To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes.

HR 83 - Consolidated and Further Continuing Appropriations Act: Funding for Title VII Health Professions Grants, AHRQ. HR 647 Better Life Experience Act: Opposing the use of savings in Medicare for non-Medicare programs. HR 2415 (S. 1184) - Treat and Reduce Obesity Act: Seeking House and Senate cosponsors for obesity legislation. HR 3547 - FY 2015 funding Increases in AHRQ, Title VII section 747, NHSC, Teaching Health Center planning grants: Federal spending priorities to support workforce, research. HR 5481 - Urge Leadership and member offices to support bill during lame-duck session; urge CMS to shorted reporting period for 2015. HR 4771 (S. 2021) - Designer Anabolic Steriod Control Act: Restricting access to anabolic steroids. S. 1184 - Treat and Reduce Obesity Act: Seeking House and Senate cosponsors for obesity legislation. S. 1759 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2978 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2229 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2694 - Ensuring Access to Primary Care for Women and Children Act: Extending for 2 years the requirement that Medicaid programs pay primary care physicians at least as much as Medicare Does; Advocate for extension of Medicaid parity which expires at the end of 2014; Urge senators to co-sponsor S. 2694. S. 2917 (HR 5729): Adding Ebola to the FDA priority Review Voucher Program Act: Adding Ebola drug research to an existing FDA priority review program. No Bill Number - SGR Repeal and Replace Process: Advocate for SGR repeal and new physician payment system that pays for value and primary-care; Repealing the current physician payment formula for Medicare. No Bill Number - Graduate Medical Education: Explain and advocate for AAFP's policy proposals on GME. No Bill Number - Addressing health care fragmentation and promoting Triple Aim of improved care and health at lower cost: Promoting health reforms that recognize the value of family medicine and primary care. No Bill Number - National Service Corps trust fund reauthorization, appropriation: NHSC scholarship, debt relief and physicians for underserved. No Bill Number - Ebola Public Health Threat: Preventing the spread of Ebola. No Bill Number - Oppose cuts to pre-resident payment for Teaching Health Center GME: Maintain the sustainability of the THCGME program. No Bill Number - Urge Congress to prevent primary care cliff cuts to THCGME, NHSC &CHCs: Protect primary care spending. No Bill Number - Medicare EHR incentive payments: Concerns over attestation process. No Bill Number - Medicare Advance Care Planning - Urge CMS to cover SPT codes for ACP services. No Bill Number - Medicare Physician Payment: Comments on 2015 final payments. No Bill Number - Veterans Affairs copayments for medications in 2015: Family Physicians ability to prescribe to VA Patients. No Bill Number - Nomination to HIV/AIDS committee: Nominated a family physician to an advisory committee. No Bill Number - Nomination to Medicare Evidence Based MEDCAC: Nominated a family physician to an advisory committee. No Bill Number - Continuing Medical Education - Urged CMS to not change Open Payment CME Policy. No Bill Number - National Defense Authorization Act: Opposing provision to prevent DOD from implementing restrictions on tobacco sales and use. No Bill Number - Confirmation of the Nominee for Surgeon General: Supporting the nomination of Dr. Murthy as Surgeon General. No Bill Number - Copayments for medications in 2015: Supporting the freezing of copayments in the VHA and allowing vets to fill perscriptions from Non-VHA Physicians. No Bill Number - Medicare EvidenceDevelopment and Coverage Advisory Committee: Offering names of family physicians who could serve on the committee. No Bill Number - Presidential Advisory Counsel on HIV/AIDS - Offering the nams of family physicians to serve on the council. No Bill Number - Children's Health Insurance Program: Supporting the reauthorization of the Children's Health Insurance Program. No Bill Number - Healthcare Infection Control Practices Advisory Committee - Offering names of family physicisans to serve on committee. No Bill Number - Health Insurance Marketplace Issues and Provider involvement with Patient Enrollment: Network adequacy, patient enrollment in marketplaces.

Client expense: $514,251 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Veterans Affairs, Dept of (VA)

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

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

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

HR 487, Primary Care Workforce Access Improvement Act; pilot test alternatives to GME payment in order to increase primary care physician training.HR 2415, Treat and Reduce Obsity, Seeking House and Senate cosponsors for obesity legislation. HR 3230, Veterans Access, Choice and Accountablility Act; Support for allowing family physicians to provide health care to veterans paid for by the VHA. HR 4015, SGR Repeal and Medicarte Provider Payment Modernization Act, Support repeal of SGR and replacement with value-based payment systems. HR 4292, The Underserved Veterans Access to Healthcare Act; support for primary care residency positionsin VA health system. HR 5481, Health IT-FLEX-IT Act, Urge leadership and member offices to support bill during lame duck session- bill would shorten 2015 reporting period for meaningful use. HR 5498, Primary Care Physician Reentry Act, Facillitate reentry into practice for primary care physicians. HJ Res. 124, the Continuing Resolution; Support for continued funding for Health Professions Grants and other discretionary programs for primary care. S. 1184, Treat and Reduce Obsity, Seeking House and Senate cosponsors for obesity legislation. S. 1759, Reauthorizing Teaching Health Center GME Program, Reauthorize the Teaching Health Centers Graduate Medical Education program. S. 1932, the Better Care at Lower Cost Act, Support for chronic care management. S. 1978, Reauthorizing Teaching Health Center GME Program, Reauthorize the Teaching Health Centers Graduate Medical Education program; Increasing Primary Care access Act, Family physician workforce. S. 2000, SGR Repeal and Medicarte Provider Payment Modernization Act, Support repeal of SGR and replacement with value-based payment systems. S. 2229, Reauthorizing Teaching Health Center GME Program, Reauthorize the Teaching Health Centers Graduate Medical Education program. S. 2694, Medicaid Parity for Primary care, including S. 2694, advocate for extension of parity which expires at the end of 2014; urge Senators to co-sponsor S. 2694. S. 2728, Extending and increasing funding for grants to teaching health centers. No Bill Number, Graduate Medical Education, Explain and advocate for AAFP's newly released policy proposals on GME; Support for primary care residency slots in non-hospital; settings. No Bill Number, SGR Repeal and Replacement process, Advocate for SGR repeal and new physician payment system that pays for value and primary care. No Bill Number, National Health Service Corps trust fund reauthorization, appropriation, NHSC provides scholarships & debt relief as well as physicians for underserved communities. No Bill Number, Patient Safety and Primary Care Research, Patient safety and primary care research at AHRQ. No Bill Number, FY funding increses in AHRQ, Title VII 747, NHSC, Teaching Health Center planning grants, Federal spending priorities to support workforce, research. No Bill Number, Advisory Committee on Training in Primary Care Medicine and Dentistry, Federal spending on primary care medicine training grants. No Bill Number, Increased funding for Title 747, Federal spending on primary care medicine training grants. No Bill Number, Joining Forces Mental Health Convening, mental health care for returning service members & families. No Bill Number, Increased funding for AHRQ, Federal spending on patient safety primary care research. No Bill Number, Ebola Public Health Threat, Family Physician Kent Brantly testified at Senate hearing. No Bill Number, Medicare EHR incentive payments, Concerns over attestation process. No Bill Number, Infection Advisory, Nominated a FP to a panel. No Bill Number, Medicare physician payment, Comments of 2015 proposed payments. No Bill Number, Medicaid advisory panel, Nomiated FPs to MACPAC. No Bill Number, Physician relative value units, Comments on proposed review of RVUs by CMS. No Bill Number, Tobacco delivery devices, Urged FDA to assert authority. No Bill Number, Continuing Medical Education, Urged CMS to not change Open Payment CME policy. No Bill Number, Food Safety Modernization Act, Support for regulation to prevent food-borne illnesses. No Bill Number, Adult Pneumococcal Vaccine, Support for Medicare payment to administer PCV13.No Bill Number, Health Insurance Marketplace Issues & Provider Involvement with Patient Enrollment, Network adequacy,Patient Enrollment in Marketplaces. No Bill Number, E-Cigarettes, Support of FDA proposed rule giving the agency authority to regulate e-cigarettes. No Bill Number, Medicare Physician Payment Proposed Rule; Support for payment strategies that recognize primary care and care coordination.

Client expense: $666,947 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR 487, Primary Care Workforce Access Improvement Act, pilot test alternatives to GME payment to increase PCP training.HR 2415, Treat and Reduce Obsity, Seeking House and Senate cosponsors for obesity legislation. HR 5481, Health IT-FLEX-IT Act, Urge leadership and member offices to support bill during lame duck session- bill would shorten 2015 reporting period for meaningful use. HR 4015, SGR Repeal and Medicarte Provider Payment Modernization Act, Support repeal of SGR and replacement with value-based payment systems. S. 1184, Treat and Reduce Obsity, Seeking House and Senate cosponsors for obesity legislation. S. 1759, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 1978, Increasing Primary Care Access Act, Family physician workforce, Teaching Health Center Reauthorization Act, Reauthorize the Teaching Health Centers Graduate Medical Education program. S. 1932, the Better Care at Lower Cost Act, Support for chronic care management. S. 2000, SGR Repeal and Medicarte Provider Payment Modernization Act, Support repeal of SGR and replacement with value-based payment systems. S. 2229, Reauthorizing Teaching Health Center GME program, Teaching Health Centers Graduate Medical Education. S. 2694, Medicaid Parity for Primary care, including S. 2694, advocate for extension of parity which expires at the end of 2014; urge Senators to co-sponsor S. 2694; Ensuring Access to Primary Care for Women and Children Act, Prevent Medicaid primary care physician pay cut; Support for extension of this provision to pay primary care physicians for primary care services; extend increase in Medicaid payments for primary care services to Medicare levels beyond 2015; Seek House companion legislation. S. 2728, Community-based Medical Education Act of 2014, Medicare GME reform and THC GME reauthorization; Extending and increasing funding for grants to teaching health centers. No Bill Number, SGR Repeal and Replacement process, Advocate for SGR repeal and new physician payment system that pays for value and primary care. No Bill Number, Graduate Medical Education, Explain and advocate for AAFP's newly released policy proposals on GME. No Bill Number, Medicare Graduate Medical Education, Medicare GME Reform. No Bill Number, Medicare EHR incentive payments, Concerns over attestation process. No Bill Number, Medicare physician payment, Comments of 2015 proposed payments. No Bill Number, Medicare Physician Payment Proposed Rule; Support for payment strategies that recognize primary care and care coordination. No Bill Number, Graduate Medical Education, Support for primary care residency slots in non-hospital settings. No Bill Number, Adult Pneumococcal Vaccine, Support for Medicare payment to administer PCV13. No Bill Number, Pharmaceutical Companies' Payments to Physicians; Support for keeping payments for continuing education excluded from reporting. No Bill Number, Meaningful Use of Health Information Technology Requirements, Support for 90-day EHR reporting period for 2015. No Bill Number, Narrow Networks, Support for restricting health plans' ability to disassociate with primary care physicians. No Bill Number, Repeal SGR, Positive update and higher rate for primary care.

Client expense: $666,947 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR 83 - Consolidated and Further Continuing Appropriations Act: Funding for Title VII Health Professions Grants, AHRQ. HR 647 Better Life Experience Act: Opposing the use of savings in Medicare for non-Medicare programs. HR 2415 (S. 1184) - Treat and Reduce Obesity Act: Seeking House and Senate cosponsors for obesity legislation. HR 3547 - FY 2015 funding Increases in AHRQ, Title VII section 747, NHSC, Teaching Health Center planning grants: Federal spending priorities to support workforce, research. HR 5481 - Urge Leadership and member offices to support bill during lame-duck session; urge CMS to shorted reporting period for 2015. HR 4771 (S. 2021) - Designer Anabolic Steriod Control Act: Restricting access to anabolic steroids. S. 1184 - Treat and Reduce Obesity Act: Seeking House and Senate cosponsors for obesity legislation. S. 1759 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2978 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2229 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2694 - Ensuring Access to Primary Care for Women and Children Act: Extending for 2 years the requirement that Medicaid programs pay primary care physicians at least as much as Medicare Does; Advocate for extension of Medicaid parity which expires at the end of 2014; Urge senators to co-sponsor S. 2694. S. 2917 (HR 5729): Adding Ebola to the FDA priority Review Voucher Program Act: Adding Ebola drug research to an existing FDA priority review program. No Bill Number - SGR Repeal and Replace Process: Advocate for SGR repeal and new physician payment system that pays for value and primary-care; Repealing the current physician payment formula for Medicare. No Bill Number - Graduate Medical Education: Explain and advocate for AAFP's policy proposals on GME. No Bill Number - Addressing health care fragmentation and promoting Triple Aim of improved care and health at lower cost: Promoting health reforms that recognize the value of family medicine and primary care. No Bill Number - National Service Corps trust fund reauthorization, appropriation: NHSC scholarship, debt relief and physicians for underserved. No Bill Number - Ebola Public Health Threat: Preventing the spread of Ebola. No Bill Number - Oppose cuts to pre-resident payment for Teaching Health Center GME: Maintain the sustainability of the THCGME program. No Bill Number - Urge Congress to prevent primary care cliff cuts to THCGME, NHSC &CHCs: Protect primary care spending. No Bill Number - Medicare EHR incentive payments: Concerns over attestation process. No Bill Number - Medicare Advance Care Planning - Urge CMS to cover SPT codes for ACP services. No Bill Number - Medicare Physician Payment: Comments on 2015 final payments. No Bill Number - Veterans Affairs copayments for medications in 2015: Family Physicians ability to prescribe to VA Patients. No Bill Number - Nomination to HIV/AIDS committee: Nominated a family physician to an advisory committee. No Bill Number - Nomination to Medicare Evidence Based MEDCAC: Nominated a family physician to an advisory committee. No Bill Number - Continuing Medical Education - Urged CMS to not change Open Payment CME Policy. No Bill Number - National Defense Authorization Act: Opposing provision to prevent DOD from implementing restrictions on tobacco sales and use. No Bill Number - Confirmation of the Nominee for Surgeon General: Supporting the nomination of Dr. Murthy as Surgeon General. No Bill Number - Copayments for medications in 2015: Supporting the freezing of copayments in the VHA and allowing vets to fill perscriptions from Non-VHA Physicians. No Bill Number - Medicare EvidenceDevelopment and Coverage Advisory Committee: Offering names of family physicians who could serve on the committee. No Bill Number - Presidential Advisory Counsel on HIV/AIDS - Offering the nams of family physicians to serve on the council. No Bill Number - Children's Health Insurance Program: Supporting the reauthorization of the Children's Health Insurance Program. No Bill Number - Healthcare Infection Control Practices Advisory Committee - Offering names of family physicisans to serve on committee. No Bill Number - Health Insurance Marketplace Issues and Provider involvement with Patient Enrollment: Network adequacy, patient enrollment in marketplaces.

Client expense: $2,438,717 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Veterans Affairs, Dept of (VA)

Monitor federal issues and legislation related to healthcare policy; Monitor implementation, P.L. 111-148; H.R. 460, Patients Access to Treatment Act of 2013; Extension, Section 3111, P.L. 111-148; H.R. 1701 / S. 972, Cutting Costly Codes Act; H.R. 1429 Scleroderma Research and Awareness Act; H.R. 2663 / S. 1422, To Amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013; H.R. 4282, Creating Access to Residency Education Act of 2014; H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under EHR incentive payment programs

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

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

Repeal Medicare Sustainable Growth Rate formula; Monitor implementation, P.L. 111-148; Extend Section 3111, P.L. 111-148; H.R. 4015 / S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act; H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013; S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013; H.R. 4302, Protecting Access to Medicare Act; H.R. 1416, Cancer Patient Protection Act; H.R. 2305 / S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act; H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under EHR incentive payment programs; H.R. 800, To exclude prompt pay discounts from ASP formula

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

HR 83 - Consolidated and Further Continuing Appropriations Act: Funding for Title VII Health Professions Grants, AHRQ. HR 647 Better Life Experience Act: Opposing the use of savings in Medicare for non-Medicare programs. HR 2415 (S. 1184) - Treat and Reduce Obesity Act: Seeking House and Senate cosponsors for obesity legislation. HR 3547 - FY 2015 funding Increases in AHRQ, Title VII section 747, NHSC, Teaching Health Center planning grants: Federal spending priorities to support workforce, research. HR 5481 - Urge Leadership and member offices to support bill during lame-duck session; urge CMS to shorted reporting period for 2015. HR 4771 (S. 2021) - Designer Anabolic Steriod Control Act: Restricting access to anabolic steroids. S. 1184 - Treat and Reduce Obesity Act: Seeking House and Senate cosponsors for obesity legislation. S. 1759 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2978 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2229 - Teaching Health Center Reauthorization Act GME program: Teaching Health Centers Graduate Medication Education. S. 2694 - Ensuring Access to Primary Care for Women and Children Act: Extending for 2 years the requirement that Medicaid programs pay primary care physicians at least as much as Medicare Does; Advocate for extension of Medicaid parity which expires at the end of 2014; Urge senators to co-sponsor S. 2694. S. 2917 (HR 5729): Adding Ebola to the FDA priority Review Voucher Program Act: Adding Ebola drug research to an existing FDA priority review program. No Bill Number - SGR Repeal and Replace Process: Advocate for SGR repeal and new physician payment system that pays for value and primary-care; Repealing the current physician payment formula for Medicare. No Bill Number - Graduate Medical Education: Explain and advocate for AAFP's policy proposals on GME. No Bill Number - Addressing health care fragmentation and promoting Triple Aim of improved care and health at lower cost: Promoting health reforms that recognize the value of family medicine and primary care. No Bill Number - National Service Corps trust fund reauthorization, appropriation: NHSC scholarship, debt relief and physicians for underserved. No Bill Number - Ebola Public Health Threat: Preventing the spread of Ebola. No Bill Number - Oppose cuts to pre-resident payment for Teaching Health Center GME: Maintain the sustainability of the THCGME program. No Bill Number - Urge Congress to prevent primary care cliff cuts to THCGME, NHSC &CHCs: Protect primary care spending. No Bill Number - Medicare EHR incentive payments: Concerns over attestation process. No Bill Number - Medicare Advance Care Planning - Urge CMS to cover SPT codes for ACP services. No Bill Number - Medicare Physician Payment: Comments on 2015 final payments. No Bill Number - Veterans Affairs copayments for medications in 2015: Family Physicians ability to prescribe to VA Patients. No Bill Number - Nomination to HIV/AIDS committee: Nominated a family physician to an advisory committee. No Bill Number - Nomination to Medicare Evidence Based MEDCAC: Nominated a family physician to an advisory committee. No Bill Number - Continuing Medical Education - Urged CMS to not change Open Payment CME Policy. No Bill Number - National Defense Authorization Act: Opposing provision to prevent DOD from implementing restrictions on tobacco sales and use. No Bill Number - Confirmation of the Nominee for Surgeon General: Supporting the nomination of Dr. Murthy as Surgeon General. No Bill Number - Copayments for medications in 2015: Supporting the freezing of copayments in the VHA and allowing vets to fill perscriptions from Non-VHA Physicians. No Bill Number - Medicare EvidenceDevelopment and Coverage Advisory Committee: Offering names of family physicians who could serve on the committee. No Bill Number - Presidential Advisory Counsel on HIV/AIDS - Offering the nams of family physicians to serve on the council. No Bill Number - Children's Health Insurance Program: Supporting the reauthorization of the Children's Health Insurance Program. No Bill Number - Healthcare Infection Control Practices Advisory Committee - Offering names of family physicisans to serve on committee. No Bill Number - Health Insurance Marketplace Issues and Provider involvement with Patient Enrollment: Network adequacy, patient enrollment in marketplaces.

Client expense: Not reported · Firm income: $2,438,717

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Veterans Affairs, Dept of (VA)

H.R. 4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014, all provisions H.R. 1179, Improving Access to Medicare Coverage Act of 2013, all provisions S. 569, Improving Access to Medicare Coverage Act of 2013, all provisions H.R. 647, Achieving a Better Life Experience Act of 2014 (ABLE Act of 2014), provisions relating to Misvalued Codes S. 313, Achieving a Better Life Experience Act of 2013 (ABLE Act of 2013), provisions relating to Misvalued Codes H.R. 962, Medicare Diabetes Prevention Act of 2013, all provisions S. 452, Medicare Diabetes Prevention Act of 2013, all provisions H.R. 4282, Creating Access to Residency Education Act of 2014, all provisions H.R. 4843, Native Contract and Rate Expenditure Act of 2014 (Native CARE Act of 2014), all provisions H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes, all provisions H.R. 4998, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions S. 2552, Medicare Advantage Participant Bill of Rights Act of 2014, all provisions H.R. 1180, Resident Physician Shortage Reduction Act of 2013, all provisions S. 577, Resident Physician Shortage Reduction Act of 2013, all provisions S. 1180, Medicare Data Access for Transparency and Accountability Act, all provisions S. 2501, Hospital Readmissions Program Accuracy and Accountability Act of 2014, all provisions H.R. 5723, Ensuring Access to Primary Care for Women & Children Act, all provisions S. 2694, Ensuring Access to Primary Care for Women & Children Act, all provisions H.R. 5780, Protecting the Integrity of Medicare Act (PIMA) of 2014, all provisions H.R. 4302, Protecting Access to Medicare Act of 2014, provisions relating to coding and pricing issues Medicare program: SGR Repeal Medicare program: Independent Payment Advisory Board (IPAB) Repeal Medicare program: Medicare Patient Empowerment Act Medicare program: Graduate Medical Education Medicare program: ICD-10 Repeal Medicare program: Overlapping Medicare incentive programs Medicare program: HIPAA including ICD-10 Medicare program: Electronic Health Records (EHR) - Meaningful Use Medicare program: EHR Certification Medicare program: Physician Quality Reporting System (PQRS) Medicare program: Laboratory Developed Tests Medicare program: Alternative Payment Models/quality performance measures Medicare program: Physician payment and delivery reform issues Medicare program: Hospital short stay Medicare program: Medicare funding for quality measure development Medicare program: Value-Based Modifiers Medicare program: Global Surgical Codes Medicare program: In-Office Ancillary Services Exception Medicare program: RUC - Misvalued and Care Coordination Codes Medicare program: Diabetes Medicare program: Recovery Audit Contractors Medicare program: Program Integrity - Meaningful Use Audits Medicare program: Program Integrity - Modifiers Medicare program: Program Integrity - Electronic Health Records Medicare and Medicaid programs: Coverage of lung cancer screening for high-risk patients

