 4656 and S2276, Caring for America's Heroes Act, a bill to improve access to mental health services under the TRICARE program; Funding for Ebola treatment and preparedness as part of the FY15 Omnibus Appropriations Act. Met to discuss the HHS calculator issue to ensure employers cannot offer health plans that exclude inpatient hospital care.

Client expense: $5,590,000 · Firm income: Not reported

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

H.R. 1180, S. 577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Endowment for the Arts, SENATE

H.R. 4302, Protecting Access to Medicare Act of 2014: Medicare reimbursement pertaining to Medicare Sustainable Growth Rate Formula (SGR). S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2013; H.R. 3698, Two-Midnight Rule Delay Act of 2013: executive action pertaining to two-midnight rule issue; H.R. 1180, S. 577, Resident Physician Shortage Reduction Act of 2013, entire bill.

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

Client expense: Not reported · Firm income: $70,000

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Natl Endowment for the Arts, SENATE

S.183, Hospital Payment Fairness Act of 2013, Issues pertaining to sunsetting national budget neutrality for the hospital wage index. H.R. 2053, S. 1012, Medicare Hospital Wage Index Equity Act, Issues pertaining to changing the national budget neutrality for the hospital wage index to a state neutrality. H.R. 1180, S.577, Resident Physician Shortage Reduction Act of 2013, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1201, Training Tomorrow's Doctors Today Act, Issues pertaining to increasing the cap on the number of resident physicians. H.R. 1250, S. 1012, Medicare Audit Improvement Act of 2013, Issues pertaining to RAC audits for hospitals. H.R. 1920, S. 1555, DSH Reduction Relief Act of 2013, Issues regarding delaying implementation of DSH cuts. Issues pertaining to protecting funding for direct graduate medical education and indirect medical education. S.1871, SGR Repeal and Medicare Beneficiary Access Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R.2810, Medicare Patient Access and Quality Improvement Act of 2013, Issues pertaining to the Sustainable Growth Rate and its offsets. H.R. 3698, S. 2082, Two-Midnight Rule Delay Act of 2013, Support for delaying the two-midnight rule from CMS and issuing a clear policy on stays for less than two midnights. HR 4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act, Issues relating to adjusting for patient disparities. S 2728, Community-Based Medical Education Act of 2014, Issues relating to concerns about reductions to IME and other items. S 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, Issues relating to adjusting for patient socioeconomic disparities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

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

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

H.R. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

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

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

H.R. 297 - Children's Hospital GME Support Reauthorization Act of 2013 S. 1557 - Children's Hospital GME Support Reauthorization Act of 2013 H.R. 1920 - DSH Reduction Relief Act of 2013 H.R. 2053 - Medicare Hospital Wage Index Equity Act of 2013 S. 183 - The Hospital Payment Fairness Act of 2013 S. 744 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 1555 - DSH Reduction Relief Act of 2013 H.R. 3547 - Consolidated Appropriations Act, 2014 H.Con.Res.96 - Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary levels for fiscal years 2016 through 2024. H.R.3698 - Two-Midnight Rule Delay Act of 2013 S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014 S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 2810 - SGR Repeal and Medicare Beneficiary Access Act of 2013 H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 H.R. 4209 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 4302 - Protecting Access to Medicare Act of 2014 S. 2450 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 H.R. 3230 - Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 S. 2501 - Hospital Readmissions Program Accuracy and Accountability Act of 2014 H.R. 4994 - IMPACT Act of 2014 H.J. Res. 124 - Continuing Appropriations Resolution, 2015 H.R. 4930 - ACE Kids Act of 2014 H.R. 83 - Consolidated and Further Continuing Appropriations Act, 2015 H.J. Res. 130 - Making further continuing appropriations for fiscal year 2015, and for other purposes.

