CHIP Extension and Improvement Act of 2014

Medicaid payment models - implementation of payment reforms included in H.R. 3590, including medical homes, pediatric accountable care, and Medicaid payment standards for primary care. H.R. 4930 - Advancing Care for Exceptional Kids Act of 2014 S. 2461 - The CHIP Extension Act of 2014 H.R. 5364 - The CHIP Extension and Improvement Act of 2014 Issues regarding The Childrens Health Insurance Program (CHIP) H.R. 3590 - Patient Protection and Affordable Care Act - implementation of all provisions related to health, coverage, benefits, and Medicaid Issues regarding pediatric quality measures program reauthorization generally (no bill number) S. 2694 - Ensuring Access to Primary Care for Women and Children Act S. 2434 - Family Coverage Act H.R. 1698 - Stabilize Medicaid and CHIP Coverage Act

Client expense: $800,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

H.R. 4930 - Advancing Care for Exceptional Kids Act of 2014 S. 2461 - The CHIP Extension Act of 2014 H.R. 5364 - The CHIP Extension and Improvement Act of 2014 Issues regarding The Childrens Health Insurance Program (CHIP) H.R. 297/S. 1557 - Acts to reauthorize and establish funding levels for the Children's Hospital Graduate Medical Education program H.R. 3590 - Patient Protection and Affordable Care Act - implementation of all provisions related to health, coverage, benefits, and Medicaid Issues regarding pediatric quality measures program reauthorization generally (no bill number) S. 2154 - The Emergency Medical Services for Children Reauthorization Act of 2014 H.R. 4290 - The Wakefield Act, reauthorizes Emergency Medical Services for Children S. 2694 - Ensuring Access to Primary Care for Women and Children Act S. 2434 - Family Coverage Act House Labor-H Appropriations (no bill number) - provisions impacting Childrens Hospital Graduate Medical Education, NIH and public health programs Senate Labor-H Appropriations (no bill number) - provisions impacting Childrens Hospital Graduate Medical Education, NIH and public health programs 340B Drug Discount Program H.R. 225/S.424 - Pediatric Research Network Act H.R. 1698 - Stabilize Medicaid and CHIP Coverage Act S. 689 - Mental Health Awareness and Improvement Act of 2013 H.R. 2607/S. 1251 Caroline Pryce Walker Conquer Childhood Cancer Reauthorization Act H.R. 1827 - Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 S. 957 - Drug Supply Chain Security Act

Client expense: $800,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Implementation of Health Reform (PPACA) The Health Information Technology for Economic and Clinical Health Act (HITECH), Regarding Implementation of Act Issues Related to the Medicare & Medicaid Protection Act of 1987 that Regulate Group Purchasing Organizations Under HHS Medicare Delivery System Reform 2011 Budget Control Act -- Sequestration Medicare Physician Payment Reform Observation Status "Two-Midnight" Rule CR/Debt Limit Medicare DSH Medicare Data Access E&M Site Neutral IMPACT Act of 2014 Medicare hospital quality improvement program Hospital readmissions reduction program CHIP Reauthorization (HR 5364 and S2461) Protecting the integrity of Medicare Act (Medicare/Medicaid waste, fraud and abuse) Telemedicine Veterans Access, Choice, and Accountability Act of 2016 Comprehensive Care Payment Innovation Act Flexibility in Health IT Act of 2014 Ebola/Appropriations Hospital Payment Improvements Act of 2014 21st Century Cures Initiative Biosimilars Hospital Drug Shortages

Client expense: $97,394 · Firm income: Not reported

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

Public Law 111-148, the Patient Protection and Affordable Care Act - implementation issues related to Medicaid reimbursement for neonatologists and pediatric cardiologists, Medicare evaluation and management coding practices, qualifying neonatologists as primary care practioners for purposes of program eligibility, Medicare reimbursement for anesthesiology services, Medicare and Medicaid incentive payments for adoption of health information technology systems.Public Law 111-152, the Health Care and Education Reconciliation Act - Implementation issues related to Medicaid reimbursement for neonatologists and pediatric cardiologists, Medicare evaluation and management coding practices, qualifying neonatologists as primary care practioners for purposes of program eligibility, Medicare reimbursement for anesthesiology services, Medicare incentive payments for adoption of health information technology systems. Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-286, the Physician Payment and Therapy Relief Act - Medicare physician payment issues and HIT incentive payments for hospital-based physicians. H.R. 1256, Medicare Physician Payment Transparency and Assessment Act of 2011, all provisions Meetings with CMS staff concerning reimbursement for anesthesiology and pediatric subspecialty services under the 2014 physician fee schedule rule. Public Law 113-93 - The Protecting Access to Medicare Act of 2014 S. 2694, Ensuring Access to Primary Care for Women & Children Act - Parity for primary care physician services. H.R. 5364, the CHIP Extension and Improvement Act of 2014 - Parity for primary care physician services.