Client expense: $4,390,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

S. 2839, Comprehensive Addiction and Recovery Act of 2014, all provisions S. 2645, Recovery Enhancement for Addiction Treatment (TREAT) Act, all provisions H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes, all provisions H.R. 1074, National Diabetes Clinical Care Commission Act, all provisions S. 539, National Diabetes Clinical Care Commission Act, all provisions H.R. 1701, Cutting Costly Codes Act of 2013, all provisions S. 972, Cutting Costly Codes Act of 2013, all provisions Affordable Care Act - implementation Ebola Prescription requirements for OTC medications Electronic Health Records - Meaningful Use ICD-10 Repeal Prescription Drug Diversion Prescription drug abuse/pain management/prescriber education Telemedicine Sunshine Act Laboratory Developed Tests 21st Century Cures Initiative Narrow Networks Mental Health Diabetes Antibiotics and data collection Personalized medicine Coverage of lung cancer screening for high-risk patients Drug Quality and Security Act/Compounded and Repackaged Medications Federal scientists and researchers - academic and scientific conference travel restrictions Men who have sex with men/blood donor deferral policy

Client expense: $4,390,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), 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 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)

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

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

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

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

H.R.4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (All sections of full text) H.R.5481, Flexibility in Health IT Reporting Act (All sections of full text) - Efforts in support of bill S.2000, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (All sections of full text) Discussions pertinent to the proposed reduction in the amount of Medicare bad debt payments to hospitalsDiscussions related to creation of new CMS endovascular heart valve replacement MS-DRGs.

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

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

1. H.R. 83 Consolidated and Further Continuing Appropriations Act, 2015 (Public Law No: 113-235) - provisions relating to the funding Medicaid, Medicare, hospitals, and Ebola preparedness. 2. H.R. 5481 Flexibility in Health IT Reporting Act of 2014 - relating to shortening the 2015 reporting period for the federal Meaningful Use electronic health records incentive program from a full year to 90 days. 3. Provided information to members of Congress and their staff on the Childrens Health Insurance Program in Texas. 4. Provided information to members of Congress and their staff on Ebola preparedness and the increased funding for the Hospital Preparedness Program (HPP). 5. Provided education to Members of Congress and their staff about the impact of repealing the Medicare sustainable growth rate (SGR) and potential offsets for the repeal package. 6. Provided education to Members of Congress and their staff about health insurance coverage expansion options in the state of Texas. 7. Patient Protection and Affordable Care Act (Pub. L. No. 111-148) - provisions relating to the expiration of primary care physician reimbursement enhancement. 8. Provided education to Members of Congress and their staff about the upcoming (2015) renewal of a Medicaid 1115 demonstration waiver by the state of Texas.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. H.R. 5481 Flexibility in Health IT Reporting (Flex-IT) Act of 2014 - relating to shortening the 2015 reporting period for the federal Meaningful Use electronic health records incentive program from a full year to 90 days. 2. Provided education to Members of Congress and their staff about the impact of repealing the Medicare sustainable growth rate (SGR) and potential offsets for the repeal package. 3. Provided education to Members of Congress and their staff about health insurance coverage expansion options in the state of Texas. 4. Patient Protection and Affordable Care Act (Pub. L. No. 111-148) - provisions relating to the expiration of primary care physician reimbursement enhancement. 5. Provided education to Members of Congress and their staff about the upcoming (2015) renewal of a Medicaid 1115 demonstration waiver by the state of Texas.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.4015, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (All sections of full text) H.R.5481, Flexibility in Health IT Reporting Act (All sections of full text) - Efforts in support of bill S.2000,SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (All sections of full text) Discussions pertinent to the proposed reduction in the amount of Medicare bad debt payments to hospitals Discussions related to creation of new CMS endovascular heart valve replacement MS-DRGs.

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

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

HR 5481 - Flexibility in Health IT Reporting Act of 2014, HR 3303 - SOFTWARE Act/MEDTECH Act Electronic Health Records, Patient Safety, Regulation of Health IT, ICD-10, Health Software Regulation, Quality Measurement, Patient Data Matching, Interoperability

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institute of Standards & Technology (NIST), SENATE

HR 5481 - Flexibility in Health IT Reporting, Meaningful Use EHR Incentive Program, ICD-10 Implementation, Electronic Health Records, Interoperability, Federal Health IT Strategic Plan

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institute of Standards & Technology (NIST), 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

Organ donation issues, including the liver transplant allocation system and in support of new proposed UNOS system, advocated in support of House and Senate letters in support; H.R.83, Consolidated and Further Continuing Appropriations Act of 2015, support Ebola funding for hospital preparedness and treatment activities; sepsis (ensuring that if new Federal rules are put into place they are not inconsistent with what NY hospitals are required to do under NYS law); Flexibility in Health IT Reporting Act of 2014 (H.R.5481) - support; educating members of Congress about hospital price transparency issues; Affordable Care Act - support for coverage expansions and delivery system reforms; veterans health care, support for prompt payment provisions (H.R.3230/H.R.4810)

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), SENATE, White House Office

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148). Monitor federal issues and legislation associated with health care policy. Monitor passage and implementation of Consolidated and Further Continuing Appropriations Act, 2015 (P.L. 113-235). H.R. 460, Patients Access to Treatment Act of 2013. H.R. 1416, Cancer Patient Protection Act of 2013. H.R. 1429, Scleroderma Research and Awareness Act of 2013. H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013. H.R. 2663, to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422, A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. H.R. 4282, Creating Access to Residency Education Act of 2014. H.R. 4302, Protecting Access to Medicare Act. H.R. 5481, To continue the use of a 3-month quarter HER reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid HER incentive payment programs, and for other purposes. S. 2658, Accelerating Biomedical Research Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148). Monitor federal issues and legislation associated with health care policy. Monitor passage and implementation of Consolidated and Further Continuing Appropriations Act, 2015 (P.L. 113-235). H.R. 460, Patients Access to Treatment Act of 2013. H.R. 1416, Cancer Patient Protection Act of 2013. H.R. 1429, Scleroderma Research and Awareness Act of 2013. H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013. H.R. 2663, to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422, A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. H.R. 4282, Creating Access to Residency Education Act of 2014. H.R. 4302, Protecting Access to Medicare Act. H.R. 5481, To continue the use of a 3-month quarter HER reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid HER incentive payment programs, and for other purposes. S. 2658, Accelerating Biomedical Research Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

End-stage renal disease reimbursement and policies related to the Medicare End Stage Renal Disease Prospective Payment System; and issues related to state-based health insurance exchanges and patient protections for patients under the Affordable Care Act (Public Law 112-25). Final Regulations issued by CMS regading Medicare payments for services for people living with ESRD. Proposal at the Center for Medicare and Medicaid Innovation to develop a coordinated kidney care pilot program that would integrate care for Medicare beneficiaries with ESRD. CMS call letter for Medicare Advantage plans with a focus on rate setting and risk adjustment issues. H.R. 4814: The Chronic Kidney Disease Improvement in Research and Treatment Act of 2014 (All provisions) CMS regulations related to the treatment of Medicare Part C and D. CMS regulations pretaining to reimbursement rates for ESRD-related services. S. 2501: Hospital Readmissions Program Accuracy and Accountability Act (All provisions) H.R. 5481: The Flexibility in Health IT Reporting Act of 2014 "Flex-IT Act" (All provisions)

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

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

LIFT Health Center Capital Financing; Family Health Care Accessibility Act of 2013(S.955); Federal Tort Claims Act Coverage for Volunteers at FQHCs; Teaching Health Centers; Immigration Reform and the Border Security, Economic Opportunity and Immigration Modernization Act (S.744); The Helping Families in Mental Health Crisis Act (H.R.3717); Veterans Access to Care through Choice(S.2450); and Accountability and Transparency Act(H.3230), Health Information Technology and TeleHealth; Flex IT Act (H.R.5481).

Client expense: $170,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

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

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

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

HR 5481: The Flex It Act - Meaningful Use program Health Care Reform Implementation CMS & CMMI Demonstration Projects

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

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

Two Midnight Rule (HR 3698 / S. 2082) Socioeconomic adjustment of the hospital readmission reduction program (H.R. 4188 / S. 2501) Medicare Audit Improvement Ace (H.R. 1250 / S. 1012) DSH Reduction Relief Act (H.R. 1920 / S. 1555)Sustainable Growth Rate Medical Liability Reform (S. 1769 / H.R. 1473, H.R. 36 / S. 961) Mental Health Policy (H.R. 3717) Rural Hospital Policies (H.R. 1787 /S. 842, H.R. 3991 / S. 2037, H.R. 3444, S. 2359, H.R. 2801 / S. 1143) Post Acute Care Policies (H.R. 4994) Graduate Medical Education (H.R. 1201 / S. 577 / H.R. 1180) Meaningful Use of Electronic Health Records (H.R. 5481) Children's Health Insurance Program Veterans Access to Care Nurse Education Policies 340B Drug Discount Program Home Health Face-To-Face Requirement FY 2015 IPPS

Client expense: $46,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5481 Flexibility in Health IT Reporting (Flex IT), any and all language giving hospitals and eligible professionals more flexibility in meeting meangingful use requirements for electronic health records in FY 2015. Any language in Helping Families in Mental Health Crisis legislation to improve access for patients and families to mental health services, including but not limited to telemedicine services.

Client expense: $35,544 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 4188) Hospital Readmissions Program Accuracy and Accountability Act (S. 2501) Training Tomorrow's Doctors Today Act (H.R. 1180/H.R. 1201)To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs, and for other purposes. (H.R. 5481)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

support HR 2027 to reverse restrictions on physician owned hospitals;support legislation on increased reimbursement for ambulatory surgical centers (HR 2500,S1137);oppose cuts to advanced medical imaging;support legislation regarding implementation of meaningful use for HIT (HR5481, HR 5556);support SGR reform

Client expense: Not reported · Firm income: $24,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

support HR 2027 to reverse restrictions on physician owned hospitals;support legislation on increased reimbursement for ambulatory surgical centers (HR 2500,S1137);oppose cuts to advanced medical imaging;support legislation regarding implementation of meaningful use for HIT (HR5481, HR 5556);support SGR reform

Client expense: Not reported · Firm income: $24,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5481 - Flexibility in Health IT Reporting Act, The Medicare/Medicaid EHR Incentive Program, Meaningful Use Program, Interoperability, Patient Data Matching, Patient Safety, Quality Measurement/ eCQMs, Healthcare Software Regulation, Cyber Security

Client expense: Not reported · Firm income: Not reported

HR 5481 - Flexibility in Health IT Reporting Act, The Medicare/Medicaid EHR Incentive Program, Meaningful Use Program, Interoperability, Patient Data Matching, Patient Safety, Quality Measurement/ eCQMs, Healthcare Software Regulation, Cyber Security

Client expense: Not reported · Firm income: Not reported

HR 5481 - Flexibility in Health IT Reporting Act, The Medicare/Medicaid EHR Incentive Program, Meaningful Use Program, Interoperability, Patient Data Matching, Patient Safety, Quality Measurement/ eCQMs, Healthcare Software Regulation, Cyber Security

Client expense: Not reported · Firm income: Not reported

HR 5481 Flexibility in Health IT Reporting (Flex IT), any and all language giving hospitals and eligibile professionals more flexibility in meeting meaningful use requirements for electronic health records in FY 2015. Any language in Helping Families in Mental Health Crisis legislation to improve access for patients and families to mental health services, including but not limited to telemedicine services

Client expense: $11,564 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Submitted comments on the Hatch Entitlement Reform in support of the several key reforms proposed for the Medicare program as alternative reductions to provider payments; Support S 351 Protecting Seniors Access to Medicare Act, a bill to repeal the provisions of the Patient Protection and Affordable Care Act providing for the Independent Payment Advisory Board; Support HR 297 and S1557, Children's Hospital GME Support Reauthorization Act of 2013, the bill would reauthorize the CHGME program for an additional five years through fiscal year (FY) 2017; Support HR 1250 and S 1012 Medicare Audit Improvement Act of 2013, a bill to amend title XVIII of the Social Security Act to improve operations of recovery auditors under the Medicare integrity program, to increase transparency and accuracy in audits conducted by contractors; Support S. 596 Fostering Independence Through Technology Act of 2014, a bill to establish pilot projects under the Medicare program to provide incentives for home health agencies to furnish remote patient monitoring services that reduce expenditures under such program; Support HR 1787 and S 842 Rural Hospital Access Act of 2013, a bill to amend title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program; Support HR 1920 and S 1555 DSH Reduction Relief Act of 2013, a bill to amend titles XVIII and XIX of the Social Security Act to provide for a delay in the implementation schedule of the reductions in disproportionate share hospital payments;AHA submitted a statement to the Presidents and Other Bipartisan Proposals to Reform Medicare Post-Acute Care Payments hearing to provide input on proposals to reform Medicares post-acute care payment systems; AHA submitted a statement to the Program Integrity: Oversight of Recovery Audit Contractors hearing supporting increased oversight of Recovery Audit Contractors (RACs); Support HR 2578 Rural Hospital Fairness Act of 2013, a bill to amend title XVIII of the Social Security Act to extend for one year the hold harmless provision for small rural hospitals and sole community hospitals under the Medicare prospective payment system for hospital outpatient department services related to enhanced physician supervision requirements; AHA submitted a statement to the Health Care Quality: The Path Forward hearing in support of improving transparency for the public, continuing and enhancing support of efforts to improve the safety and quality of the care delivered,and reduce unnecessary hospital expenditures; Support HR 2931 Fairness in Health Care Claims, Guidance and Investigations Act, a bill to amend the false claims provisions of title 31, United States Code, with respect to health care programs; Request additional guidance on and delay of two-midnight rule from CMS; Request issue corrected data on OPPS proposed rule and delay comment period from CMS; Discussion of ACAs patient safety evaluation system with CMS; Discussed the improvements to the National Practitioner Data Bank and new compliance efforts at HRSA; Discussions of Medicaid presumptive eligibility; Medicaid DSH; and request release of DSH audit rule with CMS; Follow up on GPO exclusion related to 340(b) entities; discussions to help shape upcoming proposed rule on 340B with HRSA; Discussed the Qualified Health Plans (QHP) 90day grace period with HHS and its implications for hospitals; Support HJ Res 59, a continuing Appropriations Resolution for 2014, which includes a provision that averts Medicare physician payment cuts as Congress continues to work on a replacement of the flawed SGR formula; Support HR 3444 Critical Access Hospital Flexibility Act of 2013, to amend title XVIII of the Social Security Act to provide flexibility in the manner in which beds are counted for purposes of determining whether a hospital may be designated as a critical access hospital under the Medicare program; Support H.R.3698 and S. 2037 Two-Midnight Rule Delay Act of 2013, to delay the enforcement of the Medicare two-midnight rule for short inpatient hospital stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays; Requested CMS and ONC to extend the EHR Incentive program regulatory timelines for 2014 and allow all providers greater flexibility in Stage 2 by giving all hospitals the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or the revised Stage 1 requirements, as applicable) over the course of 2014 or 2015; Support HR 3991 and S 2037 Critical Access Hospital Relief Act of 2014, amends title XVIII (Medicare) of the Social Security Act to repeal the 96-hour physician certification requirement for inpatient critical access hospital services under which a physician must certify that a patient may reasonably be expected to be discharged or transferred to a hospital within 96 hours after admission to the critical access hospital; Support HR 4188 Establishing Beneficiary Equity in the Hospital Readmission Program Act, to amend title XVIII of the Social Security Act to adjust the Medicare hospital readmission reduction program to respond to patient disparities; Support H.R. 2801 and S 1143 Protecting Access to Rural Therapy Services (PARTS) Act of 2013, a bill to adopt a default standard of general supervision for outpatient therapeutic services, develop a reasonable exceptions process with provider input to identify specific procedures that require direct supervision, ensure that, for CAHs, the definition of direct supervision is consistent with the CAH conditions of participation that allow a physician or NPP to present within 30 minutes of being called and prohibit enforcement of CMSs retroactive reinterpretation that the direct supervision requirements applied to services furnished since January 1, 2001; S.1932/H.R. 3890 Better Care, Lower Cost Act , AHA has not taken position on the bill, but did establish an AHA working group to analyze the legislation to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program to provide integrated care for Medicare beneficiaries with chronic conditions; requested that the increasing number of hospital compliance reviews performed by the Office of Inspector General (OIG) Office of Audit Services in which the OIG has extrapolated audit findings to estimate Medicare overpayments to the hospitals and the hospitals Medicare Administrative Contractors (MACs)have sought to recover the extrapolated overpayment amounts be halted without delay; Support HR 5481, The Flexibility in Health IT Reporting (Flex-It) Act, a bill to continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid EHR incentive payment programs.

Client expense: $4,270,000 · Firm income: Not reported

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

Repeal Sustainable Growth Rate formula; Monitor implementation, P.L. 111-148; Extend Section 3111, P.L. 111-148; H.R. 4015 / S. 2000, SGR Repeal and Medicare Provider Payment Modernization Act; S. 1871, SGR Repeal and Medicare Beneficiary Access Act of 2013; H.R. 1416, Cancer Patient Protection Act; H.R. 2305 / S. 1123, Preventing and Reducing Improper Medicare and Medicaid Expenditures Act; H.R. 2810, Medicare Patient Access and Quality Improvement Act; H.R. 4302, Protecting Access to Medicare Act; H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under EHR incentive payment programs; H.R. 800, To exclude prompt pay discounts from ASP formula

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

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

Monitor federal issues and legislation related to healthcare policy; Monitor implementation, P.L. 111-148; H.R. 460, Patients Access to Treatment Act of 2013; Extension, Section 3111, P.L. 111-148; H.R. 1701 / S. 972, Cutting Costly Codes Act; H.R. 1429 Scleroderma Research and Awareness Act; H.R. 2663 / S. 1422, To Amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings; H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013; H.R.4282, Creating Access to Residency Education Act of 2014; H.R. 5481, To continue the use of a 3-month quarter EHR reporting period for health care providers to demonstrate meaningful use for 2015 under EHR incentive payment programs

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

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

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)

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148). Monitor federal issues and legislation associated with health care policy. Draft, House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. H.R. 460, Patients Access to Treatment Act of 2013. H.R. 1416, Cancer Patient Protection Act of 2013. H.R. 1429, Scleroderma Research and Awareness Act of 2013. H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013. H.R. 2663, to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422, A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. H.R. 4282, Creating Access to Residency Education Act of 2014. H.R. 4302, Protecting Access to Medicare Act. H.R. 5481, To continue the use of a 3-month quarter HER reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid HER incentive payment programs, and for other purposes. S. 2658, Accelerating Biomedical Research Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor implementation of the Patient Protection and Affordable Care Act. (P.L. 111-148). Monitor federal issues and legislation associated with health care policy. Draft, House Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. Draft, Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2015. H.R. 460, Patients Access to Treatment Act of 2013. H.R. 1416, Cancer Patient Protection Act of 2013. H.R. 1429, Scleroderma Research and Awareness Act of 2013. H.R. 1827, Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013. H.R. 2663, to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. S. 1422, A bill to amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings. H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. H.R. 4282, Creating Access to Residency Education Act of 2014. H.R. 4302, Protecting Access to Medicare Act. H.R. 5481, To continue the use of a 3-month quarter HER reporting period for health care providers to demonstrate meaningful use for 2015 under the Medicare and Medicaid HER incentive payment programs, and for other purposes. S. 2658, Accelerating Biomedical Research Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5481 Flexibility in Health IT Reporting (Flex IT), any and all language giving hospitals and eligibile professionals more flexibility in meeting meaningful use requirements for electronic health records in FY 2015. Any language in Helping Families in Mental Health Crisis legislation to improve access for patients and families to mental health services, including but not limited to telemedicine services

Client expense: $28,392 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE