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.

H.R.5780, Protecting Integrity of Medicare Act of 2014 (PIMA) H.R. 5860, the Small Business Healthcare Relief Act H.R. 83, CRomnibus - Consolidated & Further Continuing Appropriations Act, 2015 H.J. Res 124, Continuing Appropriations Resolution, 2015 H.R. 4015/S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S.2966, Critical Care Assessment and Improvement Act of 2014 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.2240, Medicare Choices Empowerment and Protection Act H.R. 4190, To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services H.R. 2663/S. 1422 Preventive Health Savings Act H.R. 5644 Medicare CGM Access Act of 2014

Client expense: $140,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.5780, Protecting Integrity of Medicare Act of 2014 (PIMA) H.R. 83, CRomnibus - Consolidated & Further Continuing Appropriations Act, 2015 H.J. Res 124, Continuing Appropriations Resolution, 2015 H.R. 4015/S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 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.2240, Medicare Choices Empowerment and Protection Act H.R. 4190, To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services H.R. 5644 Medicare CGM Access Act of 2014

Client expense: $140,000 · Firm income: Not reported

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961 Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins(R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 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; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it.

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 and 2014 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 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 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 - Ensuring Access to Primary Care for Women & Children Act

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 Medicare Part D Prior Authorization Delay

Support The Importance of Rural Health Access for American Communities and the need for rural hospitals and their value to rural areas; Support of HR 1326 Health Care Price Transparency Promotion Act of 2013, to amend title XIX of the Social Security Act to provide for increased price transparency of hospital information and to provide for additional research on consumer information on charges and out-of-pocket costs; Support CMS proposed rule aimed at reducing burden and promoting efficiency for hospitals,critical access hospitals and other providers. The rule addresses stakeholder concerns about governance-related provisions in the most recent changes to the Medicare Conditions of Participation; Support S 689 Mental Health Awareness and Improvement Act of 2013, a bill to reauthorize and improve programs related to mental health and substance use disorders; Support S 961Health Care Safety Net Enhancement Act of 2013, a bill to improve access to emergency medical services; Oppose HR 2027 Expanding Patients' Access to Quality Care Act of 2013, a bill to amend section 1877 of the Social Security Act to modify the requirements for hospitals to qualify for the rural provider and hospital exception to physician ownership or investment prohibition in order to take into account hospitals that were under construction or development at the time of imposing such requirements, hospital expansions, and hospitals in financial distress; Support 340B Drug Program; Support Rep. Lynn Jenkins (R-KS) H. Res 356 in support of rural hospitals and rural health care providers. The resolution calls access to rural hospitals and other health care providers essential to the survival and success of communities; Support for the current October 1, 2014 implementation date for adoption of the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10-CM) for all health care providers, as well as the adoption of the Procedure Coding System of ICD-10 for hospital reporting of inpatient procedures; Encourage HHS to speed up processing of CAC applications and discussed questions about the new Marketplaces; Participated in the White House National Mental Health Conference and had several discussions on how hospitals can help raise awareness about mental health in their communities with ACA; Discussions with the Senate Finance Committee in response to the Committees outreach to behavioral health stakeholders seeking input to help improve the behavioral health care system; Helping to shape agencys forthcoming compliance initiative related to hospitals reporting obligations to the National Practitioner Data Bank; Support S. 2196 Good Samaritan Health Professional Act, by extending to licensed, volunteer health professionals the same protective standards included in the Volunteer Protection Act of 1997, this legislation takes critical steps to help victims have access to critical onsite medical attention during declared federal disasters; Support S 2501 Hospital Readmissions Program Accuracy and Accountability Act of 2014, to amend title XVIII (Medicare) of the Social Security Act, with respect to the Hospital Readmissions Reduction Program, to direct the Secretary of Health and Human Services (HHS), in determining a hospital's excess readmission ratio for purposes of making payments for discharges starting in FY2016, to risk adjust readmissions to account for patient socioeconomic status; Requested that the Secretary issue a written statement on behalf of the entire department confirming that the HHS is not discouraging hospital-affiliated or other charitable foundations from subsidizing premiums purchased through the new Health Insurance Marketplaces (exchanges) or cost-sharing expenses for needy enrollees; Support HR 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; HR 4810 Veteran Access to Care Act of 2014 and H.R.3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, support specific provisions in the two bills and to address this issue and allow veterans to more easily secure care from civilian providers. We urge Congress to move expeditiously to resolve differences between the House and Senate bills and look forward to working with our VA colleagues, Congress and the Administration to ensure veterans receive the care they need when they need it.

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 and 2014 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 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. 4930 - Advancing Care for Exceptional (ACE) Kids Act H.R. 4994/S. 2553 - Improving Medicare Post-Acute Care Transformation (IMPACT) 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. 2552/H.R. 4998 - Medicare Advantage Participant Bill of Rights Act

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

H.R. 1250/S. 1012 Medicare Audit Improvement Act of 2013, entire bill. H.R. 2578, the Rural Hospital Fairness Act of 2013, entire bill. S. 1143, Protecting Access to Rural Therapy Services Act, entire bill. H.R. 1787/S. 842, the Rural Hospital Access Act of 2013, entire bills.S. 183, Hospital Payment Fairness Act of 2013. S. 1053/H.R. 2302, the HELP Hospice Act, entire bill. H.R. 2053/ S. 183, to amend title XVIII of the Social Security Act to apply budget neutrality on a state-specific basis in the calculation of the Medicare hospital wage index floor for non-rural areas, entire bill. H.R. 1920, DSH Reduction Relief Act of 2013, entire bill. H.R. 2801/S. 1143, Protecting Access to Rural Therapy Services (PARTS) Act, entire bill. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. Proposals surrounding the Sustainable Growth Rate (SGR) and deficit/debt reduction as related to hospitals and physicians, including H.R.2810, the Medicare Patient Access and Quality Improvement Act of 2013, entire bill. Bi-partisan, bi-cameral proposal in Senate Finance Committee to permanently repeal SGR and amendments. H. Resolution 356/ S Resolution 26, The Importance of Rural Health Access for American Communities. President Obama's budget for FY 2014, budget proposal with a focus on Medicare and Medicaid policies. H.R. 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) 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 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 preceeding potential proposals for raising the debt limit and funding.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. H.R. 3630 (introduced by 112th Congress), Middle Class Tax Relief and Job Creation Act of 2011, Title II, Subtitle C--Medicare Extensions; Other Health Provisions, Part 1--Medicare extensions, Section 2201, Physician payment update. Section 2202: Ambulance Add-ons; Section 2203: Medicare payment for outpatient therapy services; Section 2204: Work geographic Adjustment; Part 3--Offsets, Section 2223: Parity in Medicare payments for hospital outpatient department evaluation and management office visit services; Section 2224, Reduction of bad debt treated as an allowable cost; Section 2225, Rebasing of State DSH allotments for FY 2021. Part 2 of Subtitle C--Other Health Provisions, Section 2213: Modification to requirements for qualifying for exception to Medicare prohibition on certain physician referrals for hospitals. Other issues: 2014 Inpatient/Long term care hospital Prospective Payment System rule, entire rule. 2014 Outpatient Prospective Payment System rule, entire rule. 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. Proposals involving site-neutral payment policies impacting payments to hospitals.

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 and 2014 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 H.R. 351/S. 351 - Protecting Seniors Access to Medicare Act H.R. 574 - Medicare Physician Payment Innovation Act H.R. 1698 - Stabilize Medicaid and CHIP Coverage Act H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2524/S. 1228 - Medicare Better Health Rewards 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. 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 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