Client expense: Not reported · Firm income: $75,000

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

H.R. 4920: ACE Kids Act of 2014; issues related to CHIP HR. 5364; S. 2461 Issues related to CHIP H.R. 2810- Medicare Patient Access and Quality Improvement Act; Sustainable Growth Rate provision H.R. 3077: Telehealth Enhancement Act of 2013 H.R. 3991: Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302 Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System H.R. 5558: ACO Improvement Act H.R. 4851: FLEX-IT Act; provisions related to "Meaningful Use"

Client expense: Not reported · Firm income: $5,850

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 2461/HR 5364, CHIP Extension and Improvement Act of 2014. S 425/HR 896, Quality Care for Moms and Babies Act. S 2434/HR 4865, Family Coverage Act. Affordable Care Act pertaining to women and children. Medicaid. CHIP reauthorization. Health care quality issues relating to women and children. Health insurance coverage of for immigrant pregnant women and children.

Client expense: $54,373 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), SENATE, Treasury, Dept of, U.S. Postal Service (USPS)

H.R. 162, Medicaid Integrity Act (Bachmann) - Medicaid health plan audits H.R. 670, Puerto Rico Medicare Part B Equity Act (Pierluisi) H.R. 928, Medicare Prescription Drug Savings and Choice Act (Schakowsky) - Medicare Part D changes H.R. 1024, Medication Therapy Management Empowerment Act (McMorris Rodgers) - medication therapy management programs H.R. 1179, Improving Access to Medicare Coverage Act (Courtney) - Medicare coverage of skilled nursing care H.R. 1102, Medicare Prescription Drug Price Negotiation Act (Welch) - Medicare Part D price negotiations H.R. 1853, Medicaid Accountability and Care Act (Cassidy) -federal financing of state Medicaid programs H.R. 2305, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Roskam-Carney) - fighting fraud and abuse H.R. 2453, Medicare Beneficiary Preservation of Choice Act (Rothfus-Schrader) - MA enrollment rules H.R. 2524, Medicare Better Health Rewards Program Act (Paulsen-Kind) - wellness incentives H.R. 2753, Securing Care for Seniors Act (Black) - MA payment and enrollment issues, wellness incentives H.R, 2960, Medicare Prescription Drug Integrity Act of 2013 (Pallone) - Part D drug utilization review H.R. 3512, Seniors' Health Care Choice Act (Heck) - MA open enrollment period H.R. 3890, Better Care, Lower Cost Act (Paulsen-Welch) - delivery models for Medicare beneficiaries with chronic conditions H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act (Burgess) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate delay H.R. 4160, Keep the Promise to Seniors Act (Ellmers) - blocking Medicare Part D proposed rule H.R. 4302, Protecting Access to Medicare Act (Pitts) - 12-month Medicare SGR patch, Medicare Advantage Special Needs Plans, Appropriate Use Criteria for Advanced Diagnostic Imaging, Medicare sequestration cuts, Other Medicare-Medicaid Extenders H.R. 4484, Strengthening Healthcare Options for Vulnerable Populations Act (Sinema) - MA special needs plans H.R. 4998, MA Participant Bill of Rights Act (DeLauro) - MA plan provider networks H.R. 5113, Protecting Seniors' Medicare Choices from Obamacare Act (Coffman) - MA stabilization program H.R. 5183, Value Based Insurance Design for Better Care Act (Black) - MA demonstration to test VBID methodologies H.R. 5364, CHIP Extension and Improvement Act (Pallone) - federal CHIP funding Draft Bill, Protecting the Integrity of Medicare Act (Brady) - preventing fraud in Medicare and Medicaid S. 11, Fiscal Sustainability Act (Corker) - Medicare, Medigap, Medicaid issues S. 25 (Hatch) - extension of Medicare sequestration cuts S. 117, Medicare Prescription Drug Price Negotiation Act (Klobuchar) - Medicare Part D price negotiations S. 324, Puerto Rico Medicare Part B Equity Act (Schumer) S. 408, Medicare Prescription Drug Savings and Choice Act (Durbin) - Medicare Part D changes S. 569, Improving Access to Medicare Coverage Act (Brown) - Medicare coverage of skilled nursing care S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act (Carper-Coburn) - fighting fraud and abuse S. 1228, Medicare Better Health Rewards Program Act (Wyden-Portman) - wellness incentives S. 1787, Medicaid Managed Care Responsibility and Equity Act (Rockefeller) - medical loss ratio requirement for Medicaid managed care organizations S. 1871, SGR Repeal and Medicare Beneficiary Access Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms, MA Special Needs Plans, Cost Plans, QI and TMA programs S. 1932, Better Care, Lower Cost Act (Wyden-Isakson) - delivery models for Medicare beneficiaries with chronic conditions S. 1980, Medicaid and CHIP Continuous Quality Act (Rockefeller) - 12 month continuous enrollment S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act (Senate Finance Committee) - SGR repeal, quality- and value-based payment reforms S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act (Wyden) - SGR repeal, quality- and value-based payment reforms, Medicare and Medicaid extenders S. 2122, Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act (Hatch) - SGR repeal, quality- and value-based payment reforms, ACA individual mandate repeal S. 2361, Stop SCAMS Act (Nelson-Collins) - reducing Medicare fraud S. 2461, CHIP Extension Act (Rockefeller) --- federal CHIP funding S. 2552, MA Participant Bill of Rights Act (Brown-Blumenthal) - MA plan provider networks S. 2783, Value Based Insurance Design for Better Care Act (Thune) - MA demonstration to test VBID methodologies Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, encounter data and other data-related issues, and audit issues; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, and audits); in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, SSA and CMS premium withhold processing issues, enrollment rules, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible Special Needs Plans (SNPs); Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); Medication Therapy Management Program requirements; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) changes to the Part D coverage gap; ongoing implementation issues for the Medicare cost plan program including enrollment, marketing materials review and approval and other operational issues;implementation issues for the Medicare Retiree Drug Subsidy program; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including the Capitated Financial Alignment Demonstration; Medicaid managed care regulations and policies, including the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans ; issues related to Medigap coverage financing for infectious disease such as Ebola; and other issues relating to health care reform implementation. *AddMACPACtoAgencyList

