Doctors Helping Heroes Act of 2015

Hospital Payment Reform/Site Neutral 340B Liver Transplants H.R. 1272 The Doctors Helping Heroes Act of 2015 S.1189 Conrad State 30 and Physician Access Act Medicare Part B Drug Payment Proposed Model

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

President's Budget, FY 2017 H.R. 2029 and draft Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2016 P.L. 114-113, Consolidated Appropriations Act, 2016, Division J, Title IIIssues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. S. 1676, H.R. 3755, H.R. 4011, Delivering Opportunities for Care and Services (DOCs) for Veterans Act of 2015 Issue: Support extension of VA GME increase. Support exemption of certain VA residents from Medicare GME caps. H.R. 3879, Enhanced Veterans Healthcare Act of 2015 Issue: Support joint venture authority for VA and academic affiliates P.L. 114-41, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 Issue: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages

Client expense: $780,000 · Firm income: Not reported

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

S. 1189, Conrad State 30 and Physician Access Act Issue: Support permanently reauthorization and expansion of the Conrad 30 J-1 visa waiver program for physicians. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages

Client expense: $780,000 · Firm income: Not reported

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

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), Hospital Preparedness Program, NIH, Title VII & VIII Presidents Budget, FY 2016 H.R. 3020/S. 1695, Labor, HHS, Education and Related Agencies Act, 2016, Title II P.L. 114-113, H.R. 2029, Consolidated Appropriations Act, 2016, Division H, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs,. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2017 H.R. 2029 and draft Senate Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2016 P.L. 114-113, Consolidated Appropriations Act, 2016, Division J, Title II Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Draft Debt in Health Education Loan Programs (DebtHELP) legislative proposal Issues: Expand National Health Service Corps State Loan Repayment program, and align Department of Education and HRSA student loan programs. H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Funding and reporting requirements for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. H.R. 3288, Strengthening DSH and Medicare through Subsidy Recapture and Payment Reform Act of 2015 Issue: Alter DSH payment methodology and increase DSH spending in non-Medicaid expansion states H.R. 3292, Medicare IME Pool Act of 2015 Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. H.R. 3291, Medicare Crosswalk Hospital Code Development Act of 2015 Issue: Create a crosswalk between Medicare Part A and Part B payments P.L. 114-10, Medicare Access and CHIP Reauthorization Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). Issue: Support the use of animals in medical research. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. P.L. 114-74, H.R. 1314, Bipartisan Budget Act of 2015 Issue: Oppose Medicare site-neutral payment policy. Oppose extension of Medicare sequester S. 2107/H.R. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2016 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015. S. 688, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics, prescription drug abuse, pain management, female genital mutilation, and sepsis. Issue: Implementation of the 340B drug pricing program. Oppose efforts to restrict the program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose extension of Medicare sequester Issue: Oppose Medicare hospital cuts as offsets for physician payment reform. Issue: Preserve funding for the Primary Care Residency Expansion program. P.L. 114-41, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 Issue: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Draft Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 1455, Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Issue: Funding for Ebola Treatment Centers and hospital preparedness Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. H.R. 2513, Promoting Access, Competition, and Equity Act of 2015 Issue: Oppose easing restrictions on physician owned hospitals Issue: Senate Finance Committee Chronic Care Workgroup, support and send comments on efforts to improve care for Medicare patients with chronic conditions. H.R. 3285, Reducing Disparities Using Care Models and Education Act of 2015 Issue: Studying and developing guidelines to reduce health disparities Draft Health Equity and Accountability Act Issue: Addressing health equity through health care workforce programs Issue: Support federal funding for research using human fetal tissue. H.R. 3119, draft Senate legislation, Palliative Care and Hospice Education and Training Act Issue: Health professions education on palliative care Submitted comments to: -HRSA on Proposed Omnibus Guidance on 340B Drug Pricing Program -FDA on International Scheduling of Ketamine -CMS on implementation of the Medicare Access and CHIP Reauthorization Act of 2015 -NIH on its strategic plan to advance research on the health and well-being of sexual and gender minorities -HHS on nondiscrimination in heath programs and activities

S. 1189, Conrad State 30 and Physician Access Act Issue: Support permanently reauthorization and expansion of the Conrad 30 J-1 visa waiver program for physicians. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages

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

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

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ), Hospital Preparedness Program, NIH, Title VII & VIII Presidents Budget, FY 2016 H.R. 3020/S. 1695, Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs,. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support Obama Administrations position on King v Burwell Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Draft Debt in Health Education Loan Programs (DebtHELP) legislative proposal Issues: Expand National Health Service Corps State Loan Repayment program, and align Department of Education and HRSA student loan programs. H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Funding and reporting requirements for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. H.R. 3288, Strengthening DSH and Medicare through Subsidy Recapture and Payment Reform Act of 2015 Issue: Alter DSH payment methodology and increase DSH spending in non-Medicaid expansion states H.R. 3292, Medicare IME Pool Act of 2015 Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. H.R. 3291, Medicare Crosswalk Hospital Code Development Act of 2015 Issue: Create a crosswalk between Medicare Part A and Part B payments P.L. 114-10, Medicare Access and CHIP Reauthorization Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). Issue: Support the use of animals in medical research. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. S. 2107/H.R. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2016 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015. S. 688, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics, prescription drug abuse, pain management, female genital mutilation, and sepsis. Issue: Implementation of the 340B drug pricing program. Oppose efforts to restrict the program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform. Issue: Preserve funding for the Primary Care Residency Expansion program. P.L. 114-41, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 Issue: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Draft Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 1455, Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Issue: Funding for Ebola Treatment Centers and hospital preparedness Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. H.R. 2513, Promoting Access, Competition, and Equity Act of 2015 Issue: Oppose easing restrictions on physician owned hospitals Issue: Senate Finance Committee Chronic Care Workgroup, support and send comments on efforts to improve care for Medicare patients with chronic conditions. H.R. 3285, Reducing Disparities Using Care Models and Education Act of 2015 Issue: Studying and developing guidelines to reduce health disparities Draft Health Equity and Accountability Act Issue: Addressing health equity through health care workforce programs Issue: Support federal funding for research using human fetal tissue. Submitted comments to: Department of Veterans Affairs on VA health care contracting and potential risks to VA-academic affiliations Centers for Medicare & Medicaid Services (CMS) on CY 2016 Physician Fee Schedule proposed rule CMS on the on the Comprehensive Care for Joint Replacement (CCJR) proposed rule CMS on CY 2016 Outpatient Prospective Payment System (OPPS) proposed rule CMS on the methodology of overall Hospital Quality Star Ratings technical expert panel report CMS on the Medicaid and CHIP Managed Care proposed rule

President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issue: Support funding for Veterans Affairs medical research, research infrastructure, and health care. S. 1676, Delivering Opportunities for Care and Services (DOCs) for Veterans Act of 2015 Issue: Support extension of VA GME increase. Support exemption of certain VA residents from Medicare GME caps. P.L. 114-41, Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 Issue: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages Submitted comments to: Department of Veterans Affairs on VA health care contracting and potential risks to VA-academic affiliations

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

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

S. 1189 Conrad State 30 and Physician Access Act HR 1272 Doctors Helping Heroes Act of 2015

Client expense: $64,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issue: Support funding for Veterans Affairs medical research, research infrastructure, and health care. P.L. 113-564, Veterans Access, Choice, and Accountability Act of 2014 Issue: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages Draft legislation to increase Medicare GME at hospitals with VA GME affiliations Issue: Support Medicare GME cap relief for hospitals with residents rotating through the VA

Client expense: $920,000 · Firm income: Not reported

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

S. 1189, Conrad State 30 and Physician Access Act Issue: Support permanently reauthorization and expansion of the Conrad 30 J-1 visa waiver program for physicians. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages

Client expense: $920,000 · Firm income: Not reported

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

Presidents Budget, FY 2017 Issue: Funding for Agency for Healthcare Research and Quality (AHRQ) Presidents Budget, FY 2016 S. 1695 and draft House Labor, HHS, Education and Related Agencies Act, 2016, Title II Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, and CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. Oppose House proposal to eliminate AHRQ. Oppose rescissions from CMMI and PCORI. President's Budget, FY 2016 H.R. 4486 and draft Senate House Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2015 Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support Obama Administrations position on King v Burwell Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Draft Debt in Health Education Loan Programs (DebtHELP) legislative proposal Issues: Expand National Health Service Corps State Loan Repayment program, and align Department of Education and HRSA student loan programs. H.R. 2124/S. 1148, Resident Physician Shortage Reduction Act of 2015 Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Funding and reporting requirements for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015. H.R. 810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). Issue: Support the use of animals in medical research. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. H.R. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015. S. 688, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics. Issue: Implementation of the 340B drug pricing program. Oppose efforts to restrict the program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform. Issue: Preserve funding for the Primary Care Residency Expansion program. P.L. 113-564, Veterans Access, Choice, and Accountability Act of 2014 Issues: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages S. 289/H.R. 2104, American Cures Act Issue: Increases budget authority for National Institutes of Health NIH), Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health (NIH), adjusted annually for inflation. H.R. 6, 21st Century Cures Act Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. H.R. 2102, Research for All Act of 2015 Issue: Support inclusion of male and female cells and animals in basic research, and NIH updating its guidelines on inclusion of women in clinical research. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Draft Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments S. 1455, Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Draft Hospital Improvements for Payment (HIP) Act of 2014 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Issue: Funding for Ebola Treatment Centers and hospital preparedness Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. H.R. 2513, Promoting Access, Competition, and Equity Act of 2015 Issue: Oppose easing restrictions on physician owned hospitals Issue: Senate Finance Committee Chronic Care Workgroup, support and send comments on efforts to improve care for Medicare patients with chronic conditions. Submitted comments to: CMS on the FY 2016 Inpatient Prospective Payment System (IPPS) proposed rule CMS on the modifications on meaningful use 2015-2017 proposed rule HHS on the CMS short-stay inpatient admission policy, the Two Midnights rule The Office of the National Coordinator for Health Information Technology (ONC) on the 2015 Edition Health Information Technology Certification Criteria proposed rule CMS on the Meaningful Use Stage 3 proposed rule FDA on public health concerns of demographic subgroups The White House on AAMCs commitment to the effective use and management of antibiotic treatment

Presidents Budget, FY 2016 Issues: Support funding for National Institutes of Health (NIH), Title VII and Title VIII health professions and nursing education programs, Agency for Healthcare Research and Quality (AHRQ), National Health Service Corps (NHSC), Childrens Hospitals Graduate Medical Education (CHGME), Health Resources and Services Administration (HRSA), the Prevention and Public Health Fund (PPHF), biodefense and public health preparedness programs, CDC's National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program, funding for Ebola Treatment Centers and hospital preparedness, and trauma and emergency care programs. Maintain NIH salary cap at Executive Level II. Encourage the highest possible allocation for the Labor-HHS Subcommittee. President's Budget, FY 2016 Draft House Military Construction and Veterans Affairs and Related Agencies Appropriations bill Issues: Support funding for Veterans Affairs medical research, research infrastructure, and health care. Issue: Support mandatory funding for Community Health Centers and the National Health Service Corps (NHSC) authorized under P.L. 111-148, the Patient Protection and Affordable Care Act, Title V and Section 10503. Draft Debt in Health Education Loan Programs (DebtHELP) legislative proposal Issues: Expand National Health Service Corps State Loan Repayment program, and align Department of Education and HRSA student loan programs. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments and increase Graduate Medical Education (GME) accountability and transparency. Issue: Support funding and reporting requirements for Teaching Health Center Graduate Medical Education program under section 340G of the Public Health Service Act. H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015. H.R. 810/S. 1871, SGR Repeal and Medicare Beneficiary Access Improvement Act of 2015. Issues: Support repeal of Medicare's sustainable growth rate (SGR) formula; Medicare physician payment reform; extension of the Childrens Health Insurance Program (CHIP); and extension of mandatory funding for the National Health Service Corps (NHSC). Issue: Support the use of animals in medical research. Issue: Promote interprofessional education and training of the health care workforce. Issue: Support funding for the National Healthcare Workforce Commission. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. S. 1006, Building A Health Care Workforce for the Future Act Issue: Support bill to increase scholarship opportunities for medical students and encourage primary care workforce development. Issue: Oppose inclusion of Medicare add-on payments in Hospital-Acquired Condition (HAC) program. Issue: Support delay of enforcement of new CMS inpatient criteria (e.g., "Two-Midnight" rule) in FY 2014 Inpatient Prospective Payment System (IPPS) final rule. Issue: Support Medicare GME per Resident Amount and cap trigger technical corrections and administrative relief. H.R. 1343, Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015. S. 688, Hospital Readmission Accuracy and Accountability Act. Issue: Support inclusion of socioeconomic status as part of hospital readmissions program, including support for adoption of National Quality Forum (NQF) recommendations. President's Budget, FY 2016 Issues: Oppose proposed reductions in Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments; oppose use of Medicare GME funding for creation of new GME grant program; oppose elimination of Children's Hospitals GME program. Issue: Legislation on educating health professionals regarding appropriate use of antibiotics. Issue: Support report language and efforts of HHS agencies to support efforts of urban-based institutions to improve health equity. Support use of holistic review in admissions. Issue: Implementation of the 340B drug pricing program. Issue: Oppose Medicare payment reductions as offsets for non-Medicare spending. Issue: Oppose Medicare hospital cuts as offsets for physician payment reform. Issue: Preserve funding for the Primary Care Residency Expansion program. P.L. 113-564, Veterans Access, Choice, and Accountability Act of 2014 Issues: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages S. 289, American Cures Act Issue: Increases budget authority for National Institutes of Health, Center for Disease Control and Prevention, Department of Defense Health Program, and the VA Medical and Prosthetics Research Program S. 320/H.R. 744, Medical Innovation Act Issue: Requires covered manufacturers of blockbuster drugs developed, in whole or in part, through federal investments in medical research that enter settlement agreements with a federal agency to pay 1 percent of net income over five years to increase congressional investments in biomedical research. S. 318/H.R. 531, Accelerating Biomedical Research Act Issue: Increases discretionary spending cap to increase funding for the National Institutes of Health (NIH). H.R. 777, Permanent Investment in Health Research Act Issue: Creates mandatory appropriation for the National Institutes of Health, adjusted annually for inflation. 21st Century Cures Initiative discussion draft Senate HELP Committee Innovation Initiative Issue: Support increased funding for medical research, reduce administrative and regulatory burden on scientists and research institutions, and support young investigators. Issue: FDA regulation of Laboratory Developed Tests (LDTs) Issue: Provide comments to House Energy and Commerce Committee on GME financing Draft Community Based Medical Education Act of 2014 Issue: Oppose reduction of Medicare GME/IME payments Draft Recovery Enhancement for Addiction Treatment (TREAT) Act Issue: Support legislation to increase access to care for patients addicted to opioids Draft Hospital Improvements for Payment (HIP) Act of 2015 Issues: Support repeal of CMS Two-Midnights Rule, extending RAC audit moratorium for short stays, and permanent bundle program. Issue: Oppose further delays in the implementation of the ICD-10 system H.R. 1411, Expanding Nutrition's Role in Curricula and Healthcare Act (ENRICH Act) Issue: Support grants for medical schools to develop or expand nutrition and physical activity curricula. Issue: Educate congressional staff on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages Submitted comments to: FDA on Laboratory Developed Tests (LDTs) White House Ebola Response Coordinator offering to work with federal and state officials to prepare and respond to Ebola cases. CMS on measure selection for Hospital Compare Star Ratings Technical Expert Panel Report CMS on Notice of Proposed Rulemaking for Medicare Share Savings Program/Accountable Care Organizations CMS on the Medicare Advantage and Medicare Part D 2016 Advance Notice and Draft Call Letter CMS on policy priorities for FY 2016 Hospital Inpatient Prospective Payment System (IPPS) NIH and HHS on clinical trials registrations and results submission to ClinicalTrials.gov National Quality Forum (NQF) on the Measure Applications Partnership (MAP) pre-rulemaking draft report HHS Office for Human Research Protections (OHRP) on draft guidance regarding standard of care research NIH on the use of a single Institutional Review Board (IRB) for multi-site research NIH Advisory Committee to the Director (ACD) on the strategic vision for the National Library of Medicine

Issues: Permanently reauthorize and expand the J-1 visa waiver program for physicians. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages Submitted comments to: U.S. Citizenship and Immigration Services (USCIS) on the impact of Medicare GME cap on physician immigration and U.S. workforce shortages

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

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

President's Budget, FY 2016 Draft House Military Construction and Veterans Affairs and Related Agencies Appropriations bill Issue: Support funding for Veterans Affairs medical research, research infrastructure, and health care. P.L. 113-564, Veterans Access, Choice, and Accountability Act of 2014 Issue: Support improved contracting with academic affiliates and increased VA GME funding. H.R.1272, Doctors Helping Heroes Act of 2015 Issue: Support expansion of the Conrad 30 J-1 visa waiver program and physician immigration to address VA workforce shortages Issue: Explaining the relationship between VA GME and Medicare GME

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

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