Medicare Access to Rehabilitation Services Act of 2013

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (observation stay) H.R. 713/S 367 Medicare Access to Rehabilitative Services Act of 2013 (all sections) H.R. 4994/S 2553 Improving Medicare Post Acute Transformation Act of 2014 (all sections) H.R. 647/S 313 Achieving a Better Life Experience Act of 2013 (all sections) S 1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014, Title II, Section 202 H.R. 5110 SAVE Medicare Home Health Act of 2014 (all sections) H.R. 3245 Medicare Home Health Fraud Reduction Act (all sections) H.R. 5780 Protecting the Integrity of the Medicare Act of 2014, Sec 15 Modification of Medicare Home Health Surety Bond Condition of Participation Requirement H.R. 2 Medicare Access and CHIP Reauthorization Act of 2015 (all sections) H.R. 1458 BACPAC of 2015 (all sections) H.R. 1250/S 1211 A bill to amend title XVIII of the Social Security Act to provide that payment under the Medicare program to a long-term care hospital for inpatient services shall not be made at the applicable site neutral payment rate for certain discharges involving severe wounds, and for other purposes (all sections) H.R. 2208 Hospice CARE (all sections) H.R. 6 21st Century Cures Act H.R. 2196/S 971 Medicare Independence at Home Medical Practice Demonstration Improvement Act of 2015 (all sections) H.R. 441/S 202 To provide for a technical change to the Medicare long-term care hsopital moratorium exception (all sections) S 1549 Care Planning Act of 2015 (all sections) Other Issues Related to Post-Acute Care Policy

Client expense: $412,000 · Firm income: Not reported

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (observation stay) HR 713/S 367 Medicare Access to Rehabilitative Services Act of 2013 (all sections) HR 4994/S2553 Improving Medicare Post Acute Transformation Act of 2014 (all sections) HR 647/S 313 Achieving a Better Life Experience Act of 2013 (all sections) S1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014, Ttile II, Section 202 HR 5110 SAVE Medicare Home Health Act of 2014 (all sections) HR 3245 Medicare Home Health Fraud Reduction Act (all sections) Other Issues Related to Post-Acute Care Policy HR 5780 Protecting the Integrity of the Medicare Act of 2014, Sec 15 Modification of Medicare Home Health Surety Bond Condition of Participation Requirement HR2 Medicare Access and CHIP Reauthorization Act of 2015 (all sections) HR1458 BACPAC of 2015 (all sections)

Client expense: $630,000 · Firm income: Not reported

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

HR713/S367 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) H.R. 3426/S.2818 Locum Tenens H.R. 1310 opt out

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

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

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

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

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

Medicare Part D HR 713/S 367, Medicare Access to Rehabilitation Services Act of 2013

Client expense: $65,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE

ACE Kids Act (H.R. 4930) Better Care, Lower Cost Act (Wyden) (S.1932) CMS Request for Comments: Enhancements to the Star Ratings for 2016 and Beyond Medication AdherenceMedicare Access to Rehabilitation Services Act (H.R. 713/S.367) Medicare Diabetes Prevention Act (S. 452) Medicare SGR Reform (Senate Finance draft, House Ways & Means draft) Medicare SGR Repeal & Beneficiary Access Improvement Act (S.2110) Medication Therapy Management Act of 2013 (H.R. 1024/S.557) Pathway for SGR Reform Act (temporary extension of Medicare extenders) (H.J. Res.59) 2015 Physician Fee Schedule (CMS-1612-P) Protecting Access to Medicare Act (H.R.4302) Recruiting Individuals to Drive our Elders (RIDE) Act-not yet introduced SGR Repeal and Medicare Beneficiary Access Act (S.1871& H.R.2810) Telehealth Enhancement Act (H.R.3306/ S.2662)

Client expense: $176,171 · 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), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