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

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

Funding for Graduate and Indirect Medical Education H.R. 4015; S. 2110: "SGR Repeal and Medicare Provider Payment Modernization Act of 2014" - To fix how physician payments are determined H.R. 3698 - Two-Midnight Rule Delay Act of 2013 - to delay the enforcement of the "two-midnight" rule for Medicare patients

Client expense: Not reported · Firm income: $70,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 83: Consolidated and Further Continuing Appropriations Act, 2015 (H.R. 83) Funding for Ebola preparedness and treatment Medicare Audit Improvement Act of 2013 (H.R. 1250) Resident Physician Shortage Reduction Act (S. 577/H.R. 1180) Protecting Seniors Access to Medicare Act of 2013 (H.R. 351 and S. 351) The DSH Reduction Relief Act of 2013 (H.R. 1920) Rural Hospital Access Act (H.R. 1787) Rural Hospital Fairness Act (H.R. 2578) Two Midnight Rule Delay Act (H.R. 3698)/Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082) Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 4188)/ Hospital Readmissions Program Accuracy and Accountability Act of 2014 (S. 2501) Craig Thomas Rural Hospital and Provider Equity Act (S. 2359) Flexibility in Health IT Reporting Act (HR 5481) Making the Education of Nurses Dependable for Schools (MEND) Act (H.R. 5227) Medicare physician fee schedule fix Severe sepsis protocols Medicare and Medicaid Recovery Audit Contractor (RAC) Programs Funding for National Institutes of Health Medicare and Medicaid Payment reductions, including Graduate Medical Education, bad debt payments, post-acute care payments, Disproportionate Share Hospital (DSH) Payments, CAH payments, IPPS coding offset, rural hospital payments, Medicare Dependent Hospital authorization, inpatient coding offset, hospital outpatient department (HOPD) evaluation and management (E/M) services, and sequestration. Medicare and Medicaid Electronic Health Record Incentive Payment Programs Medicaid, New York State Medicaid Vital Access Provider Program Hospital and health system pricing transparency Clinical quality measures and electronic clinical quality measures FY 2014 Inpatient Prospective Payment System Final Rule (CMS-1599-F) - Two-Midnight Policy FFY 2015 Inpatient Prospective Payment System Proposed Rule (CMS-1607-P) - Two-Midnight Policy

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 4015 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014; H.R. 4302 - Protecting Access to Medicare Act of 2014; S. 1871 - SGR Repeal and Medicare Beneficiary Access Act of 2013; S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014; S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014; S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Access Act of 2014; Graduate Medical Education Payment Issues; Implementation of the Patient Protection & Affordable Care Act (P.L. 111-148); Accountable Care Organizations/Medicare Shared Savings Program; Quality of Care Measurements/Pay for Value/Delivery System Reform; H.R. 49030 - ACE Kids Act of 2014; H.R. 3698 - The Two Midnight Delay Act of 2013; H.R. 1250/S. 1012 - The Medicare Audit Improvement Act of 2013; S. 2082 - The Two-Midnight Rule Coordination and Improvement Act of 2014; site neutral payments; post-acute care/skilled nursing facilities access; Medicare three-day rule. observation stays policies; Medicaid Primary Care Payment Parity; Home Health Care; ICD 10 Implementation; Hospital Improvements for Payment Act; Medicare Advantage Program; Postacute care.

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

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

H.R.5464 and draft Senate legislation, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division G, Title II Issues: Support funding for NIH, Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Children's Hospitals Graduate Medical Education program (CHGME), HRSA, biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Support emergency supplemental funding to prepare and respond to Ebola and to reimburse for Ebola Virus Disease treatment. H.R. 4486 and draft Senate legislation, Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015, Title II H.R. 83, P.L.113-235, Consolidated and Further Continuing Appropriations Act, 2015, Division I, Title II President's Budget, FY 2016 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Funding for Community Health Centers and the NHSC. Debt in Health Education Loan programs (DebtHELP) bill (draft) Issues: Expand National Health Service Corps State Loan Repayment program, align Department of Education and Health Resources and Services Administration student loan programs. S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction Act of 2013 Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. H.R. 487, Primary Care Workforce Access Improvement Act Issue: Residency training in community-based settings. P.L. 111-148, Affordable Care Act, Sections 5503 and 5506 Issue: Redistribution of residency positions. Issue: Implementation of and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the Affordable Care Act. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform. Issue: Support the use of animals in medical research. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014 Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Implementation of Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose discretionary spending cuts through sequestration, including NIH, Titles VII and VIII health professions and nursing education programs, and other science programs. Issue: Support primary care workforce development S. 1759, Teaching Health Center Reauthorization Act Issue: Legislation to reauthorize the Teaching Health Center Program and payments. Issue: Draft legislation on pain education in undergraduate and graduate medical education. H.R.548/S. 1152, The Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. H.R. 5294, Health Equity and Accountability Act of 2014 Issue: Support bill to improve health equity. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. H.R. 3698, Two Midnight Rule Delay Act of 2013 S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act. S. 2501, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. Issue: Educating health professionals regarding prescription drug abuse and appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Support use of holistic review in admissions. Issue: Support ACA consumer outreach and enrollment efforts. Issue: Implementation of the 340B drug discount program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Support preservation of funding for the Primary Care Residency Expansion program. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 5411, Trafficking Awareness Training for Health Care Act of 2014 Issue: Medical education curricula content pertaining to human trafficking. S. 2658/H.R.5580, Accelerating Biomedical Research Act Issue: To increase discretionary spending cap to increase funding for the National Institutes of Health (NIH). S. 2450, Veterans' Access to Care through Choice, Accountability, and Transparency Act H.R. 4810, Veteran Access to Care Act Issue: Addressing VA backlogs by increasing care for veterans provided by non-VA facilities. S. 2115, American Cures Act H.R. 4384, America HEALS ACT Issue: Support establishment of a fund to provide an expanded and sustained investment in biomedical research. H.R. 4879, Research for All Act Issues: Support inclusion of male and female cells, tissues and animals in basic biomedical research. Support update of NIH guidelines to increase participation of women in clinical trials. Issue: FDA regulation of Laboratory Developed Tests (LDTs) S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 2645, The Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids S. 2942, The Infectious Disease Hospitals Hubs Act Issue: Support legislation to establish a network of hospitals in preparing for and responding to infectious diseases. Issue: Support nomination of Dr. Vivek Murthy as U.S. Surgeon General Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: U.S. Census Bureau on the American Community Survey CMS on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program CMS on final rule regarding definition of uninsured for purposes of Medicaid DSH limits HHS on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.) FDA on strategies for increasing patient involvement in regulatory processes. White House Ebola Response Coordinator offering to work with federal and state officials to prepare and respond to Ebola cases. NIH in response to an RFI related to the development of grant program to help facilitate the transition from training to independence. NIH on the consideration of sex as a biological variable in biomedical research The Patient-Centered Outcomes Research Institute (PCORI) on the proposed process for peer review and public release of its primary research finding. DEA on delaying the Disposal of Controlled Substances Final Rule.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

S. 577, Resident Physician Shortage Reduction Act of 2013 H.R. 1180, Resident Physician Shortage Reduction of 2013. Issue: Support lifting the cap on the number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education and Indirect Medical Education payments. H.R. 1201, Training Tomorrow's Doctors Today Act Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare DGME and IME payments and increase GME accountability and transparency. Issue: Implementation and funding for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. Issue: Health Insurance Exchanges mandated by the Affordable Care Act (ACA) to recognize and not penalize the unique missions of medical schools and teaching hospitals. Issue: Support Medicare physician payment reform. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. H.R. 487, Primary Care Workforce Access Improvement Act. Issue: Residency training in community-based settings. Issue: Primary Care Workforce Development. President's Budget, FY 2015 Issue: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. S. 2082, Two Midnight Rule Coordination and Improvement Act of 2014 H.R. 3698, Two Midnight Rule Delay Act of 2013 Issue: Support delay of Enforcement of new Centers for Medicare and Medicaid Services inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare Graduate Medical Education (GME) per resident amount technical corrections and administrative relief. H.R. 4188, Establishing Beneficiary Equity in the Hospital Readmissions Program Act S. 2501, Hospital Readmission Accuracy and Accountability Act Issue: Support inclusion of socioeconomic status as part of hospital readmissions program. H.R. 2810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Issues: Support repeal of Medicares Sustainable Growth Rate (SGR) formula; Medicare physician payment reform. Issue: Draft legislation on educating health professionals regarding appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Issue: Implementation of the 340B drug discount program. H.R. 4302, Protecting Access to Medicare Act of 2013. Issues: Support Medicare physician payment relief and extended delay of Medicare's "two-midnights" policy for hospital admissions; support the addition of GME language related to establishing Medicare caps and PRA; support delayed implementation of Medicaid DSH cuts. H.R. 4282, Creating Access to Residency Education Act of 2014 Issue: Create CMS grant program for new residency programs. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program including support for adoption of National Quality Forum (NQF) recommendations. Issue: Support Medicaid expansion advocacy efforts. Issue: Draft legislation on pain education in undergraduate and graduate medical education. S. 2229, Expanding Primary Care Access and Workforce Act Issue: Offer comments on primary care workforce legislation. H.R. 4942, Underserved Veterans Access to Health Care Act Issue: Increasing funding for VA GME and Medicare GME. S. 2553/H.R. 4994, Improving Medicare Post-Acute Care Transformation Act of 2014. Issue: Standardization of post-acute care assessment data for quality, payment, and discharge planning. S. 2728, Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments. Issue: Development and implementation of new Medicare Disproportionate Share Hospital (DSH) formula required under the ACA. Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system Submitted comments to: Centers for Medicare & Medicaid Services (CMS) on the Hospital Acquired Conditions Reduction Program (HAC)s technical expert panel (TEP)s report regarding the scoring of hospitals in the HAC program. Centers for Medicare & Medicaid Services (CMS) on final rule regarding definition of uninsured for purposes of Medicaid DSH limits The Department of Health and Human Services (HHS) on revisions to the safe harbors under the anti-kickback statute and civil monetary penalty rules (gainsharing, etc.)

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Bureau of the Census, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Drug Enforcement Administration (DEA), Federal Reserve System, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Patent & Trademark Office (PTO), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

H.R. 4302 - Protecting Access to Medicare Act of 2014. H.R. 3698 - Two-Midnight Rule Delay Act of 2013. S. 2082 - Two-Midnight Rule Coordination and Improvement Act of 2014.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues concerning hospital reimbursement, two midnight rule, Medicare Recovery Audits, and specialty hospitals. Issues related to S. 1012/H.R. 1250, The Medicare Audit Improvement Act. H.R. 3698, The Two Midnight Rule Delay Act of 2013. Issues related to physician payment reform.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L.112-25, The Budget Control Act (Sections regarding the impact of Medicare sequestration on hospitals) H.R.351, Protecting Seniors Access to Medicare Act of 2013 (All sections of full text) H.R.2027, Expanding Patients Access to Quality Care Act of 2013 (All sections of full text) H.R.3121, American Health Care Reform Act of 2013 (All sections of full text)H.R.3698, Two-Midnight Rule Delay Act of 2013 (All sections of full text) H.R.3796, Comprehensive Care Payment Innovation Act (All sections of full text) S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 (All sections of full text) Draft Senate legislation known as the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act. Discussions involving group purchasing organizations. Discussions regarding the status of construction of new veteran's affairs facility in the Denver metro area.

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

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

Inpatient and outpatient hospital payments Issues and Legislation related to the Medicare Sustainable Growth Rate H.R.3698, Two-Midnight Rule Delay Act of 2013 S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014Issues Related to 340B Program Changes Issues Related to ICD-10 - No More Delay Issues Related to Reductions/Payment Cuts Re: Site-Neutral Payments & Graduate Medical Education Telehealth Issues & Legislation, Including: H.R. 3077, TELE-MED Act of 2013 H.R.5380, Latest Title: Medicare Telehealth Parity Act of 2014

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

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

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increased Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013.S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367: The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness For Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodalogy for short inpatient hospitals stays. H.R. 3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.2157: Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014. Advocacy work on HCBS proposed rule: passsed in January. S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. H.R. 1250: The Medicare Audit Improvement Act of 2013. S. 1012: Medicare Audit Improvement Act of 2013. S. 2082: The two-midnight rule coordinator and Improvement Act of 2014. Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014). Protect and Preserve Medicaid funding for Long Term Services and Supports Medicaid Provider Assessement. Improving the CMS State Plan Amdt. Process. Opposition to H.B. No. 5051 An Act Improving Transparency of Nursing Home Operations. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. Improving Medicare Post-Acute Care Transformation Act (IMPACT) Department of VA Provider Agreement proposaed rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors. MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). H.R. 4994, IMPACT Act of 2014.H.R. 5098: To amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. H.R. 5232: A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. H.R. 5373: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE

Organ Transplant Allocation Ebola Funding HR 3698 - 2 Midnight Rule Delay Act S 2082 - 2 Midnight Rule Delay Act S 577 - The Resident Physician Shortage Reduction Act HR 4188 - Establishing Beneficiary Equity in the Hospital Readmission Program Act FY 2015 Labor/HHS Appropriations

Client expense: Not reported · Firm income: $46,275

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L.112-25, The Budget Control Act (Sections regarding the impact of Medicare sequestration on hospitals) H.R.351, Protecting Seniors' Access to Medicare Act of 2013 (All sections of full text) H.R.2027, Expanding Patients' Access to Quality Care Act of 2013 (All sections of full text) H.R.3121, American Health Care Reform Act of 2013 (All sections of full text) H.R.3698, Two-Midnight Rule Delay Act of 2013 (All sections of full text) H.R.3796 Comprehensive Care Payment Innovation Act (All sections of full text) S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 (All sections of full text) Draft Senate legislation known as the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act Discussions involving group purchasing organizations Discussions regarding the status of construction of new veteran's affairs facility in the Denver metro area. P.L.113-146, Veterans Access, Choice, and Accountability Act of 2014 (Section 105. Prompt Payment by Department of Veterans Affairs) Monitored legislative branch oversight of executive branch-led Ebola treatment protocol for hospitals. Monitored draft House Ways and Means legislation entitled "The Hospital Improvements for Payment Act of 2014."

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

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid funding Proposed changes to Medicare hospital reimbursement policies Health Care Reform Implementation Graduate Medical Education - H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Graduate Medical Education, H.R. 1180 and S. 577, "Resident Physician Shortage Reduction Act of 2013" Proposed changes to Medicare hospital reimbursement policies H.R. 3698, "Two Midnight Rule Delay Act" S. 2082, "Two-Midnight Rule Coordination and Improvement Act of 2014" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative proposals affecting Medicare and Medicaid hospital reimbursement policies Health Information Technology Health Care Reform Implementation Medicare Graduate Medical Education Payments H.R. 1180 and S. 577, Resident Physician Shortage Reduction Act of 2013 S. 183, Hospital Payment Fairness Act of 2013 H.R. 2053, "Medicare Hospital Wage Index Equity Act" S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2353 and H.R. 1821, Registered Nurses Safe Staffing Act S. 2501, Hospital Readmission Accountability and Improvement Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of Health Care Reform Health care policy H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2942, Infectious Disease Hospital Hubs Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed changes to Medicare hospital reimbursement policy S. 1012 and H.R. 1250, Medicare Audit Improvement Act of 2013 H.R. 3698, Two Midnight Rule Delay Act S. 2082, Two-Midnight Rule Coordination and Improvement Act of 2014 S. 2942, Infectious Disease Hospital Hubs Act Hospitals Improvements for Payment (HIP) Act of 2014

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid disproportionate share hospital cuts, including DSH Reduction Relief Act - support amendments to mitigate the impact of cuts on losing hospitals, postpone Medicaid DSH cuts; Graduate Medical Education issues (including Resident Physician Shortage Reduction Act (S.577/H.R.1180) - support; Amendments to the Medicare hospital readmissions penalty program methodology (providing SES adjustments, fixing the formula flaw), H.R.4188/S.2501 - support; IMPACT Act (S.2553/H.R.4994), support reducing burdensome hospital requirements in original bill; support of final bill; Medicare Audit Improvement Act (H.R.1250/S.1012) and other issues related Medicare claims appeal backlogs - support; Proposals to amend the 2 Midnight Policy (CMS-1599-F)(H.R. 3698/S.2082) - support; comments on House Ways and Means discussion draft legislation, Hospital Improvements for Payment Act of 2014, concerns about new proposed short stay payment methdology and impact on teaching hospitals; CMS Disallowance to NYS File No.:NY-2014-03-MAP - oppose, support NYS Congressional delegation letter to CMS; legislation to create a comprehensive Medicare home infusion benefit (H.R.5435) - support; comments on physician services pertaining to non-face-to-face chronic care management services (CMS-1612-P); support NYS Congressional delegation letter to CMS on NYS State plan amendments on Medicaid rates for hospitals (2% cut restoration, Vital Access Provider funds).

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), 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), Housing & Urban Development, Dept of (HUD), SENATE, White House Office

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare ACt of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increasd Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013.S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367 The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness for Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays. H.R.3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S.1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.157 - Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014 Advocacy work on HCBS proposed rule: passed in January S.1932 - A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program HR 1250 - The Medicare Audit Improvement Act of 2013 S.1012 - Medicare Audit Improvement Act of 2013 S.2082 - The two-midnight rule coordinator and Improvement Act of 2014 Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014) Protect and Preserve Medicaid funding for long Term Services and Supports Medicaid Provider Assessment Improving the CMS State Plan Amdt. Process Opposition to H.B. No. 5051 - An Act Improving Transparency of Nursing Home Operations Sustainable Growth Rate (SGR) and other reform proposals Reducing hospital readmissions from skilled nursing facility Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors MedPAC site neutral payment system for post acute care CME proposed Rule for SNF Prospective Payment System (PPS) HR 4994, IMPACT Act of 2014 HR 5098 - to amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. HR 4232 - A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. HR 5373 - To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

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

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

H.R. 3698/S. 2082: Two-Midnight Rule Delay Act of 2013, All provisions relating to healthcare.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2801/S 1143: Protecting Access to Rural Therapy Services (PARTS) Act HR 1250/S 1012: The Medicare Audit Improvement Act of 2013 HR 4067/S 1954: Extension of Moratorium on Direct Supervision HR 3769: Extension of Moratorium on Direct Supervision HR 4015/ S 2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 HR 3698: Two Midnight Rule Delay Act of 2013 S 2082: Two Midnight Rule Coordination and Improvement Act of 2014 H.R. 3991/ S. 2037 Critical Access Hospital Relief Act of 2014 (96 Hour Rule) H.R. 4188, the Establishing beneficiary Equity in the Hospital Readmission Program Act H.R. 4668 Protect Patient Access and Promote Hospital Efficiency Act HR 4015/ S 2000: SGR Repeal and Medicare Provider Payment Modernization Act of 2014; HR 4302: Protecting Access to Medicare Act 2014 S. 25: Repealing the Reduction in the Cost of Living Adjustment (COLA) for Retired Members of the Armed Services Bureau By Extending the Medicare Sequester. S.540 - Temporary Debt Limit Extension Act and preceding potential proposals for raising the debt limit and funding. S. 2359 Craig Thomas Rural Hospital and Provider Equity Act (R-HoPE) H.R. 3590, Patient Protection and Affordable Care Act, provisions relating to hospitals, hospice and physicians including: Section 3001: hospital value-based purchasing; Section 3125: low-volume hospital payment; Section 3401: productivity adjustments; Section 3121: outpatient hold harmless for hospitals; Sections 7101-7103: 340B Program; Section 3401: Independent Payment Advisory Board; Section 3015: hospital readmissions program; Section 3124: Extension of Medicare Dependent Hospital program; Section 3137: Section 508 Reclassification; Section 9007: non-profit hospital provision; Section 3105: ambulance services; Section 3008 and Section 2702: payment adjustment for hospital acquired conditions; Section 3133: Medicare DSH; Section 2551: Disproportionate Share Hospitals; Section 5501: Primary Care Provisions; Section 5503: Graduate Medical Education; Sections 2001-2081: Expansion of Medicaid, CHIP; Sections 1311- 1343: CO-OPs and Exchanges; Section 3022: Accountable Care Organizations; Section 3023: Hospital Bundling Provision; Section 6401- 6402: Program Integrity Provisions; Section 6501-6503, 6505, 6508: Medicaid Program Integrity Provisions; Section 3141: Changes to the Rural Floor of the Hospital Wage Index. H.R. 4872, Health Care & Education Affordability Reconciliation Act of 2010: provisions relating to hospitals and physicians, including: Section 2302: 340B program; Section 1104 and Section 1203: Medicare and Medicaid DSH Payments; Sections 1108 and 1109 involving geographic disparities in Medicare payment; Section 1105: Market basket updates; Section 1201: Federal funding for States. Other issues: Medicaid DSH Reduction rule, entire rule. Medicare and Medicaid Recovery Audit Contractor programs, including CMS' proposed changes to the rebilling policy for hospitals, CMS1455P. Medicare and Medicaid Electronic Health Record Payment Incentive Programs. Simpson/Bowles Budget proposal released in April 2013, entire proposal. Implementation of the state health insurance exchanges. 340B Drug Discount Program. Critical Access Hospitals/OIG report and potential changes to CAH designation and payment. Proposals involving site-neutral payment policies impacting payments to hospitals. Medicare Part D pre-authorization policy affecting hospices. Effects of expanded sequestration on hospital, payment issues for hospitals Two-midnight rule effects on patients and facilities 96 hour rule effects on patients and facilities

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health Delay of implementation of Medicare durable medical equipment documentation requirements Medicare Shared Savings Program beneficiary assignment requirements Medicare-Medicaid hospital conditions of participation Draft legislation on admission of advanced practice registered nurses to hospital medical staff and granting of clinical privileges Provisions of the 2013, 2014 and 2015 Medicare fee schedule final regulations Draft legislation to require states to recognize nurse practitioners as primary care case managers and as primary care providers in managed care plans Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration Medicare-Medicaid Program Integrity policies Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures Medicaid per capita cap policy options Medicare-Medicaid dual eligible coverage and demonstration Draft Hospital Improvement for Payment (HIP) Act H.R. 351/S. 351 - Protecting Seniors Access to Medicare Act H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2810 - Medicare Patient Access and Quality Improvement Act H.R. 2817 - Protect Patient Access to Quality Health Professionals Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 3698 - Two-Midnight Rule Delay Act H.R. 3796 - Comprehensive Care Payment Innovation Act H.R. 3833 - To amend title XVIII of the Social Security Act to modify the Medicare durable medical equipment face-to-face encounter documentation requirement. H.R. 4015/S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act H.R. 4302 - Protecting Access to Medicare Act H.R. 4663 - Protect Patient Access and Promote Hospital Efficiency Act H.R. 4930 - Advancing Care for Exceptional (ACE) Kids Act H.R. 4994/S. 2553 - Improving Medicare Post-Acute Care Transformation (IMPACT) Act H.R. 5098 - Ensuring Medicaid and Medicare Access to Providers Act H.R. 5353 - Medicaid Parity Act H.R. 5364 - CHIP Extension and Improvement Act H.R. 5780 - Protecting the Integrity of Medicare Act S. 1143/H.R. 2810 - Protecting Access to Rural Therapy Services (PARTS) Act S. 1871 - SGR Repeal and Medicare Beneficiary Access Act S. 1954/H.R. 4067 - To provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2014. S. 1980 - Medicaid and CHIP Continuous Quality Act S. 2110 - Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2122 - Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2157 - Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act S. 2359 - Craig Thomas Rural Hospital and Provider Equity Act of 2014 S. 2461 - Childrens Health Insurance Program Reauthorization Act S. 2491 - Medicare Protection Act S. 2552/H.R. 4998 - Medicare Advantage Participant Bill of Rights Act S. 2694/H.R. 5723 - Ensuring Access to Primary Care for Women & Children Act

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), 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, Veterans Affairs, Dept of (VA), White House Office

HR 3698/S2082: The Two Midnight Rule Coordination & Improvement Act HR 3993/S2037: Critical Access Hospital Relief Act HR 1250/S1012: Medicare Audit Improvement Act - Legislation to improve the system of hospital payment audits conducted by Medicare Recovery Audit Contractors. HR 1920/S1555: DSH Reduction Relief Act - Legislation to delay the Medicare & Medicaid disproportionate share hospital (DSH) cuts contained in the ACA until Fiscal Year 2016. HR 2801/S842: Protecting Access to Rural Therapy Services Act - Legislation to protect access to outpatient therapeutic services in small & rural and critical access hospitals. HR 4302: Protecting Access to Medicare Act of 2014 - Sustainable growth rate - doc. fix. HR 1201: Training Tomorrow's Doctors Act - Legislation to revise the distribution of resident positions and calculation of payment for direct medical education costs. HR 2810/S2000: Permanent Sustainable Growth Rate for Medicare Physicians HR 1787/S842: Rural Hospital Access Act HR 5481: Continue 3 month quarter reporting in 2015 under Medicare & Medicaid EHR Site Neutral Payments. Medicaid & Medicare Funding in the Federal Budget Medicare Payment Advisory Commission

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

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

H.R.3698, Two-Midnight Rule Delay Act of 2013; S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014; H.R.1180/S.577, Resident Physician Shortage Reduction Act of 2013; H.R.4188, Establishing Beneficiary Equity in the Hospital Readmission Program Act;S.2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014; Issues related to hospital and related provider reimbursement, disproportionate share hospitals, graduate medical education and delivery system reforms.

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

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