Client expense: $2,230,000 · Firm income: Not reported

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

HR 45-To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010: entire bill HR 132: ObamaCare Repeal Act: entire bill Public Law No. 111-148- Patient Protection and Affordable Care Act: entire law Public Law No. 111-152- Health Care and Education Reconciliation Act of 2010: entire law HR 2457- Womens Preventive Health Awareness Campaign Act: entire bill HR 1975- Pregnant Workers Fairness Act: entire bill S. 942- Pregnant Workers Fairness Act: entire bill HR 2632- School-based Health Centers Program Reauthorization Act of 2013: entire bill HR 2676- Medicaid Information Technology to Enhance Community Health Act of 2013: entire bill S. 1286- Medicaid Information Technology to Enhance Community Health Act of 2013: entire bill HR 2810- To amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians' services, and for other purposes: amendments and provisions related to and affecting reproductive health and family planning S. 1871- SGR Repeal and Medicare Beneficiary Access Act of 2013: amendments and provisions related to and affecting reproductive health and family planning S. 1871- SGR Repeal and Medicare Beneficiary Access Act of 2013: amendments and provisions related to and affecting reproductive health and family planning S. 1009 - Chemical Safety Improvement Act: entire bill HR 4302- Protecting Access to Medicare Act: amendments and provisions related to and affecting reproductive health and family planning HR 3723 - Viral Hepatitis Testing Act of 2013: entire bill HR 5364/S 2461 - Amend title XXI of the Social Security Act to extend and improve the CHIP Program: entire bill HR 5353 - Amend title XIX of the Social Security Act to extend for 5 years payment parity with Medicare for primary care services: Entire bill HR 5380 - Medicare Parity Act: entire bill S 2662 - Telehealth Enhancement Act of 2014: entire bill HR 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 purpose (Flexibility in Health IT Reporting (Flex-IT) Act of 2014"): entire bill S 2629 - Preventive Care Coverage Notification Act: entire bill S 2694 - Ensuring Access to Primary Care for Women & Children Act: entire bill S 2908 - A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan, and for other purposes: entire bill S 2578/ HR 5150 - Protect Women's Health From Corporate Interference Act: entire bill HR 5294 - Health Equity and Accountability Act HR 5723 - Ensuring Access to Primary Care for Women & Children Act

Client expense: $73,680 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), Peace Corps, SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID)

S. 755 / H.R. 1838: Enhanced Access to Medicaid Services Act of 2013: H.R.5364: CHIP Extension and Improvement Act of 2014: Sec. 304. Payment parity for Medicaid primary care services H.R.5353: Medicaid Parity Act of 2014 H.R. 5458: The Building a Health Care Workforce for the Future ActH.R. 5481, the Flexibility in Health IT Reporting (Flex-IT) Act HR 5723 / S. 2694: Ensuring Access to Primary Care for Women & Children Act S. 3007: Ensuring Enhanced Access to Primary Care Act Maintenance/expansion of Graduate Medical Education (GME); Permanent repeal to the sustainable growth rate (SGR) formula; Preservation of the in-office ancillary exception to the Stark law

Client expense: $173,880 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

Client expense: $72,153 · Firm income: Not reported

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

Addressing primary care access issues for Medicaid beneficiaries. Reauthorization of Medicaid-Medicare Parity for Primary Care and program design. S. 2694, H.R. 5364, H.R. 5353 and H.R.5723.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Reauthorization of Medicaid-Medicare Parity for Primary Care and program design. S. 2694, H.R. 5364, H.R. 5353 and H.R. 5723.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R 4920- ACE Kids Act of 2014; issues related to CHIP H.R. 5364: S. 2461- Issues related to CHIP H.R. 2810 Meducare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077- Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System- Update for FY 2015 H.R. 5558- ACO Improvement Act H.R. 4851 FLEX-IT Act; provisions related to "Meaningful Use" H.R. 1180; S. 577 Resident Physician Shortage Reduction Act; issues related to Graduate Medical Education slots, criteria, and funding H.R. 1201 Training Tomorrow's Doctors Today; issues related to Graduate Medical Education slots, criteria, and funding