S 367/HR 713 - Medicare Access to Rehabilitation Services Act: Advocate for removal of cap on occupational therapy services and passage. HR 942/S 948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013: Advocate for inclusion of occupational therapy professionals as providers of complex rehabilitation technology. No bill# - Educate about role of occupational therapy in primary care. HR 2810 - The Medicare Patient Access and Quality Improvement Act of 2013: Advocated regarding sustainable growth rate and educate about the role of occupational therapy in health care and need for improving Medicare to assure that patients receive appropriate care, especially occupational therapy services, and that payment is fair and equitable. No bill# - Multiple Procedure Payment Reduction (MPPR): Advocate the separation of occupational therapy from physical therapy/speech language pathology in application of MPPR policy. No bill# - Manual Medicare Review (MMR: Advocate for improved MMR procedures including electronic submission and 10 day turn around. S 1871/S 2110 - the Sustainable Growth Rate (SGR) Repeal and Medicare Beneficiary Access Improvement Act of 2013 AND HR 4015/S 2000 - SGR Repeal and Medicare Provider payment Modernization Act of 2014: Advocated for improvements to the bills that address policies that pertain to beneficiaries' access to occupational therapy services and how occupational therapy services are reimbursed under the Medicare program. Advocate for repeal of the Medicare Part B outpatient therapy cap on occupational therapy services. HR 3749 - The Medicare Demonstration of Coverage for Low Vision Devices Act: Support for greater attention to low vision coverage and highlight role of occupational therapy in ensuring the devices are utilized properly and to their full potential. S 1932/HR 3890 - Better Care, Lower Cost Act: Educate about role of occupational therapy in helping people with chronic conditions. Support including occupational therapy in the chronic care innovation centers. HR 4994/S 2553 0 The Improving Medicare post-Acute Care transformation Act of 2014 "IMPACT Act of 2014": Advocated for improvements in the bill that would help ensure Medicare beneficiaries' access to quality post-acute care in the right setting is preserved. Advocated to ensure data collection program includes elements that reflect the contributions of occupational therapy across the various post-acute settings. HR 5380 - Medicare Telehealth Parity Act: Support passage and inclusion of occupational therapy services. HR 3306 - The Telehealth Enhancement Act of 2013: educate about how occupational therapy can be utilized in telehealth. HR 3877 - Lymphedema Treatment Act: Support passage and educate about role of occupational therapy services. No. bill# (PL 113-93) - Advocate for inclusion of occupational therapy in the Excellence in Mental Health Act's Medicaid Demonstration by encouraging Members of Congress to send a letter of support to the Substance Abuse and Mental Health Administration. HR 5547/S 2515 - Community Integration Act: Discussed Act's aims to strengthen Medicaid beneficiaries' opportunities to receive home and community-based services. Met with staff from the Health Resources and Services Administration (HRSA), including Dr. Marcia Brand, HRSA Deputy Administrator, along with other representatives of allied health professionals, to discuss recent restructuring of HRSA that appears to deemphasize allied health professions and lack of funding for allied health training programs. Also discussed the need to clearly define "allied health professionals" both for existing policies and new programs being developed at the Centers for Medicare and Medicaid Innovation; and the role of allied health professionals in the changing health care landscape.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

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

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

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

HR713/S367 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) H.R. 3426/S.2818 Locum Tenens H.R. 1310 opt out

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

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

Support for H.R.713 and S.367, "Medicare Access to Rehabilitation Services Act of 2013." Reform of the sustainable growth rate formula for Medicare provider payments in S.1871 "SGR Repeal and Medicare Beneficiary Access Act of 2013,"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