Client expense: Not reported · Firm income: $34,400

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL-111-148, Patient Protection and Affordable Care Act: multi-employer health plans, state exchanges, implementation, calls, research. H.R. 4414, Expatriate health Coverage Clarification Act: Provisions creating exemptions to Affordable Care Act requirements for employers and health plans, H.R. 5213, STARS Act: Provisions changing definition of seasonal employee for purposes of the Affordable Care Act employer responsibility requirement. S.2253, Healthcare Fairness and Stability Act of 2014: delay implementation S. 2461/H.R. 5364, CHIP Extension Act of 2014 S. 2176, CommonSense Reporting Act S. 2168, Small Business Stability Act: provisions relating to changing definition of large employer for the purpose of employer. S. 1188/H.R. 2575, Forty Hours if Full Time Act of 2013: provisions relating to changing definition of full-time employment, provisions that would increase threshold for full-time work to 40 hours per week. H.R. 4775, Safeguarding Classrooms Hurt by ObamaCare's Obligatory Levies: provisions relating to exemption of educational employees from ACA. H.R. 5298, Student Job Protection Act of 2014: Provisions exempting institutions of higher learning from the requirement to offer health insurance coverage to full-time students working more than 30 hours a week for the institution. S. 2434 Family Coverage Act: provisions affecting access to health care exchange for subsidies for spouses and dependents. H.R. 3522, Employee Health Care Protection Act of 2013 H.R. 1286, Paid Sick Days Executive Order 13673, Fair Pay and Safe Workplace: safety and health Repeal of the Affordable Care Act excise tax on high cost plans: provisions repealing the excise tax on employer-based high cost health plans. Ebola: Safety and health precautions, emergency supplemental funding, protecting workers during outbreak, White House response.

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

Government targets: Administration for Children & Families (ACF), Commerce, Dept of (DOC), Council of Economic Advisers (CEA), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Reserve System, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Labor Relations Board (NLRB), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of the Vice President of the United States, Pension Benefit Guaranty Corporation (PBGC), SENATE, State, Dept of (DOS), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4920- ACE Kids Act of 2014; issues related to CHIP H.R. 5364; S. 2461- Issues related to CHIPH.R. 2810- Medicare Patient Access and Quality Improvement Act; Sustainable Growth Rate Provisions H.R. 3077-Telehealth Enhancement Act of 2013 H.R. 3991- Critical Access Hospital Relief Act of 2014; provisions on 96-hour physician certification requirement H.R. 4302- Protecting Access to Medicare Act of 2014 CMS-1606-P Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal Year Beginning October 1, 2014 H.R. 5558- ACO Improvement Act H.R. 4851- FLEX-IT Act; provsions related to "Meaningful Use" H.R. 1180; S. 577 Resident Physician Shortage Reduction Act; issues related to Graduate Medical Education slots, criteria, and funding H.R. 1201- Training Tomorrow's Doctors Today; issues related to Graduate medical Education slots, criteria, and funding

Client expense: $60,391 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Emergency Contraception (general; Health Care Reform Implementation. Drug Dependence (general); HIV Screening (general); Gynecological Cancer; Breast Cancer (general); Breastfeeding (general); Medical Liability Reform (general); Health IT (general); Prematurity (general)Obesity (general); Disparities (general); Prevention and Public Health Trust Fund (general); Imaging (general); Graduate Medical Education (general); Quality Improvement Measurement (general); Contraception (general); CMS Provider Penalties (general)Preeclampsia (general); National Health Service Corps (general); Abortion (general); Indian Health (general); CMS Health IT incentive program, meaningful use State 3; Immigrant Health Care Access; S. 237, Advancing FASD Research, Prevention and Services Act; S. 333/H.R. 728, Access to Birth Control Act; H.R. 1331, Electronic Health Records Improvements Act; H.R. 1201, Training Tomorrows Doctors Today Act; H.R. 896/X. 425, Quality Care for Moms and Babies Act; H.R. 1281/S. 1417, Newborn Screening Saves Lives Reauthorization Act; H.R. 36/S. 961, Health Care Safety Net Enhancement Act; H.R. 1975/S. 942 Pregnant Workers Fairness Act; Implementation of H.R. 3204, the Drug Quality and Security Act; H.R. 1915/S. 907 GEDI Act; H.R. 5364 CHIP Extension and Improvement ACT; S. 1009, Chemical Safety Improvement Act; H.R. 2286, Maximizing Optimal Maternity Services for the 21st Century Act; H.R. 4106, Saving Lives, Saving Costs Act; Pregnancy Discrimination (general); S. 1124, BPA in Food Packaging Right to Know Act; H.R. 4240, HEAL Immigrant Women and Families Act; H.R. 4216, Maternal Health Accountability Act; S. 1978, Increasing Primary Care Access Act; H.R. 4435/S. 2410 Carl Levin National Defense Authorization Act for Fiscal Year 2015; H.R. 4385, To Amend the Public Health Service Act to provide for the Designation of maternity care health professional shortage areas; H.R. 4492/S. 1994 TRICARE Moms Improvement Act of 2014; H.R. 4750/S. 1769, Standard of Care Protection Act of 2014; S. 2461, CHIP Extension Act of 2014; H.R. 4888 CRIB Act; S. 2722 Protecting our Infants Act; H.R. 5524/S. 2687 Access to contraception for Women Service Members and Dependents Act; 21st Century Cures; H.R> 5294 Health Equity and Accountability Act; H.R. 5539 Except certain transfers of value from reporting requirements under Sunshine Act; H.R. 5486 Child Nicotine Poisoning Prevention Act.

Client expense: $394,993 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), White House Office

Dental issues in CHIP Reauthorization (HR 5364), CHIP Extension and Improvement Act of 2014, and CHIP Extension Act of 2014 (S. 2461)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.2810; S.2110; H.R.4302; H.R.4015; S.2157; H.R. 5353; H.R.5364; S. 2694; Provider Enrollment; Medicare-Medicaid Parity for Primary Care; Reimbursement including SGR; Out-of-Network Reimbursement.

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

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

Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments Medicare and Medicaid paymentMedicaid Waivers Extension of Medicare Sustainable Growth Rate Medicare Evaluation and Management Reimbursement Reduction Proposal Issues related to waste, fraud, and abuse in Medicaid Medicare Disproportionate Share Hospital Payments H.R. 574 Medicare Physician Payment Innovation Act of 2013, all provisions H.R. 1853 Medicaid Accountability and Care Act, all provisions H.R. 574 Medicare Physician Payment Act, all provisions 5.577/HR 1180 Resident Physician Shortage Reduction Act , all provisions H.R. 1201 Training Tomorrow's Doctors Act, all provisions H.R. 1250/5.1012 Medicare Audit Improvement Act, all provisions H.R. 1487 Improved Healthcare at a Lower Cost Act, all provisions H.R. 1698 Stabilize Medicaid and CHIP Coverage, all provisions H.R. 1326 Health Care Price Transparency Promotion Act, all provisions H.R. 1920 DSH Reduction Relief Act, all provisions Issues related to Medicaid enrollment of newborns CMS FY2014 Hospital Inpatient Prospective Payment System Rule Issues related to admission and medical review criteria for inpatient services ("two midnights rule") S.1555 DSH Reduction Relief Act of 2013, all provisions S.1871 SGR Repeal and Medicare Beneficiary Access Act - all sections H.R. 2810 Medicare Patient Access and Quality Improvement Act - all sections H.R. 4302 Protecting Access to Medicare Act - all sections H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act S. 1980 Medicaid and CHIP Continuous Quality Act H.R. 3678 Two-Midnight Rule Delay Act - all sections H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 2082 Two-Midnight Rule Coordination and Improvement Act S. 2501 Hospitals Readmissions Program Accuracy and Accountability Act, all sections Issues related to quality measures reporting in Medicaid S. 2461 CHIP Extension act of 2014, all provisions Issues related to Medicare payment for patients in "observation status" in hospitals CMS FY 2014 Outpatient Prospective Payment System Rule Issues related to Medicare Recovery Audit Contractors S. 2941 Medicare Protection Act, all Provisions Extension of SSA 1902 (a) (b) (c) - Medicaid Primary Care payment parity Childrens Health Insurance Program Medicare Hospital Re-admissions Program Meaningful Use Stage 2 H.R. 5481 The Flexibility in Health IT Reporting Act H.R. 5364 CHIP Extension and Improvement Act, All provisions Hospital Improvements for Payment Act of 2014 (generally and specific sections) Section 101: Hospital Prospective Payment System 102: Per Diem payment rate for short lengths of stay 103: Repeal of the Two- Midnights payment reduction 104 and 105: Monitoring performance of and improvements to the RAC program 109: Hospital assessment data 110: Cost information on hospital payments 201: Repeal of the moratorium on physician owned hospitals 214: Tennessee DSH allotment for FY2015 and succeeding fiscal years 216: NOTICE Act 217: Establishing equity in the Hospital Readmissions Program Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

HR 83 - Consolidated and Further Continuing Appropriations Act, 2015. HR 416 - Health Insurance Rate Review Act:A bill to amend the Public Health Service Act to provide protection for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. HR 979 - FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act: To amend chapter of title 5, United States Code to ensure program integrity, transparency and cost savings in the pricing and contracting of prescription drug benefits under the Federal Employees Health Benefits Program. HR 1370 - To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act. HR 2577 - SAFE Data Act: A bill to protect consumers by requiring reasonable security policies and procedures to protect data containing personal information and to provide for nationwide notice in the event of a security breach. HR 2676 - Small Business Health Relief Act of 2011: To lower health premiums and increase choice for small business. HR 3350 - Keep your Health Plan Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3522 - Employee Health Care Protection Act of 2013: To authorize health insurance issuers to continue to offer for sale current individual health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement and for other purposes. HR 3541 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. HR 4805 - No subsidies Without Verification Process Act of 2014: To delay the provision of the Affordable Care Act premium and cost-sharing subsidies until the eligibility verification process for such subsidies is complete and for other purposes. HR 5214 - Clinical Data Registries: To require the Secretary of Health & Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 5364 - CHIP Extension & Improvement Act of 2014: To amend title XXI of the Social Security Act to extend and improve Childrens Health Insurance Program and for other purposes. S 24 - Small Business Health Relief Act of 2013: To lower health premiums and increase choice for small business. S 40 - American Liberty Restoration Act: To restore Americans individual liberty by striking the federal mandate to purchase insurance. S 482 - Health Insurance Rate Review Act: To amend the Public Health Service to provide protections for consumers against excessive, unjustified or unfairly discriminatory increases in premium rates. S 1726 - Obamacare Taxpayer Bailout Prevention Act: To prevent a taxpayer bailout of health insurance issuers. S 1729 - Expanded Consumer Choice Act: To amend the Patient Protection and Affordable Care Act to provide further options with respect to levels of coverage under qualified health plans. S 1880 - Jobs and Premium Protection Act: To repeal the annual fee on health care laws job-killing health insurance tax. S 2174 - Commonsense Competition and Access to Health Insurance Act: To amend the Patient Protection and Affordable Care Act to provide greater flexibility in offering health insurance coverage across state lines. S 2461 - CHIP Extension Act of 2014: Amend title XXI of the Social Security Act to extend & improve the Childrens Health Insurance Program and for other purposes. Department of Health & Human Services Implementation of Medical Loss Ratio arrangements; Implementation of health insurance exchanges; Implementation of Qualified Health Plans, Implementation Essential Health Benefits.

Client expense: $1,510,000 · Firm income: Not reported

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

Legislation and policies related to: Graduate Nursing Education and Community-Based Workforce Development pilot project 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 Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration Draft Hospital Improvement for Payment (HIP) Act H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 4015/S. 2000 - SGR Repeal and Medicare Provider Payment Modernization 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. 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. 2461 - Childrens Health Insurance Program Reauthorization Act S. 2694/H.R. 5723 - Ensuring Access to Primary Care for Women and Children Act

Client expense: Not reported · Firm income: $9,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

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

Maternal, Infant and Early Childhood Home Visiting Program -- Push to reauthorize in the last quarter of 2014 or the first quarter of 2015 as part of the SGR or other available vehicle CHIP Extension Act of 2014 (S 2461) Push for four year extension of funding for CHIP CHIP Extension Improvement Act of 2014 (HR 5364) Push for four year extension of funding for CHIP

Client expense: Not reported · Firm income: Not reported

CHIP Extension Act of 2014 (S 2461) CHIP Extension and Improvement Act of 2014 (HR 5364)

Client expense: Not reported · Firm income: Not reported

S.2461/H.R.5364, CHIP Extension Act of 2014. Support.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Children's Hospital GME Support Reauthorization Act of 2013 (HR 297, S 1557) Enhanced Access to Medicaid Services Act (HR 1838, S 755) CHIP Extension Act of 2014 (S 2461) CHIP Extension and Improvement Act of 2014 (HR 5364) Ensuring Access to Primary Care for Women & Children Act (S 2694) Medicaid Parity Act of 2014 (HR 5353)

Client expense: $43,400 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institute of Mental Health (NIMH), Natl Institutes of Health (NIH), Office of Juvenile Justice & Delinquency Prevention, Office of Natl Drug Control Policy (NDCP), Office of the Vice President of the United States, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Health Issues, H.R. 3522- Employee Health Care Protection Act of 2014, H.R. 4414, H.R. 5364, H.R. 5533, S. 2461, S. 2859, S. 2578 - Protect Women's Health From Corporate Interference Act of 2014

Client expense: $227,000 · Firm income: Not reported

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

H.R. 4930 - Advancing Care for Exceptional Kids Act of 2014 S. 2461 - The CHIP Extension Act of 2014 H.R. 5364 - The CHIP Extension and Improvement Act of 2014 Issues regarding The Childrens Health Insurance Program (CHIP) H.R. 297/S. 1557 - Acts to reauthorize and establish funding levels for the Children's Hospital Graduate Medical Education program H.R. 3590 - Patient Protection and Affordable Care Act - implementation of all provisions related to health, coverage, benefits, and Medicaid Issues regarding pediatric quality measures program reauthorization generally (no bill number) S. 2154 - The Emergency Medical Services for Children Reauthorization Act of 2014 H.R. 4290 - The Wakefield Act, reauthorizes Emergency Medical Services for Children S. 2694 - Ensuring Access to Primary Care for Women and Children Act S. 2434 - Family Coverage Act 21st Century Cures Initiative House Labor-H Appropriations (no bill number) - provisions impacting Childrens Hospital Graduate Medical Education, NIH and public health programs Senate Labor-H Appropriations (no bill number) - provisions impacting Childrens Hospital Graduate Medical Education, NIH and public health programs 340B Drug Discount Program H.R. 225/S.424 - Pediatric Research Network Act H.R. 1698 - Stabilize Medicaid and CHIP Coverage Act H.R. 2607/S. 1251 Caroline Pryce Walker Conquer Childhood Cancer Reauthorization Act H.R. 1827 - Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 S. 957 - Drug Supply Chain Security Act

Client expense: $790,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

CHIP Extension and Improvement Act (H.R. 5364/S. 2461) DSH Reduction Relief Act (H.R. 1920/S. 1555) Medicare Audit Improvement Act (H.R. 1250/S. 1012) SGR Repeal and Medicare Provider Payment Modernization Act (H.R. 4015/S. 2000)

Client expense: $12,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-148, the Patient Protection and Affordable Care Act - implementation issues related to Medicaid reimbursement for neonatologists and pediatric cardiologists, Medicare evaluation and management coding practices, qualifying neonatologists as primary care practioners for purposes of program eligibility, Medicare reimbursement for anesthesiology services, Medicare and Medicaid incentive payments for adoption of health information technology systems.Public Law 111-152, the Health Care and Education Reconciliation Act - Implementation issues related to Medicaid reimbursement for neonatologists and pediatric cardiologists, Medicare evaluation and management coding practices, qualifying neonatologists as primary care practioners for purposes of program eligibility, Medicare reimbursement for anesthesiology services, Medicare incentive payments for adoption of health information technology systems. Public Law 111-5, the American Recovery and Reinvestment Act of 2009 - Implementation issues related to Medicare incentives and penalties for adoption of health information technology, comparative effectiveness issues. Public Law 111-192 (H.R. 3962), the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 - Medicare physician payment issues. Public Law 111-286, the Physician Payment and Therapy Relief Act - Medicare physician payment issues and HIT incentive payments for hospital-based physicians. H.R. 1256, Medicare Physician Payment Transparency and Assessment Act of 2011, all provisions Medicare Program - Long term reform proposals for the Medicare physician payment system. P.L. 112-240, the American Taxpayer Relief Act of 2012 - Preservation of bonus payments to primary care physicians serving Medicaid patients, Medicare physician payment issues. S. 388, American Family Economic Protection Act of 2013 - sequestration issues affecting Medicare physician payments and drug reimbursement issues. Meetings with CMS staff concerning reimbursement for anesthesiology and pediatric subspecialty services under the 2014 physician fee schedule rule. Public Law 113-93 - The Protecting Access to Medicare Act of 2014 S. 2694, Ensuring Access to Primary Care for Women & Children Act - Parity for primary care physician services. H.R. 5364, the CHIP Extension and Improvement Act of 2014 - Parity for primary care physician services.

Client expense: Not reported · Firm income: $75,000

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

Legislation and policies related to: Graduate Nursing Education and Community-Based Workforce Development pilot project 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 Draft legislation to extend Medicaid incentives to adopt electronic health records to nurse-managed health clinics Evaluation of the Medicare Graduate Nurse Education demonstration H.R. 2504/S. 1332 - Home Health Care Planning Improvement Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 4015/S. 2000 - SGR Repeal and Medicare Provider Payment Modernization 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. 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. 2461 - Childrens Health Insurance Program Reauthorization Act S. 2694 - Ensuring Access to Primary Care for Women and Children Act

Client expense: Not reported · Firm income: $9,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

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

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 45-To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010: entire bill HR 132: ObamaCare Repeal Act: entire bill Public Law No. 111-148- Patient Protection and Affordable Care Act: entire law Public Law No. 111-152- Health Care and Education Reconciliation Act of 2010: entire law HR 2457- Womens Preventive Health Awareness Campaign Act: entire bill HR 1975- Pregnant Workers Fairness Act: entire bill S. 942- Pregnant Workers Fairness Act: entire bill HR 2632- School-based Health Centers Program Reauthorization Act of 2013: entire bill HR 2676- Medicaid Information Technology to Enhance Community Health Act of 2013: entire bill S. 1286- Medicaid Information Technology to Enhance Community Health Act of 2013: entire bill HR 2810- To amend title XVIII of the Social Security Act to reform the sustainable growth rate and Medicare payment for physicians' services, and for other purposes: amendments and provisions related to and affecting reproductive health and family planning S. 1871- SGR Repeal and Medicare Beneficiary Access Act of 2013: amendments and provisions related to and affecting reproductive health and family planning S. 1871- SGR Repeal and Medicare Beneficiary Access Act of 2013: amendments and provisions related to and affecting reproductive health and family planning S. 1009 - Chemical Safety Improvement Act: entire bill HR 4302- Protecting Access to Medicare Act: amendments and provisions related to and affecting reproductive health and family planning HR 3723 - Viral Hepatitis Testing Act of 2013: entire bill HR 5364/S 2461 - Amend title XXI of the Social Security Act to extend and improve the CHIP Program: entire bill HR 5353 - Amend title XIX of the Social Security Act to extend for 5 years payment parity with Medicare for primary care services: Entire bill HR 5380 - Medicare Parity Act: entire bill S 2662 - Telehealth Enhancement Act of 2014: entire bill HR 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 purpose (Flexibility in Health IT Reporting (Flex-IT) Act of 2014"): entire bill S 2629 - Preventive Care Coverage Notification Act: entire bill S 2694 - Ensuring Access to Primary Care for Women & Children Act: entire bill S 2908 - A bill to amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan, and for other purposes: entire bill S 2578/ HR 5150 - Protect Women's Health From Corporate Interference Act: entire bill HR 5294 - Health Equity and Accountability Act

Client expense: $484,122 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), Peace Corps, SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID)

Reauthorization of Medicaid-Medicare Parity for Primary Care and program design. S. 2694, H.R. 5364, H.R. 5353.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Dental issues in CHIP Reauthorization (HR 5364), CHIP Extension and Improvement Act of 2014, and CHIP Extension Act of 2014 (S. 2461)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

PL-111-148, Patient Protection and Affordable Care Act: multiemployer health plans, state exchanges, implementation H.R. 4414, Expatriate Health Coverage Clarification Act H.R. 5213, STARS Act S. 2253, Health Care Fairness and Stability Act: delay implementation S. 2461/H.R. 5364, CHIP Extension Act of 2014 S. 2176, CommonSense Reporting Act S. 2168, Small Business Stability Act S. 1188/H.R. 2575, Forty Hours is Full Time Act of 2013 H.R. 4775, Safeguarding Classrooms Hurt by ObamaCare's Obligatory Levies H.R. 5298, Student Job Protection Act of 2014 S. 2434, Family Coverage Act H.R. 3522 Employee Health Care Protection Act of 2013 Expatriate Health Plans Bills S. 1789, Medicaid managed Care Responsibility and Equity Act

Client expense: $700,000 · Firm income: Not reported

Government targets: Bureau of the Census, Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of the Vice President of the United States, Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

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

Client expense: $2,010,000 · Firm income: Not reported

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

Issues pertaining to Medicaid reform, block grant proposals, per capita caps Medicare and Medicaid Graduate Medical education, Medicaid provider taxes, Medicare bad debt payments Medicare and Medicaid paymentMedicaid Waivers Extension of Medicare Sustainable Growth Rate Medicare Evaluation and Management Reimbursement Reduction Proposal Issues related to waste, fraud, and abuse in Medicaid Medicare Disproportionate Share Hospital Payments H.R. 574 Medicare Physician Payment Innovation Act of 2013, all provisions H.R. 1853 Medicaid Accountability and Care Act, all provisions H.R. 574 Medicare Physician Payment Act, all provisions 5.577/HR 1180 Resident Physician Shortage Reduction Act , all provisions H.R. 1201 Training Tomorrow's Doctors Act, all provisions H.R. 1250/5.1012 Medicare Audit Improvement Act, all provisions H.R. 1487 Improved Healthcare at a Lower Cost Act, all provisions H.R. 1698 Stabilize Medicaid and CHIP Coverage, all provisions H.R. 1326 Health Care Price Transparency Promotion Act, all provisions H.R. 1920 DSH Reduction Relief Act, all provisions Issues related to Medicaid enrollment of newborns CMS FY2014 Hospital Inpatient Prospective Payment System Rule Issues related to admission and medical review criteria for inpatient services ("two midnights rule") S.1555 DSH Reduction Relief Act of 2013, all provisions S.1871 SGR Repeal and Medicare Beneficiary Access Act - all sections H.R. 2810 Medicare Patient Access and Quality Improvement Act - all sections H.R. 4302 Protecting Access to Medicare Act - all sections H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act S. 1980 Medicaid and CHIP Continuous Quality Act H.R. 3678 Two-Midnight Rule Delay Act - all sections H.R. 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 2082 Two-Midnight Rule Coordination and Improvement Act S. 2501 Hospitals Readmissions Program Accuracy and Accountability Act, all sections Issues related to quality measures reporting in Medicaid S. 2461 CHIP Extension act of 2014, all provisions Issues related to Medicare payment for patients in "observation status" in hospitals CMS FY 2014 Outpatient Prospective Payment System Rule Issues related to Medicare Recovery Audit Contractors S. 2941 Medicare Protection Act, all Provisions Extension of SSA 1902 (a) (b) (c) - Medicaid Primary Care payment parity Childrens Health Insurance Program Medicare Hospital Re-admissions Program Meaningful Use Stage 2 H.R. 5481 The Flexibility in Health IT Reporting Act H.R. 5364 CHIP Extension and Improvement Act, All provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Implementation of the Affordable Care Act and Medicare Improving access to home care services HR 5364, S 2461 - Children's Health Insurance Program (CHIP) Extension HR 5294 - Health Equity and Accountability Act of 2014 Increasing access to medical language interpreters HR 3522 - Employee Health Care Protection Act (part of HR 4) HR 4414 - Expatriate Health Coverage Clarification Act Repeal of Affordable Care Act's excise tax on high cost plans HR 4 - Jobs for America Act HR 2575 - Save American Workers Act (part of HR 4) S 2253 - Health Care Fairness and Stability Act Protecting the ACA in general S 2578 - Protect Women's Health from Corporate Interference Act H Res 676 - Authorizing civil action against President with respect to the implementation of the Affordable Care Act Federal income tax exclusion for employer-sponsored health care Federal excise tax on high-cost employer-sponsored health care

Client expense: $550,000 · Firm income: Not reported

Government targets: Council of Economic Advisers (CEA), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office

S 2087, S 2491 - Medicare Protection Act, reconciliation budget rules Implementation of the Affordable Care Act and Medicare Improving access to home care services HR 5364, S 2461 - Children's Health Insurance Program (CHIP) Extension HR 4998, S 2552 - Medicare Advantage Participant Bill of Rights Act Reduce prescription drug costs in Medicare/Medicaid HR 5294 - Health Equity and Accountability Act of 2014 Increasing access to medical language interpreters Conflict of interest section of Home and Community Based Regulations issued by CMS. Asked Senate help to obtain CMS intent of regulation Medicaid funding/benefits Medicare funding/benefits/policy/eligibility age/mean test

Client expense: $550,000 · Firm income: Not reported

Government targets: Council of Economic Advisers (CEA), HOUSE OF REPRESENTATIVES, SENATE, U.S. Trade Representative (USTR), White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 755/ H.R. 1838: Enhanced Access to Medicaid Services Act of 2013: H.R.5364: CHIP Extension and Improvement Act of 2014: Sec. 304. Payment parity for Medicaid primary care services H.R.5353: Medicaid Parity Act of 2014 S. 2694: Ensuring Access to Primary Care for Women & Children ActH.R. 5304: Audiology Patient Choice Act of 2014 Maintenance/expansion of Graduate Medical Education (GME); Permanent repeal to the sustainable growth rate (SGR) formula; Preservation of the in-office ancillary exception to the Stark law, Reimbursement and use of chronic care management codes; Elimination of global surgical periods; Retention of the CME exclusion in the Sunshine Act; Reimbursement and use of magnetoencephalography codes; Fair valuation, utilization and access to NCS/EMG services

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)