H.J. RES 59, as related to the amendment, the Pathway for SGR Reform Act of 2013. H.R. 713/S.367, the Medicare Access to Rehabilitation Services Act of 2013, as related to the Medicare Part B cap on outpatient therapy services. Public Law No: 113-93, Protecting Access to Medicare Act of 2014, as related to extending the Medicare Part B cap on outpatient therapy services exceptions process. S.2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014, as related to repealing the Medicare Part B cap on outpatient therapy services. H.R. 2330, the Medicare Audiology Services Enhancement Act of 2013, as related to comprehensive Medicare coverage of audiology services. Various issues related to SGR reform proposals. Various issues related to CMS actions surrounding Medicare physician supervision requirements. Various issues related to CMS actions surrounding the therapy cap and the institution of a manual medical review process for therapy services. Various issues related to CMS actions surrounding Medicare coverage of intraoperative monitoring services. Various issues related to CMS actions surrounding Medicare coverage of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. Various issues related to CMS actions surrounding audits of medical records and claims for Part A and Part B services. Various issues related to the Physician Quality Reporting System for audiology and speech-language pathology participation. Various issues related to the Medicare Physician Fee Schedule (MPFS), as related to fees for audiology and speech-language pathology services. Various issues related to preservation of Medicaid funding. Various issues regarding CMMI demonstration projects/episodic payment models. Various issues related to ensuring access to speech-generating devices (SGDs) needed to supplement or replace speech or writing for individuals with severe speech impairments. H.R. 5380, the Medicare Telehealth Parity Act of 2014, as related to allowing audiologists and speech-language pathologists to be reimbursed by Medicare for providing telehealth services. Various issues related to the provision and payment for Part A therapy. Various issues related to the reimbursement under the Outpatient Prospective Payment System (OPPS).

Client expense: $260,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), SENATE

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111-152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare; HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; S 1546: Protecting Student Athletes from Concussions Act of 2013; S 152: Older Americans Act Reauthorization Act of 2013; S 423/HR 564: Family-to-Family Health Information Centers; HR 3850/HR 4122: Older Americans Act Reauthorization Act of 2014; HR 3114: Helping Families & Seniors Save on Health Care Act of 2014; HR 4118: SIMPLE (Suspending the Individual Mandate Penalty Law Equals) Fairness Act of 2014; HR 4302: Protecting Access to Medicare Act of 2014; S 2110: Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014; S 2410/HR 4435: National Defense Authorization Act 2015; S 2449/HR 4631: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014; S 531: Promoting Physical Activity for Americans Act; S 2539: TBI Reauthorization Act; S 531: Physical Activity Guidelines; and S 1847: National Defense Authorization Act.

Client expense: $74,594 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

"H.R. 713/S. 367, Medicare Access to Rehabilitation Services Act of 2013," all sections; and efforts to permanently repeal the Medicare Therapy Cap in the Sustainable Growth Rate repeal discussions.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Site neutral payment issues; implementation of the Continuing Care Hospital; medical necessity, H.R. 713/S. 367; Medicare Access to Rehabilitation Services Act of 2013; post-acute care reform; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; Protecting Access to Medicare Act (P.L. 113-93); Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act, S. 2157; H.R. 4994/S. 2553, IMPACT Act of 2014 (P.L. 113-185); Protecting Integrity in Medicare Act of 2014 (H.R. 5780); draft Hospital Improvements for Payment Act of 2014

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

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

Site neutral payment issues; implementation of the Continuing Care Hospital; medical necessity, H.R. 713/S. 367; Medicare Access to Rehabilitation Services Act of 2013; post-acute care reform; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; Protecting Access to Medicare Act (P.L. 113-93); Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act, S. 2157; H.R. 4994/S. 2553, IMPACT Act of 2014 (P.L. 113-185); Protecting Integrity in Medicare Act of 2014 (H.R. 5780); draft Hospital Improvements for Payment Act of 2014

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

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

HR 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (observation stay) HR 713/S 367 Medicare Access to Rehabilitative Services Act of 2013 (all sections) HR 4994/S 2553 Improving Medicare Post Acute Transformation Act of 2014 (all sections) HR 647/S 313 Achieving a Better Life Experience Act of 2013 (all sections) S1871 Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014, Title II, Section 202 HR 5110 SAVE Medicare Home Health Act of 2014 (all sections) HR 3245 Medicare Home Health Fraud Reduction Act (all sections) Other issues related to Post-Acute Care Policy HR 5780 Protecting the Integrity of the Medicare Act of 2014, Sec 15 modification of Medicare Home Health surety bond condition of participation requirement

Client expense: $490,000 · Firm income: Not reported

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

Better Care, Lower Cost Act (Wyden) (S.1932) Medication Adherence Medicare Access to Rehabilitation Services Act (H.R. 713/S.367) Medicare Diabetes Prevention Act (S. 452)Medicare SGR Reform (Senate Finance draft, House Ways & Means draft) Medicare SGR Repeal & Beneficiary Access Improvement Act (S.2110) Medication Therapy Management Act of 2013 (H.R. 1024/S.557) Pathway for SGR Reform Act (temporary extension of Medicare extenders) (H.J. Res.59) 2015 Physician Fee Schedule (CMS-1612-P) Protecting Access to Medicare Act (H.R.4302) Recruiting Individuals to Drive our Elders (RIDE) Act-not yet introduced SGR Repeal and Medicare Beneficiary Access Act (S.1871& H.R.2810)

Client expense: $19,160 · 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), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

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

Government targets: Defense, Dept of (DOD), Education, Dept of, Federal Communications Commission (FCC), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Transportation, Dept of (DOT), White House Office

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

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

Government targets: Defense, Dept of (DOD), Education, Dept of, Federal Communications Commission (FCC), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Transportation, Dept of (DOT), White House Office

HR713/S367 Medicare Access to Rehabilitation Services Act (Repeal of Medicare Therapy Caps) H.R. 3426/S.2818 Locum Tenens H.R. 1310 opt out

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

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

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

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

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

Support for H.R.713 and S.367, "Medicare Access to Rehabilitation Services Act of 2013." Reform of the sustainable growth rate formula for Medicare provider payments in S.1871 "SGR Repeal and Medicare Beneficiary Access Act of 2013,"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

Client expense: $830,000 · Firm income: Not reported

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

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increased Administrative Burdens Act H.R. 1179: Improving Access to Medicare Coverage Act of 2013 S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367 The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness for Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays. H.R.3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S.1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.2157 - Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014 Advocacy work on HCBS proposed rule: passed in January S.1932 - A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program HR 1250 - The Medicare Audit Improvement Act of 2013 S.1012 - Medicare Audit Improvement Act of 2013 S.2082 - The two-midnight rule coordinator and Improvement Act of 2014 Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014) Protect and Preserve Medicaid funding for long Term Services and Supports Medicaid Provider Assessment Improving the CMS State Plan Amdt. Process Opposition to H.B. No. 5051 - An Act Improving Transparency of Nursing Home Operations Sustainable Growth Rate (SGR) and other reform proposals Reducing hospital readmissions from skilled nursing facility Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors MedPAC site neutral payment system for post acute care CME proposed Rule for SNF Prospective Payment System (PPS) HR 4994, IMPACT Act of 2014 HR 5098 - to amend the Internal Revenue Code of 1986 to temporarily exempt from the employer. HR 4232 - A bill to amend title of the Social Security Act to require hospitals to provide certain notifications to individuals classified by such hospitals under observation status rather than admitted as inpatients of such hospitals; to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. HR 5373 - To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes.

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

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

S 367/HR 713 - Medicare Access to Rehabilitation Services Act: Advocate for removal of cap on occupational therapy services and passage of bills. HR 942/S 948 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013: Advocate for inclusion of occupational therapy professionals as providers of Complex Rehabilitation Technology. No bill# - Educate about role of occupational therapy in primary care. HR 2810 - The Medicare Patient Access and Quality Improvement Act of 2013: Advocated regarding Sustainable growth rate and educate about the role of occupational therapy in health care and need for improving Medicare to assure that patients receive appropriate care, especially occupational therapy services, and that payment is fair and equitable. No bill# - Multiple Procedure Payment Reduction (MPPR): Advocate for separation of occupational therapy from physical therapy/speech language pathology in application of MPPR policy. No bill# Manual Medicare Review (MMR): Advocate for improved MMR procedures including electronic submission and 10 day turn around. S 1871/S 2110 - the Sustainable Growth Rate (SGR) Repeal and Medicare Beneficiary Access Improvement Act of 2013 AND HR 4015/S 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014: Advocated for improvements to the bills that address policies that pertain to beneficiaries' access to occupational therapy services and how occupational therapy services are reimbursed under the Medicare program. Advocate for repeal of the Medicare Part B outpatient therapy cap on occupational therapy services. HR 3749 - The Medicare Demonstration of Coverage for Low Vision Devices Act: Support for greater attention to low vision coverage and highlight role of occupational therapy in ensuring the devices are utilized properly and to their full potential. S 1932/HR 3890 - Better Care, Lower Cost Act: Educate about role of occupational therapy in helping people with chronic conditions. Support including occupational therapy in the chronic care innovation centers. HR 4994/S 2553 - The Improving Medicare Post-Acute Care Transformation Act of 2014 "IMPACT Act of 2014": Advocated for improvements in the bill that would help ensure Medicare beneficiaries' access to quality post-acute care in the right setting is preserved. Advocated to ensure data collection program included elements that reflected the contributions of occupational therapy across the various post-acute settings. HR 5380 - Medicare Telehealth Parity Act: Support passage and inclusion of occupational therapy services. HR 3306 - The Telehealth Enhancement Act of 2013: Educate about how occupational therapy can be utilized in telehealth. HR 3877 - Lymphedema Treatment Act - support passage and educate about role of occupational therapy services. No bill# (PL 113-93) - Advocate for inclusion of occupational therapy in the Excellence in Mental Health Act's Medicaid Demonstration by encouraging Members of Congress to send a letter of support to the Substance Abuse and Mental Health Administration.

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

"H.R. 3077, TELEmedicine for MEDicare Act of 2013"; "H.R. 5380, the Medicare Telehealth Parity Act of 2014"; and "H.R.713/S. 367, Medicare Access to Rehabilitation Services Act of 2013."

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.J. RES 59, as related to the amendment, the Pathway for SGR Reform Act of 2013. H.R. 713/S.367, the Medicare Access to Rehabilitation Services Act of 2013, as related to the Medicare Part B cap on outpatient therapy services.Public Law No: 113-93, Protecting Access to Medicare Act of 2014, as related to extending the Medicare Part B cap on outpatient therapy services exceptions process. S.2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014, as related to repealing the Medicare Part B cap on outpatient therapy services. H.R. 2330, the Medicare Audiology Services Enhancement Act of 2013, as related to comprehensive Medicare coverage of audiology services. Various issues related to SGR reform proposals. Various issues related to CMS actions surrounding Medicare physician supervision requirements. Various issues related to CMS actions surrounding the therapy cap and the institution of a manual medical review process for therapy services. Various issues related to CMS actions surrounding Medicare coverage of intraoperative monitoring services. Various issues related to CMS actions surrounding Medicare coverage of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. Various issues related to CMS actions surrounding audits of medical records and claims for Part A and Part B services. Various issues related to the Physician Quality Reporting System for audiology and speech-language pathology participation. Various issues related to the Medicare Physician Fee Schedule (MPFS), as related to fees for audiology and speech-language pathology services. Various issues related to preservation of Medicaid funding. Various issues regarding CMMI demonstration projects/episodic payment models. Various issues related to ensuring access to speech-generating devices (SGDs) needed to supplement or replace speech or writing for individuals with severe speech impairments. H.R. 5380, the Medicare Telehealth Parity Act of 2014, as related to allowing audiologists and speech-language pathologists to be reimbursed by Medicare for providing telehealth services.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), SENATE

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare;HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; S 1546: Protecting Student Athletes from Concussions Act of 2013; S 152: Older Americans Act Reauthorization Act of 2013; S 423/HR 564: Family-to-Family Health Information Centers; HR 3850/HR 4122: Older Americans Act Reauthorization Act of 2014; HR 3114: Helping Families & Seniors Save on Health Care Act of 2014; HR 4118: SIMPLE (Suspending the Individual Mandate Penalty Law Equals) Fairness Act of 2014; HR 4302: Protecting Access to Medicare Act of 2014; S 2110: Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014; S 2410/HR 4435: National Defense Authorization Act 2015; S 2449/HR 4631: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014; and S 531: Promoting Physical Activity for Americans Act.

Client expense: $52,871 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Education, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

Implementation of the Continuing Care Hospital; medical necessity, H.R. 713/S. 367; Medicare Access to Rehabilitation Services Act of 2013; post-acute care reform, site neutral; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; Protecting Access to Medicare Act (P.L. No. 113-93); Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act, S. 2157; H.R. 4994/S. 2553, IMPACT Act of 2014; frand/abuse, draft; Protecting Integrity in Medicare Act of 2014

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

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

Implementation of the Continuing Care Hospital; medical necessity, H.R. 713/S. 367; Medicare Access to Rehabilitation Services Act of 2013; post-acute care reform, site neutral; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; Protecting Access to Medicare Act (P.L. No. 113-93); Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act, S. 2157; H.R. 4994/S. 2553, IMPACT Act of 2014; frand/abuse, draft; Protecting Integrity in Medicare Act of 2014

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

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

HR 1179/S 569 Improving Access to Medicare Coverage Act of 2013 (Observation stay) HR 713/ S 367 Medicare Access to Rehabilitative Services Act of 2013 (All sections) HR 4994/S 2553 Improving Medicare Post Acute Transformation Act of 2014 (All sections) HR 647/S 313 Achieving a Better Life Experience Act of 2013 (All sections)S. 1871 Title II, Section 202, Medicare Payment for Therapy Services SGR Repeal and Medicare Provider Payment Modernization Act of 2014 HR 5110 SAVE Medicare Home Health Act of 2014 (All sections) HR 3245 Medicare Home Health Fraud Reduction Act (All sections) Other issues related to Post-Acute Care Policy

Client expense: $380,000 · Firm income: Not reported

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

Better Care, Lower Cost Act (Wyden) (S.1932) Medication Adherence Medicare Access to Rehabilitation Services Act (H.R. 713/S.367) Medicare Diabetes Prevention Act (S. 452)Medicare SGR Reform (Senate Finance draft, House Ways & Means draft) Medicare SGR Repeal & Beneficiary Access Improvement Act (S.2110) Medication Therapy Management Act of 2013 (H.R. 1024/S.557) Pathway for SGR Reform Act (temporary extension of Medicare extenders) (H.J. Res.59) Protecting Access to Medicare Act (H.R.4302) Recruiting Individuals to Drive our Elders (RIDE) Act-not yet introduced SGR Repeal and Medicare Beneficiary Access Act (S.1871& H.R.2810)

Client expense: $205,194 · 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), Commerce, Dept of (DOC), Education, Dept of, Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, White House Office

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare ACt of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increasd Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013.S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367 The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness for Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodology for short inpatient hospital stays. H.R.3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S.1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.157 - Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014 Advocacy work on HCBS proposed rule: passed in January S.1932 - A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program HR 1250 - The Medicare Audit Improvement Act of 2013 S.1012 - Medicare Audit Improvement Act of 2013 S.2082 - The two-midnight rule coordinator and Improvement Act of 2014 Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014) Protect and Preserve Medicaid funding for long Term Services and Supports Medicaid Provider Assessment Improving the CMS State Plan Amdt. Process Opposition to H.B. No. 5051 - An Act Improving Transparency of Nursing Home Operations Sustainable Growth Rate (SGR) and other reform proposals Reducing hospital readmissions from skilled nursing facility IMPACT Act Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors MedPAC site neutral payment system for post acute care CME proposed Rule for SNF Prospective Payment System (PPS)

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

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

PL 109-442: Lifespan Respite Care Act; PL 109-365: Older Americans Act Amendments of 2006; PL 111-148: The Patient Protection and Affordable Care Act; PL 111-152: Affordable Health Care for America Act; PHS 42 USC 254C-8: Healthy Start Reauthorization of 2007; PL 111-192: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act; PL 111152, 124 Stat. 1029: Health Care & Education Reconciliation Act; HR 351: Protecting Seniors Access to Medicare;HR 713/S 367: Repeal Outpatient Rehab Caps; HR 928/S 408: Medicare Prescription Drug Savings & Choice Act; HR 132: ObamaCare Repeal Act; S 1028: Older Americans Act Amendments of 2013; S 1034/HR 1960: National Defense Authorization Act 2014; S 948/HR 942: Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013; S 1562: Older Americans Act Reauthorization Act of 2013; HR 2667: Authority for Mandate Delay Act; HR 2668: Fairness for American Families Act: HR 2009: Keep the IRS Off Your Healthcare Act; S 1546: Protecting Student Athletes from Concussions Act of 2013; S 152: Older Americans Act Reauthorization Act of 2013; S 423/HR 564: Family-to-Family Health Information Centers; HR 3850/HR 4122: Older Americans Act Reauthorization Act of 2014; HR 3114: Helping Families & Seniors Save on Health Care Act of 2014; HR 4118: SIMPLE (Suspending the Individual Mandate Penalty Law Equals) Fairness Act of 2014; HR 4302: Protecting Access to Medicare Act of 2014; S 2110: Medicare SGR Repeal & Beneficiary Access Improvement Act of 2014; S 2410/HR 4435: National Defense Authorization Act 2015; and S 2449/HR 4631: Autism CARES (Collaboration, Accountability, Research, Education and Support) Act of 2014.

Client expense: $86,759 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Council on Disability, SENATE, Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), White House Office

P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 3633: Protecting Health Care Providers from Increased Administrative Burdens Act. H.R. 1179: Improving Access to Medicare Coverage Act of 2013.S. 569: Improving Access to Medicare Coverage Act of 2013. S. 367: The Medicare Access to Rehabilitation Services Act. H.R. 3144: Fairness For Beneficiaries Act of 2013. H.R. 713: Medicare Access to Rehabilitation Service Act of 2013. H.R. 3698: A bill to delay the enforcement of the Medicare two-midnight rule for short inpatient stays until the implementation of a new Medicare payment methodalogy for short inpatient hospitals stays. H.R. 3531: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1871: SGR Repeal and Medicare Beneficiary Access Act of 2013. S.2157: Commonsense Medicare SGR and Beneficiary Access Improvement Act of 2014. Advocacy work on HCBS proposed rule: passsed in January. S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. H.R. 1250: The Medicare Audit Improvement Act of 2013. S. 1012: Medicare Audit Improvement Act of 2013. S. 2082: The two-midnight rule coordinator and Improvement Act of 2014. Improving Medicare Post-Acute Care Transformation Act of 2014 (Impact Act of 2014). Protect and Preserve Medicaid funding for Long Term Services and Supports Medicaid Provider Assessement. Improving the CMS State Plan Amdt. Process. Opposition to H.B. No. 5051 An Act Improving Transparency of Nursing Home Operations. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. IMPACT Act. Department of VA (VA) Provider Agreement final rule RIN 2900-AO15 Repealing the Cap on Medicare Part B therapy services for seniors. MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS).

Client expense: $980,000 · Firm income: Not reported

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

Implementation of the Continuing Care Hospital; medical necessity, H.R. 713/S. 367; Medicare Access to Rehabilitation Services Act of 2013; post-acute care reform; H.R. 1250/S. 1012, Medicare Audit Improvement Act of 2013; Protecting Access to Medicare Act (P.L. No. 113-93); Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act, S. 2157; H.R. 4994/S. 2553, IMPACT Act of 2014

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

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

Implementation of the continuing care hospital, H.R. 713/S. 367; Medicare Access to Rehabilitation Services Act of 2013; post-acute care reform; Protecting Access to Medicare Act (P.L. No. 113-93); Common Sense Medicare SGR Repeal and Beneficiary Access Improvement Act (S. 2157); IMPACT Act of 2014

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

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

H.J. RES 59, as related to the amendment, the Pathway for SGR Reform Act of 2013. H.R. 713/S.367, the Medicare Access to Rehabilitation Services Act of 2013 as related to the Medicare Part B cap on outpatient therapy services.Public Law No: 113-93, Protecting Access to Medicare Act of 2014, as related to extending the Medicare Part B cap on outpatient therapy services exceptions process. S.2110, the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014, as related to repealing the Medicare Part B cap on outpatient therapy services. H.R. 2330, the Medicare Audiology Services Enhancement Act of 2013, as related to comprehensive Medicare coverage of audiology services. Various issues related to SGR reform proposals. Various issues related to CMS actions surrounding Medicare physician supervision requirements. Various issues related to CMS actions surrounding the therapy cap and the institution of a manual medical review process for therapy services. Various issues related to CMS actions surrounding Medicare coverage of intraoperative monitoring services. Various issues related to CMS actions surrounding Medicare coverage of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. Various issues related to CMS actions surrounding audits of medical records and claims for Part A and Part B services. Various issues related to the Physician Quality Reporting System for audiology and speech-language pathology participation. Various issues related to the Medicare Physician Fee Schedule (MPFS), as related to fees for audiology and speech-language pathology services. Various issues related to preservation of Medicaid funding. Various issues regarding CMMI demonstration projects/episodic payment models.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), SENATE

H.R.4302, Protecting Access to Medicare Act of 2014, Title I: Medicare Extendes, Section 101 & 102 Items related to the Physician Payment Update and Therapy Cap Exceptions Process and Section 112 Items related to Medicare Long Term Care Hospital Requirements and Title II: Other Health provisions, Section 215, Items related to SNF value-based purchasing. H.R. 1179/S.569: Improving Access to Medicare Coverage Act of 2013 Entire bill - Observation stays.H.R. 713/S.367: Medicare Access to Rehabilitative Services Act of 2013 Entire bill: Repeal of Therapy Cap H.R.574: Medicare Physician Payment Innovation Act of 2013 Entire bill - Doc Fix S.2553/H.R.4994, Improving Medicare Post-Acute Care Transformation Act of 2014, all sections.

Client expense: $320,000 · Firm income: Not reported

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

S. 367/HR 713 - Medicare Access to Rehabilitation Services Act: advocate for removal of cap on occupational therapy services and passage of bills.HR 942 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013: Advocate for inclusion of occupational therapy professionals as providers of Complex Rehabilitation Tecnology. No bill# - Educate about role of occupational therapy in primary care. H.R. 2810 - The Medicare Patient Access and Quality Improvement Act of 2013: Sustainable growth rate - Educate about the role of occupational therapy in health care and need for improving Medicare to assure that patients receive appropriate care, especially occupational therapy services, and that payment is fair and equitable. No bill#--Multiple Procedure Payment Reducation (MPPR): advocate for separation of occupational therapy from physical therapy/speech language pathology in applicaiton of MPPR policy. No bill#--Manual Medical Review (MMR): advocate for improved MMR procedures including electronic submission and 10 day turn-around. S. 1871 - The SGR Repeal and Medicare Beneficiary Access Improement Act of 2013: Advocate for improvements to the bill that address policies that pertain to beneficiary access to occupational therapy services and how occupational therapy services are reimbursed under the Medicare program. S. 1932/HR 3890 - Better Care, Lower Cost Act: Educate about role of occupational therapy in helping people with chronic conditions. Support including occupational therapy in the chronic care innovation centers. No bill #: The Improving Medicare Post-Actue Care Transformation Act of 2014 "IMPACT Act of 2014": Advocated for improvements in the bill that would help ensure Medicare beneficiaries access to quality post-acute care in the right setting is preserved. Advocated to ensure data collection program included elements that reflected the contributions of occupational therapy across the various post acute settings. H.R. 4015/S. 2000 - SGR Repeal and Medicare Provider Payment Modernization Act of 2014 AND S. 2110, Medicare SGR Repeal and Beneficiary Access Imrpovement Act of 2014: Advocated for improvements to the bills that address policies that pertain to beneficiary access to occupational therapy services and how occupational therapy services are reimbursed under the Medicare program. Advocated for repeal of the Medicare Part B outpatient therapy cap on occupational therapy services. HR 3749: The Medicare Demonstration of Coverage for Low Vision Devices Act: Support for greater attention to low vision coverage and highlight the role of occupational thearpy in ensuring the devices are utilized properly and to their full potential.

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE