Protecting Our Infants Act of 2015

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Letter to Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Statement for the record to Senate Finance Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365/ S. 2932, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care;Supported House and Senate letters to CMS asking for flexibility when interpreting section 603 of the BBA of 2015 in regulation; Support HR 5547, the Health Care Price Transparency Promotion Act of 2016, a bill to require the sharing of health care price information; Support HR 5273, the Helping Hospitals Improve Patient Care Act of 2016, a bill to address outstanding issues with section 603 of the BBA of 2015 and provide for a socioeconomic adjustment to the Hospital Readmissions Reduction Program; Supported a letter to CMS on implementation of Sec. 603 of the Bipartisan Budget Acts site neutral cuts for off-campus HOPDs; Support H. res. 699 promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2016; Support H.R.4641 - a bill to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication; Support H.R. 4982, the Examining Opioid Treatment Infrastructure Act of 2016, a bill which would require the Government Accountability Office (GAO) to evaluate and report on the capacity, availability and need for inpatient and outpatient treatment for opioid use disorders in the United States; Supports H.R. 3680, the Co-Prescribing to Reduce Overdoses Act of 2015, a bill would establish federal grants to carry out co-prescribing of overdose reversal drugs in areas experiencing significant numbers of opioid overdoses and deaths; Support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015, a bill that would reauthorize essential residential treatment programs for pregnant and postpartum women and provide grants to states to address the growing epidemic of infants suffering from opioid dependency; Support H.R. 4978, the Nurturing and Supporting Healthy Babies Act, a bill which would require a GAO evaluation of neonatal abstinence syndrome and the availability of treatment for this condition in the nations Medicaid programs; Support H.R. 4599, the Reducing Unused Medications Act of 2016, a bill to permit partial filling of schedule II prescriptions under specific circumstances; Support H.R. 4976, the Opioid Review Modernization Act of 2016, a bill which would provide for more stringent Food and Drug Administration review of new opioids without abuse-deterrent properties, recommendations for labeling of pediatric opioids, and recommendations for prescriber education; Support the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2016, a bill for achieving fair and sustainable drug pricing; Supporting full alignment of 42CFR substance use records confidentiality requirements with HIPAA privacy rule; Support S. 3173 EHR Regulatory Relief Act, a bill to amend title XVIII of the Social Security Act to provide for a 90-day EHR reporting period for the determination of whether an eligible professional or eligible hospital is a meaningful EHR user and to remove the all-or-nothing approach to meaningful use; Support for H.R. 5713, The Sustaining Healthcare Integrity and Fair Treatment Act of 2016, a bill that would extend 25% rule relief and provide targeted relief to certain LTCHs struggling to meet the new criteria standards; Support for H.R. 6174, the Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title.

Client expense: $4,970,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Health Insurance Coverage, Genetic Testing (general); Health Disparities (general); Emergency Contraception (general); Health Care Reform Implementation; Breastfeeding (general); Substance Use Disorder (general); HIV Screening (general); Gynecologic Cancer (general); Gynecologic devices (general); Breast Cancer (general); (general); E-Cigarettes (general); Medical Liability Reform (general); Health IT (general); Prematurity (general); Disparities (general); Prevention and Public Health Fund (general); Maternal Mortality and Morbidity (general); Imaging (general); Graduate Medical Education (general); Quality Improvement Measurement (general); Contraception (general); Postpartum Depression (general); CMS Provider Penalties (general); Preeclampsia (general); National Health Service Corps (general); Abortion (general); Indian Health (general); Teaching Health Centers (general); Research in Pregnant and Breastfeeding Women (general); Healthy Start (general); Zika Virus (general); Health Care Reform (general); H.R.4695/S. 466, Quality Care for Moms and Babies Act; H.R. 3865/S.2542, Cradle Act; H.R. 865/S. 3101, Good Samaritan Health Professionals Act; H.R. 4774, Training Tomorrows Doctors Today Act; H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016; H.R. 1209/S.628 Improving Access to Maternity Care Act; Implementation of H.R. 1462/S. 799, Protecting our Infants Act; H.R. 3691/S. 2226, Improving Treatment for Pregnant and Postpartum Women Act; H.R. 3706/S.1911, Reach Every Mother and Child Act of 2016; S. 304, Conscience Protection Act; H.R. 3504, Born-Alive Abortion Survivors Protection Act; Hyde Amendment (General); Senate Biomedical Innovations Packages (general); S. 2745, Advancing NIH Strategic Planning and Representation in Medical Research Act; S.2742, Promoting Biomedical Research and Public Health for Patients Act; H.R. 6, 21st Century Cures Act; H.R. 3656/S. 2100, Tobacco to 21 Act; H.R. 3652/S. 674, 21st Century Womens Health Act; S. 1532, Affordability is Access Act; H.R. 5746, Birth Control Privacy Act; H.R. 2058, FDA Deeming Authority Clarification Act of 2015; H.R. 3235/S. 2311, Bringing Postpartum Depression Out of the Shadows Act; H.R. 5369, Healthy Start Reauthorization Act; H.R. 5219 Safe Medications for Moms and Babies Act of 2016; Implementation of H.R. 953/S. 524, Comprehensive Addiction and Recovery Act; H.R. 2646, Helping Families in Mental Health Crisis Act; S. 2680, Mental Health Reform Act; H.R. 2654/S. 1512, Pregnant Workers Fairness Act; H.R. 1706/S.2765, Real Education for Healthy Youth Act; H.R. 5065/ S. 3299 Bottles and Breastfeeding Equipment Screening Act;

Client expense: $487,965 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

maternity care, research & pregnancy, maternal mental health, S. 2311 Bringing Postpartum Depression Out of the Shadows Act, 21st Century Cures, Innovations for Healthier Americans, Quality Care for Moms and Babies Act, HR 3441 Accurate Education for Prenatal Screenings Act, HR 1209/S 628 Improving Access to Maternity Care Act, S 799/HR 1462 Protecting Our Infants Act, S 2745 Advancing NIH Strategic Planning and Representation in Medical Research Act, HR 5219 Safe Medications for Moms and Babies Act

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Letter to Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Statement for the record to Senate Finance Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365/ S. 2932, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care;Supported House and Senate letters to CMS asking for flexibility when interpreting section 603 of the BBA of 2015 in regulation; Support HR 5547, the Health Care Price Transparency Promotion Act of 2016, a bill to require the sharing of health care price information; Support HR 5273, the Helping Hospitals Improve Patient Care Act of 2016, a bill to address outstanding issues with section 603 of the BBA of 2015 and provide for a socioeconomic adjustment to the Hospital Readmissions Reduction Program; Supported a letter to CMS on implementation of Sec. 603 of the Bipartisan Budget Acts site neutral cuts for off-campus HOPDs; Support H. res. 699 promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2016; Support H.R.4641 - a bill to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication; Support H.R. 4982, the Examining Opioid Treatment Infrastructure Act of 2016, a bill which would require the Government Accountability Office (GAO) to evaluate and report on the capacity, availability and need for inpatient and outpatient treatment for opioid use disorders in the United States; Supports H.R. 3680, the Co-Prescribing to Reduce Overdoses Act of 2015, a bill would establish federal grants to carry out co-prescribing of overdose reversal drugs in areas experiencing significant numbers of opioid overdoses and deaths; Support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015, a bill that would reauthorize essential residential treatment programs for pregnant and postpartum women and provide grants to states to address the growing epidemic of infants suffering from opioid dependency; Support H.R. 4978, the Nurturing and Supporting Healthy Babies Act, a bill which would require a GAO evaluation of neonatal abstinence syndrome and the availability of treatment for this condition in the nations Medicaid programs; Support H.R. 4599, the Reducing Unused Medications Act of 2016, a bill to permit partial filling of schedule II prescriptions under specific circumstances; Support H.R. 4976, the Opioid Review Modernization Act of 2016, a bill which would provide for more stringent Food and Drug Administration review of new opioids without abuse-deterrent properties, recommendations for labeling of pediatric opioids, and recommendations for prescriber education; Support the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2016, a bill for achieving fair and sustainable drug pricing; Supporting full alignment of 42CFR substance use records confidentiality requirements with HIPAA privacy rule; Support S. 3173 EHR Regulatory Relief Act, a bill to amend title XVIII of the Social Security Act to provide for a 90-day EHR reporting period for the determination of whether an eligible professional or eligible hospital is a meaningful EHR user and to remove the all-or-nothing approach to meaningful use; Support for H.R. 5713, The Sustaining Healthcare Integrity and Fair Treatment Act of 2016, a bill that would extend 25% rule relief and provide targeted relief to certain LTCHs struggling to meet the new criteria standards; Support for H.R. 6174, the Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title.

Client expense: $4,050,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition of essential health benefits and provider network adequacy Health information technology and electronic health records Telehealth provisions of draft medical innovation legislation Mental health services and violence prevention Lead contamination of drinking water H.R. 6 - 21st Century Cures Act H.R. 30 - Save American Workers Act H.R. 248/S. 305 - American Job Protection Act H.R. 512 - Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act H.R. 596 - To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 609/S. 287 - Safe Food Act H.R. 879 - Ax the Tax on Middle Class Americans' Health Plans Act H.R. 897 - Zika Vector Control Act H.R. 931 - Helping Effective Antibiotics Last (HEAL) Act H.R. 932/S. 497 - Healthy Families Act H.R. 933/S. 486 - Head Start on Vaccinations Act H.R 1189/S. 620 - Preserving Employee Wellness Programs Act H.R. 1209/S. 628 - Improving Access to Maternity Care Act H.R. 1372 - Home Visiting Extension Act H.R. 1462/S. 799 - Protecting Our Infants Act H.R 1517 - Stop Selling and Marketing to Our Kids E-Cigarettes (SMOKE) Act H.R. 1552 - Preservation of Antibiotics for Medical Treatment Act H.R. 1599 - Safe and Accurate Food Labeling Act H.R 1624 - Protecting Affordable Coverage for Employees (PACE) Act H.R. 2017/S. 2217 - Common Sense Nutrition Disclosure Act H.R. 2300/S. 2519 - Empowering Patients First Act of 2015 H.R. 2646 - Helping Families in Mental Health Crisis Act H.R. 2653 - American Health Care Reform Act H.R. 2690 - Including Families in Mental Health Recovery Act H.R. 2713 - Title VIII Nursing Workforce Reauthorization Act H.R. 2948 - Medicare Telehealth Parity Act H.R. 3081/S. 1778 - Telemedicine for Medicare (TELE-MED) Act H.R. 3299 - Strengthening Public Health Emergency Response Act of 2015 H.R. 3379 - Airplane Kits Act H.R. 3463 - Aligning Childrens Dental Coverage Act H.R. 3495 - Women's Public Health and Safety Act H.R. 3660 - Preventive Health Savings Act H.R. 3659 - Exchange Inclusion for a Healthy America Act H.R. 3762 - Restoring Americans Healthcare Freedom Reconciliation Act H.R. 3865/S. 2542 - Cradle Act H.R. 4276 - Behavioral Health Coverage Transparency Act H.R. 4400/S. 2512 - Adding Zika Virus to the FDA Priority Review Voucher Program Act H.R. 4479 - Families of Flint Act H.R. 4723 - Protecting Taxpayers by Recovering Improper Obamacare Subsidy Overpayments Act H.R. 4724 - Reducing Duplicative and Ineffective Federal Funding Act H.R. 4771 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R. 5001/S. 2822 - Flexibility in Health IT Reporting (Flex-IT) Act H.R. 5003 - Improving Child Nutrition and Education Act of 2016 H.R. 5284 - Worlds Greatest Healthcare Plan Act of 2016 H.R. 5456/S. 3065 - Family First Prevention Services Act S. 30 - Forty Hours Is Full Time Act S. 142/H.R. 1375/H.R. 3242 - Child Nicotine Poisoning Prevention Act S. 185 - Promise for Antibiotics and Therapeutics for Health (PATH) Act S. 203 - American Liberty Restoration Act S. 339 - ObamaCare Repeal Act S. 481 - Improving Regulatory Transparency for New Medical Therapies Act S. 522 - Protecting & Retaining Our Children's Health Insurance Program (PRO-CHIP) Act S. 621 - Prevention of Antibiotic Resistance Act S. 673 - Winding Down Obamacare Act S. 674 - 21st Century Womens Health Act S. 764 - National Bioengineered Food Disclosure Standard S. 971 - Medicare Independence at Home Medical Practice Demonstration Improvement Act S. 993/H.R. 1854 - Comprehensive Justice and Mental Health Act S. 1014 - Personal Care Products Safety Act S. 1016 - Preserving Freedom and Choice in Health Care Act S. 1456 - Rural ACO Improvement Act S. 1549 - Care Planning Act S. 1793 - Promoting Physical Activity for Americans Act S. 1893 - Mental Health Awareness and Improvement Act S. 1945 - Mental Health Reform Act S. 2002/H.R. 3722 - Mental Health and Safe Communities Act S. 2045/H.R. 2050 - Middle Class Health Benefits Tax Repeal Act S. 2075 - American Worker Health Care Tax Relief Act S. 2100 - Tobacco to 21 Act S. 2153 - Provider Payment Sunshine Act S. 2173/H.R. 3712 - Improving Access to Mental Health Act S. 2218/H.R. 1218 - Personal Health Investment (PHIT) Act S. 2259 - ACO Assignment Improvement Act S. 2261 - Rural ACO Provider Equity Act S. 2343/H.R. 4155 - Telehealth Innovation and Improvement Act S. 2380 - Public Health Emergency Response and Accountability Act S. 2408/H.R. 4266 - Nurse and Health Care Worker Protection Act S. 2484 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act S. 2525/H.R. 4567 - Expand Excellence in Mental Health Act of 2016 S. 2609 - An original bill to amend the Agricultural Marketing Act of 1946 to require the Secretary of Agriculture to establish a national voluntary labeling standard for bioengineered foods S. 2680 - Mental Health Reform Act of 2016 S. 2687 - Plan of Safe Care Improvement Act S. 2821 - Testing, Removal, and Updated Evaluations of Lead Everywhere in America for Dramatic Enhancements that Restore Safety to Homes, Infrastructure, and Pipes (True LEADership) Act of 2016 S. 2848/H.R. 5303 - Water Resources Development Act of 2016 S. 3190 - Strengthening Our Rural Health Workforce Act of 2016 S. 3239 - Research to Accelerate Cures and Equity (RACE) for Children Act S. 3245 - Nursing Workforce Reauthorization Act of 2016

Client expense: Not reported · Firm income: $23,450

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

Health Insurance Coverage, Genetic Testing (general); Health Disparities (general); Emergency Contraception (general); Health Care Reform Implementation; Substance Use Disorder (general); HIV Screening (general); Gynecologic Cancer (general); Gynecologic devices (general); Breast Cancer (general); Breastfeeding (general); Medical Liability Reform (general); Health IT (general); Prematurity (general); Disparities (general); Prevention and Public Health Fund (general); Maternal Mortality and Morbidity (general); Imaging (general); Graduate Medical Education (general); Quality Improvement Measurement (general); Contraception (general); Postpartum Depression (general); CMS Provider Penalties (general); Preeclampsia (general); National Health Service Corps (general); Abortion (general); Indian Health (general); Teaching Health Centers (general); Research in Pregnant and Breastfeeding Women (general); Healthy Start (general); H.R.4695/S. 466, Quality Care for Moms and Babies Act; H.R. 3865/S.2542, Cradle Act;; H.R. 865/S. 3101, Good Samaritan Health Professionals Act; H.R. 4774, Training Tomorrows Doctors Today Act; H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016; H.R. 1209/S.628 Improving Access to Maternity Care Act; Implementation of H.R. 1462/S. 799, Protecting our Infants Act; H.R. 3691/S. 2226, Improving Treatment for Pregnant and Postpartum Women Act; H.R. 448/S.217, Women's Health Protection Act of 2015; H.R. 2972, Equal Access to Abortion Coverage in Health Insurance (EACH Woman) Act; H.Res. 461, Establishing a Select Investigative Panel of the Committee on Energy and Commerce; Fetal Tissue Research (General); H.R. 3706/S.1911, Reach Every Mother and Child Act of 2016; H.Res. 558/S.Res. 327, Condemning Violence That Targets Healthcare for Women; S. 304, Conscience Protection Act; H.R. 3504, Born-Alive Abortion Survivors Protection Act; Hyde Amendment (General); Senate Biomedical Innovations Packages (general); S. 2745, Advancing NIH Strategic Planning and Representation in Medical Research Act; S.2742, Promoting Biomedical Research and Public Health for Patients Act; H.R. 6, 21st Century Cures Act; H.R. 3656/S. 2100, Tobacco to 21 Act; H.R. 3652/S. 674, 21st Century Womens Health Act; S. 1532, Affordability is Access Act; H.R. 5746, Birth Control Privacy Act; H.R. 2058, FDA Deeming Authority Clarification Act of 2015; H.R. 3441, Accurate Education for Prenatal Screenings Act; H.R. 3235/S. 2311, Bringing Postpartum Depression Out of the Shadows Act; Shackling During Pregnancy (general); and H.R. 3539, Reinvigorating Antibiotic and Diagnostic Innovation Act; H.R. 5369, Healthy Start Reauthorization Act; S. 3070, Hygiene Assistance for Families of Infants and Toddlers Act of 2016; H.R. 5219 Safe Medications for Moms and Babies Act of 2016; H.R. 953/S. 524, Comprehensive Addiction and Recovery Act; H.R. 2646, Helping Families in Mental Health Crisis Act; S. 2680, Mental Health Reform Act; H.R. 3537, Synthetic Drug Control Act; H.R. 4499/S. 2758, Promoting Responsible Opioid Prescribing (PROP) Act; H.R. 4874, Prevent Abuse by Using Interstate Exchange Act; H.R. 2805/S. 1134, Heroin and Prescription Opioid Abuse, Prevention, Education, and Enforcement Act; H.R. 2654/S. 1512, Pregnant Workers Fairness Act; H.R. 1706/S.2765, Real Education for Healthy Youth Act; H.R. 5065/ S. 3299 Bottles and Breastfeeding Equipment Screening Act; H.R. 6010, Zika Pregnancy and Infant Registry Act.

Client expense: $436,321 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, U.S. Agency for International Development (USAID), White House Office

Renewable Fuel Standard Issues: -Renewable Fuel Standard Repeal: H.R. 1461 -Renewable Fuel Standard Reform: H.R. 1462 Renewable Fuel Standard Issues (continued): -Renewable Fuel Standard Repeal: H.R. 1195 -Renewable Fuel Standard Reform: H.R.1469 -Renewable Fuel Standard Reform: S.1807 -Advanced Biofuel Mandard: Foreign Fuels Reducation Act (S.977) -RFS2 rule -E15 blend wall issues

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

maternity care, FDA, research & pregnancy; health reform; Affordable Care Act, pre-term, S.2311 Bringing Postpartum Depression Out of the Shadows Act, 21st Century Cures Innovations for Healthier Americans, Quality Care for Moms and Babies Act; HR 3441 Accurate for Prenatal Screenings Act; HR 1209/S 628 Improving Access to Maternity Care Act; S 799/HR 1462 Protecting Our Infants Act; S.2745, Advancing NIH Strategic Planning and Representation in Medical Research Act; HR 5219 Safe Medications for Moms and Babies Act.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition of essential health benefits and provider network adequacy Health information technology and electronic health records Telehealth provisions of draft medical innovation legislation Mental health services and violence prevention H.R. 6 - 21st Century Cures Act H.R. 30 - Save American Workers Act H.R. 248/S. 305 - American Job Protection Act H.R. 512 - Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act H.R. 596 - To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 609/S. 287 - Safe Food Act H.R. 879 - Ax the Tax on Middle Class Americans' Health Plans Act H.R. 897 - Zika Vector Control Act H.R. 931 - Helping Effective Antibiotics Last (HEAL) Act H.R. 932/S. 497 - Healthy Families Act H.R. 933/S. 486 - Head Start on Vaccinations Act H.R 1189/S. 620 - Preserving Employee Wellness Programs Act H.R. 1209/S. 628 - Improving Access to Maternity Care Act H.R. 1372 - Home Visiting Extension Act H.R. 1462/S. 799 - Protecting Our Infants Act H.R 1517 - Stop Selling and Marketing to Our Kids E-Cigarettes (SMOKE) Act H.R. 1552 - Preservation of Antibiotics for Medical Treatment Act H.R. 1599 - Safe and Accurate Food Labeling Act H.R 1624 - Protecting Affordable Coverage for Employees (PACE) Act H.R. 2017/S. 2217 - Common Sense Nutrition Disclosure Act H.R. 2300/S. 2519 - Empowering Patients First Act of 2015 H.R. 2646 - Helping Families in Mental Health Crisis Act H.R. 2653 - American Health Care Reform Act H.R. 2690 - Including Families in Mental Health Recovery Act H.R. 2713 - Title VIII Nursing Workforce Reauthorization Act H.R. 2948 - Medicare Telehealth Parity Act H.R. 3081/S. 1778 - Telemedicine for Medicare (TELE-MED) Act H.R. 3299 - Strengthening Public Health Emergency Response Act of 2015 H.R. 3379 - Airplane Kits Act H.R. 3463 - Aligning Childrens Dental Coverage Act H.R. 3495 - Women's Public Health and Safety Act H.R. 3660 - Preventive Health Savings Act H.R. 3659 - Exchange Inclusion for a Healthy America Act H.R. 3762 - Restoring Americans Healthcare Freedom Reconciliation Act H.R. 3865/S. 2542 - Cradle Act H.R. 4276 - Behavioral Health Coverage Transparency Act H.R. 4400/S. 2512 - Adding Zika Virus to the FDA Priority Review Voucher Program Act H.R. 4723 - Protecting Taxpayers by Recovering Improper Obamacare Subsidy Overpayments Act H.R. 4724 - Reducing Duplicative and Ineffective Federal Funding Act H.R. 4771 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R. 5001/S. 2822 - Flexibility in Health IT Reporting (Flex-IT) Act H.R. 5003 - Improving Child Nutrition and Education Act of 2016 H.R. 5284 - Worlds Greatest Healthcare Plan Act of 2016 H.R. 5456/S. 3065 - Family First Prevention Services Act S. 30 - Forty Hours Is Full Time Act S. 142/H.R. 1375/H.R. 3242 - Child Nicotine Poisoning Prevention Act S. 185 - Promise for Antibiotics and Therapeutics for Health (PATH) Act S. 203 - American Liberty Restoration Act S. 339 - ObamaCare Repeal Act S. 481 - Improving Regulatory Transparency for New Medical Therapies Act S. 522 - Protecting & Retaining Our Children's Health Insurance Program (PRO-CHIP) Act S. 621 - Prevention of Antibiotic Resistance Act S. 673 - Winding Down Obamacare Act S. 674 - 21st Century Womens Health Act S. 971 - Medicare Independence at Home Medical Practice Demonstration Improvement Act S. 993/H.R. 1854 - Comprehensive Justice and Mental Health Act S. 1014 - Personal Care Products Safety Act S. 1016 - Preserving Freedom and Choice in Health Care Act S. 1456 - Rural ACO Improvement Act S. 1549 - Care Planning Act S. 1793 - Promoting Physical Activity for Americans Act S. 1893 - Mental Health Awareness and Improvement Act S. 1945 - Mental Health Reform Act S. 2002/H.R. 3722 - Mental Health and Safe Communities Act S. 2045/H.R. 2050 - Middle Class Health Benefits Tax Repeal Act S. 2075 - American Worker Health Care Tax Relief Act S. 2100 - Tobacco to 21 Act S. 2153 - Provider Payment Sunshine Act S. 2173/H.R. 3712 - Improving Access to Mental Health Act S. 2218/H.R. 1218 - Personal Health Investment (PHIT) Act S. 2259 - ACO Assignment Improvement Act S. 2261 - Rural ACO Provider Equity Act S. 2343/H.R. 4155 - Telehealth Innovation and Improvement Act S. 2408/H.R. 4266 - Nurse and Health Care Worker Protection Act S. 2484 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act S. 2525/H.R. 4567 - Expand Excellence in Mental Health Act of 2016 S. 2609 - An original bill to amend the Agricultural Marketing Act of 1946 to require the Secretary of Agriculture to establish a national voluntary labeling standard for bioengineered foods S. 2680 - Mental Health Reform Act of 2016 S. 2687 - Plan of Safe Care Improvement Act S. 2821 - Testing, Removal, and Updated Evaluations of Lead Everywhere in America for Dramatic Enhancements that Restore Safety to Homes, Infrastructure, and Pipes (True LEADership) Act of 2016 S. 2848 - Water Resources Development Act of 2016

Client expense: Not reported · Firm income: $23,450

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

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Letter to Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Statement for the record to Senate Finance Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365/ S. 2932, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care;Supported House and Senate letters to CMS asking for flexibility when interpreting section 603 of the BBA of 2015 in regulation; Support HR 5547, the Health Care Price Transparency Promotion Act of 2016, a bill to require the sharing of health care price information; Support HR 5273, the Helping Hospitals Improve Patient Care Act of 2016, a bill to address outstanding issues with section 603 of the BBA of 2015 and provide for a socioeconomic adjustment to the Hospital Readmissions Reduction Program; Supported a letter to CMS on implementation of Sec. 603 of the Bipartisan Budget Acts site neutral cuts for off-campus HOPDs; Support H. res. 699 promoting minority health awareness and supporting the goals and ideals of National Minority Health Month in April 2016; Support H.R.4641 - a bill to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication; Support H.R. 4982, the Examining Opioid Treatment Infrastructure Act of 2016, a bill which would require the Government Accountability Office (GAO) to evaluate and report on the capacity, availability and need for inpatient and outpatient treatment for opioid use disorders in the United States; Supports H.R. 3680, the Co-Prescribing to Reduce Overdoses Act of 2015, a bill would establish federal grants to carry out co-prescribing of overdose reversal drugs in areas experiencing significant numbers of opioid overdoses and deaths; Support H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act of 2015, a bill that would reauthorize essential residential treatment programs for pregnant and postpartum women and provide grants to states to address the growing epidemic of infants suffering from opioid dependency; Support H.R. 4978, the Nurturing and Supporting Healthy Babies Act, a bill which would require a GAO evaluation of neonatal abstinence syndrome and the availability of treatment for this condition in the nations Medicaid programs; Support H.R. 4599, the Reducing Unused Medications Act of 2016, a bill to permit partial filling of schedule II prescriptions under specific circumstances; Support H.R. 4976, the Opioid Review Modernization Act of 2016, a bill which would provide for more stringent Food and Drug Administration review of new opioids without abuse-deterrent properties, recommendations for labeling of pediatric opioids, and recommendations for prescriber education; Support the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2016, a bill for achieving fair and sustainable drug pricing; Supporting full alignment of 42CFR substance use records confidentiality requirements with HIPAA privacy rule.

Client expense: $4,690,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Health Insurance Coverage, Genetic Testing (general); Health Disparities (general); Emergency Contraception (general); Health Care Reform Implementation; Drug Dependence (general); HIV Screening (general); Gynecologic Cancer (general); Gynecologic devices (general); Breast Cancer (general); Breastfeeding (general); Medical Liability Reform (general); Health IT (general); Prematurity (general); Disparities (general); Prevention and Public Health Fund (general); Maternal Mortality and Morbidity (general); Imaging (general); Graduate Medical Education (general); Quality Improvement Measurement (general); Contraception (general); Postpartum Depression (general); CMS Provider Penalties (general); Preeclampsia (general); National Health Service Corps (general); Abortion (general); Indian Health (general); Teaching Health Centers (general); Research in Pregnant and Breastfeeding Women (general); Meaningful Use Stage 3; H.R. 3940, Meaningful Use Hardship Relief Act; H.R.4695/S. 466, Quality Care for Moms and Babies Act; H.R. 3865/S.2542, Cradle Act; H.R. 836/S. 884, Health Care Safety Net Enhancement Act; H.R. 865, Good Samaritan Health Professionals Act; H.R. 2603/S. 1475, Saving Lives, Saving Costs Act; H.R. 4774, Training Tomorrows Doctors Today Act; H.R. 3658/S. 84, GEDI Act; H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016; H.R. 1209/S.628 Improving Access to Maternity Care Act; Implementation of H.R. 1462/S. 799, Protecting our Infants Act; H.R. 3691/S. 2226, Improving Treatment for Pregnant and Postpartum Women Act; H.R. 448/S.217, Women's Health Protection Act of 2015; H.R. 2972, Equal Access to Abortion Coverage in Health Insurance (EACH Woman) Act; H.Res. 461, Establishing a Select Investigative Panel of the Committee on Energy and Commerce; Fetal Tissue Research (General); H.R. 3706/S.1911, Reach Every Mother and Child Act of 2016; H.Res. 558/S.Res. 327, Condemning Violence That Targets Healthcare for Women; H.R. 4924/S.48, Prenatal Nondiscrimination Act (PRENDA) of 2016; Senate Biomedical Innovations Packages (general); S. 2745, Advancing NIH Strategic Planning and Representation in Medical Research Act; S.2742, Promoting Biomedical Research and Public Health for Patients Act; H.R. 3656/S. 2100, Tobacco to 21 Act; H.R. 3652/S. 674, 21st Century Womens Health Act; S. 1532, Affordability is Access Act; H.R. 2058, FDA Deeming Authority Clarification Act of 2015; H.R. 3441, Accurate Education for Prenatal Screenings Act; H.R. 3235/S. 2311, Bringing Postpartum Depression Out of the Shadows Act; Shackling During Pregnancy (general); and H.R. 3539, Reinvigorating Antibiotic and Diagnostic Innovation Act; H.R. 5369, Healthy Start Reauthorization Act; S. 3070, Hygiene Assistance for Families of Infants and Toddlers Act of 2016; H.R. 5219 Safe Medications for Moms and Babies Act of 2016; H.R. 953/S. 524, Comprehensive Addiction and Recovery Act; H.R. 2646, Helping Families in Mental Health Crisis Act; S. 2680, Mental Health Reform Act; H.R. 3537, Synthetic Drug Control Act; H.R. 4499/S. 2758, Promoting Responsible Opioid Prescribing (PROP) Act; H.R. 4874, Prevent Abuse by Using Interstate Exchange Act; H.R. 2805/S. 1134, Heroin and Prescription Opioid Abuse, Prevention, Education, and Enforcement Act; H.R. 2654/S. 1512, Pregnant Workers Fairness Act; H.R. 1706/S.2765, Real Education for Healthy Youth Act.

Client expense: $486,704 · Firm income: Not reported

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

Children's Health Insurance Program (CHIP). 21st Century Cures and Senate Innovations for Healthier Americans, concerning vaccine and maternal/child health provisions. Precision Medicine Initiative, concerning maternal and child health aspects. National Children's Study (ECHO). S.697, Frank R. Lautenberg Chemical Safety for the 21st Century Act, concerning child and maternal environmental health. S. 799 & H.R. 1462, Protecting Our Infants Act, on reducing neonatal abstinence syndrome. Legislation relating to maternal therapeutics, postpartum depression, and personal care products safety, Zika preparedness, neonatal abstinence syndrome, tobacco control, and lead poisoning.

Client expense: $34,678 · Firm income: Not reported

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

Renewable Fuel Standard Issues: -Renewable Fuel Standard Repeal: H.R. 1461 -Renewable Fuel Standard Reform: H.R. 1462 Renewable Fuel Standard Issues (continued): -Renewable Fuel Standard Repeal: H.R. 1195 -Renewable Fuel Standard Reform: H.R.1469 -Renewable Fuel Standard Reform: S.1807 -Advanced Biofuel Mandard: Foreign Fuels Reducation Act (S.977) -RFS2 rule -E15 blend wall issues

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

maternity care, FDA, research & pregnancy; health reform; Affordable Care Act, pre-term, S.2311 Bringing Postpartum Depression Out of the Shadows Act, 21st Century Cures Innovations for Healthier Americans, Quality Care for Moms and Babies Act; HR 3441 Accurate for Prenatal Screenings Act; HR 1209/S 628 Improving Access to Maternity Care Act; S 799/HR 1462 Protecting Our Infants Act; S.2745, Advancing NIH Strategic Planning and Representation in Medical Research Act; HR 5219 Safe Medications for Moms and Babies Act.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition of essential health benefits and provider network adequacy Health information technology and electronic health records Telehealth provisions of draft medical innovation legislation Mental health services and violence prevention H.R. 6 - 21st Century Cures Act H.R. 30 - Save American Workers Act H.R. 248/S. 305 - American Job Protection Act H.R. 270 - Flexibility in Health IT Reporting (Flex-IT) Act H.R. 512 - Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act H.R. 596 - To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 609/S. 287 - Safe Food Act H.R. 879 - Ax the Tax on Middle Class Americans' Health Plans Act H.R. 931 - Helping Effective Antibiotics Last (HEAL) Act H.R. 932/S. 497 - Healthy Families Act H.R. 933/S. 486 - Head Start on Vaccinations Act H.R 1189/S. 620 - Preserving Employee Wellness Programs Act H.R. 1209/S. 628 - Improving Access to Maternity Care Act H.R. 1372 - Home Visiting Extension Act H.R. 1462/S. 799 - Protecting Our Infants Act H.R 1517 - Stop Selling and Marketing to Our Kids E-Cigarettes (SMOKE) Act H.R. 1552 - Preservation of Antibiotics for Medical Treatment Act H.R. 1599 - Safe and Accurate Food Labeling Act H.R 1624 - Protecting Affordable Coverage for Employees (PACE) Act H.R. 2017/S. 2217 - Common Sense Nutrition Disclosure Act H.R. 2300/S. 2519 - Empowering Patients First Act of 2015 H.R. 2646 - Helping Families in Mental Health Crisis Act H.R. 2690 - Including Families in Mental Health Recovery Act H.R. 2713 - Title VIII Nursing Workforce Reauthorization Act H.R. 2948 - Medicare Telehealth Parity Act H.R. 3081/S. 1778 - Telemedicine for Medicare (TELE-MED) Act H.R. 3379 - Airplane Kits Act H.R. 3495 - Women's Public Health and Safety Act H.R. 3660 - Preventive Health Savings Act H.R. 3659 - Exchange Inclusion for a Healthy America Act H.R. 3762 - Restoring Americans Healthcare Freedom Reconciliation Act H.R. 3865/S. 2542 - Cradle Act H.R. 4276 - Behavioral Health Coverage Transparency Act H.R. 4400/S. 2512 - Adding Zika Virus to the FDA Priority Review Voucher Program Act H.R. 4723 - Protecting Taxpayers by Recovering Improper Obamacare Subsidy Overpayments Act H.R. 4724 - Reducing Duplicative and Ineffective Federal Funding Act H.R. 4771 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 S. 30 - Forty Hours Is Full Time Act S. 142/H.R. 1375/H.R. 3242 - Child Nicotine Poisoning Prevention Act S. 185 - Promise for Antibiotics and Therapeutics for Health (PATH) Act S. 203 - American Liberty Restoration Act S. 339 - ObamaCare Repeal Act S. 481 - Improving Regulatory Transparency for New Medical Therapies Act S. 522 - Protecting & Retaining Our Children's Health Insurance Program (PRO-CHIP) Act S. 621 - Prevention of Antibiotic Resistance Act S. 673 - Winding Down Obamacare Act S. 674 - 21st Century Womens Health Act S. 971 - Medicare Independence at Home Medical Practice Demonstration Improvement Act S. 993/H.R. 1854 - Comprehensive Justice and Mental Health Act S. 1014 - Personal Care Products Safety Act S. 1016 - Preserving Freedom and Choice in Health Care Act S. 1456 - Rural ACO Improvement Act S. 1549 - Care Planning Act S. 1793 - Promoting Physical Activity for Americans Act S. 1893 - Mental Health Awareness and Improvement Act S. 1945 - Mental Health Reform Act S. 2002/H.R. 3722 - Mental Health and Safe Communities Act S. 2045/H.R. 2050 - Middle Class Health Benefits Tax Repeal Act S. 2075 - American Worker Health Care Tax Relief Act S. 2100 - Tobacco to 21 Act S. 2153 - Provider Payment Sunshine Act S. 2173/H.R. 3712 - Improving Access to Mental Health Act S. 2218/H.R. 1218 - Personal Health Investment (PHIT) Act S. 2259 - ACO Assignment Improvement Act S. 2261 - Rural ACO Provider Equity Act S. 2343/H.R. 4155 - Telehealth Innovation and Improvement Act S. 2408/H.R. 4266 - Nurse and Health Care Worker Protection Act S. 2525/H.R. 4567 - Expand Excellence in Mental Health Act of 2016 S. 2609 - An original bill to amend the Agricultural Marketing Act of 1946 to require the Secretary of Agriculture to establish a national voluntary labeling standard for bioengineered foods S. 2680 - Mental Health Reform Act of 2016 S. 2687 - Plan of Safe Care Improvement Act

Client expense: Not reported · Firm income: $23,450

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

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with Members of Congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients;Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome; Discussed S.1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning treatment; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948, Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Support HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis;Spoke with Rep. Kinds office on legislation to address the opioid epidemic in America; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule; Discussion with CMS about the Emergency Preparedness final rule; Discussion with CMS regarding the 0.2 percent reduction to hospitals payments under the Inpatient Prospective Payment System (PPS); Support S. 524, the Johnson amendment and the Collins amendment, Comprehensive Addiction and Recovery Act of 2016, a bill to authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use; Support H.R. 4499, Promoting Responsible Opioid Prescribing Act of 2016, a bill to amend title XVIII of the Social Security Act to remove consideration of certain pain-related issues from calculations under the Medicare hospital value-based purchasing program; Support S. 2220, The Healthy Maternity and Obstetric Medicine Act or Healthy MOM Act guarantees maternity coverage for women who are enrolled in the exchanges established under the Affordable Care Act, as well as women who are covered by individual and group insurance plans and federal employee health benefit plans; Comments to House Ways and Means and Senate Finance Committees on how to improve the physician self-referral (Stark) law; Urged CMS to delay the April 2016 release of the hospital star ratings on the Hospital Compare Website; Supported House and Senate letters urging CMS to delay release of hospital star ratings on the Hospital Compare Website; Support H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act, a bill that would reduce health care costs and promote access to quality, affordable health care for all Americans; Comments on Senate HELP Committee draft legislation addressing health information technology (IT) and electronic health records (EHRs); Comments to CMS regarding addressing section 603 of the BBA of 2015 in regulation; Comments to House Energy & Commerce Committee regarding section 603 of the BBA of 2015 as well as site neutral payment policies in general; Statement for the record to House Energy & Commerce Committee on MACRA implementation; Comments to the Senate Finance Committee Chronic Care document -Conversations with the CDC related to their opioid guidelines for chronic pain as well as a patient education piece about opioids; Discussions with CMS about CAH designation status Health Care Issues; Discussions with Rep. Hudson about H.R. 4365, the Protecting Patient Access to Emergency Medications Act , a bill to amend the Controlled Substances Act with regard to the provision of emergency medical services; Support H.R. 4650 and S. 2108, Preserving Patient Access to Post-Acute Hospital Care Act of 2016, a bill to amend title XVIII of the Social Security Act to provide for an extension of certain Medicare long-term care hospital payment rules; Supported efforts to encourage Congress to send CMS letters on addressing the issue of colocation of facilities within a hospital; Discussions with Members of Congress on the potential implementation of Unique Device Identification on claims forms; Sponsored a Hill briefing on innovations in post-acute care.

Client expense: $5,120,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Health Insurance Coverage, Genetic Testing (general); Health Disparities (general); Emergency Contraception (general); Health Care Reform Implementation; Drug Dependence (general); HIV Screening (general); Gynecologic Cancer (general); Breast Cancer (general); Breastfeeding (general); Medical Liability Reform (general); Health IT (general); Prematurity (general); Disparities (general); Prevention and Public Health Fund (general); Maternal Mortality and Morbidity (general); Imaging (general); Graduate Medical Education (general); Quality Improvement Measurement (general); Contraception (general); Postpartum Depression (general); CMS Provider Penalties (general); Preeclampsia (general); National Health Service Corps (general); Abortion (general); Indian Health (general); Teaching Health Centers (general); Research in Pregnant and Breastfeeding Women (general); Meaningful Use Stage 3; H.R. 3940, Meaningful Use Hardship Relief Act; H.R.4695/S. 466, Quality Care for Moms and Babies Act; H.R. 3865/S.2542, Cradle Act; H.R. 836/S. 884, Health Care Safety Net Enhancement Act; H.R. 865, Good Samaritan Health Professionals Act; H.R. 2603/S. 1475, Saving Lives, Saving Costs Act; H.R. 4774, Training Tomorrows Doctors Today Act; H.R. 3658/S. 84, GEDI Act; H.R. 4771, Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016; H.R. 1209/S.628 Improving Access to Maternity Care Act; Implementation of H.R. 1462/S. 799, Protecting our Infants Act; H.R. 3691/S. 2226, Improving Treatment for Pregnant and Postpartum Women Act; H.R. 448/S.217, Women's Health Protection Act of 2015; H.R. 2972, Equal Access to Abortion Coverage in Health Insurance (EACH Woman) Act; H.R. 3504/S. 1603, Born-Alive Abortion Survivors Protection Act; H.Res. 461, Establishing a Select Investigative Panel of the Committee on Energy and Commerce; Fetal Tissue Research (General); H.Res. 558/S.Res. 327, Condemning Violence That Targets Healthcare for Women; Senate Biomedical Innovations Packages (general); S. 2745, Advancing NIH Strategic Planning and Representation in Medical Research Act; S.2742, Promoting Biomedical Research and Public Health for Patients Act; H.R. 3656/S. 2100, Tobacco to 21 Act; H.R. 3652/S. 674, 21st Century Womens Health Act; S. 1532, Affordability is Access Act; H.R. 2191/S. 1170, Breast Cancer Research Stamp Reauthorization Act of 2015; H.R. 1925, To award a Congressional Gold Medal to Dr. Ernie Bodai; H.R. 2058, FDA Deeming Authority Clarification Act of 2015; H.R. 3441, Accurate Education for Prenatal Screenings Act; H.R. 3235/S. 2311, Bringing Postpartum Depression Out of the Shadows Act; Shackling During Pregnancy (general); and H.R. 3539, Reinvigorating Antibiotic and Diagnostic Innovation Act.

Client expense: $487,965 · Firm income: Not reported

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

Renewable Fuel Standard Issues: -Renewable Fuel Standard Repeal: H.R. 1461 -Renewable Fuel Standard Reform: H.R. 1462 Renewable Fuel Standard Issues (continued): -Renewable Fuel Standard Repeal: H.R. 1195 -Renewable Fuel Standard Reform: H.R.1469 -Renewable Fuel Standard Reform: S.1807 -Advanced Biofuel Mandard: Foreign Fuels Reducation Act (S.977) -RFS2 rule -E15 blend wall issues

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues and policies relating to community behavioral health centers; issues and policies relating to behavioral healthcare; issues and policies relating to access to community-based addiction treatment services; implementation of Public Law 113-93 Section 223; issues relating to reform of the mental health system; and S. 524, H.R. 953, and H.R. 1462

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

maternity care, FDA, research & pregnancy; health reform; Affordable Care Act, pre-term birth medication in pregnancy and breastfeeding, 21st Century Cures Innovations for Healthier Americans, Quality Care for Moms and Babies Act; HR 3441 Accurate for Prenatal Screenings Act; HR 1209/S 628 Improving Access to Maternity Care Act; S 799/HR 1462 Protecting Our Infants Act; S.2745

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

Children's Health Insurance Program (CHIP). 21st Century Cures and Senate Innovations for Healthier Americans, concerning vaccine and maternal/child health provisions. Precision medicine initiative, concerning maternal and child health aspects. National Children's Study (ECHO). S.697, Frank R. Lautenberg Chemical Safety for the 21st Century Act, concerning child and maternal environmental health. S. 799 & H.R. 1462, Protecting Our Infants Act, on reducing neonatal abstinence syndrome. Legislation relating to maternal therapeutics, postpartum depression, and personal care products safety. Zika. Lead poisoning.

Client expense: $66,537 · Firm income: Not reported

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

H.R. 2, SGR reform bill, concerning extending CHIP. 21st Century Cures discussion draft (and Senate efforts), concerning ACIP and maternal/child health provisions. Precision medicine initiative, concerning maternal and child health aspects. National Children's Study. S.697, Frank R. Lautenberg Chemical Safety for the 21st Century Act, concerning child and maternal environmental health. S. 799 & H.R. 1462, Protecting Our Infants Act, on reducing neonatal abstinence syndrome.

Client expense: $57,786 · Firm income: Not reported

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

Children's Health Insurance Program (CHIP). 21st Century Cures discussion draft (and Senate's Innovations for Healthier Americans), concerning vaccine and maternal/child health provisions. Precision medicine initiative, concerning maternal and child health aspects. National Children's Study (ECHO). S.697, Frank R. Lautenberg Chemical Safety for the 21st Century Act, concerning child and maternal environmental health. S. 799 & H.R. 1462, Protecting Our Infants Act, on reducing neonatal abstinence syndrome. Legislation relating to maternal therapeutics.

Client expense: $51,672 · Firm income: Not reported

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

H.R. 6, the 21st Century Cures Act, Title I. H.R. 546/S. 298, the ACE Kids Act of 2015, all provisions. H.R. 1462, the Protecting our Infants Act of 2015,all provisions. General issues related to infant mortality and public health.

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-148, the Patient Protection and Affordable Care Act - Implementation issues related to Medicaid reimbursement for neonatologists and pediatric cardiologists, Medicare evaluation and management coding practices, qualifying neonatologists as primary care practioners for purposes of program eligibility, public insurance plan provider participation and payment issues, Medicare reimbursement for anesthesiology services. Public Law 111-152, the Health Care and Education Reconciliation Act - Implementation issues related to Medicaid reimbursement for neonatologists and pediatric cardiologists, Medicare evaluation and management coding practices, qualifying neonatologists as primary care practioners for purposes of program eligibility, public insurance plan provider participation and payment issues, Medicare reimbursement for anesthesiology services. Public Law 112-144, the Food and Drug Administration Safety and Innovation Act - Implementation issues related to drug shortage issues. Public Law 113-146, Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 - Implementation issues related to physician contracting and reimbursement issues. Public Law 114-113, Consolidated Appropriations Act, 2016, provisions relating to Medicare, Medicaid and the Meaningful Use program. Public Law 114-74, Bipartisan Budget Act of 2015, provisions relating to Medicare, Medicaid and health care generally. H.R. 1462 and S. 799 Protecting Our Infants Act of 2015, all provisions. HR. 1344, Early Hearing Detection and Intervention Act of 2015, all provisions.

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

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

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition of essential health benefits and provider network adequacy Health information technology and electronic health records Telehealth provisions of draft medical innovation legislation Mental health services and violence prevention H.R. 6 - 21st Century Cures Act H.R. 30 - Save American Workers Act H.R. 248/S. 305 - American Job Protection Act H.R. 270 - Flexibility in Health IT Reporting (Flex-IT) Act H.R. 512 - Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act H.R. 596 - To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 609/S. 287 - Safe Food Act H.R. 879 - Ax the Tax on Middle Class Americans' Health Plans Act H.R. 931 - Helping Effective Antibiotics Last (HEAL) Act H.R. 932/S. 497 - Healthy Families Act H.R. 933/S. 486 - Head Start on Vaccinations Act H.R 1189/S. 620 - Preserving Employee Wellness Programs Act H.R. 1209/S. 628 - Improving Access to Maternity Care Act H.R. 1372 - Home Visiting Extension Act H.R. 1462/S. 799 - Protecting Our Infants Act H.R 1517 - Stop Selling and Marketing to Our Kids E-Cigarettes (SMOKE) Act H.R. 1552 - Preservation of Antibiotics for Medical Treatment Act H.R. 1599 - Safe and Accurate Food Labeling Act H.R 1624 - Protecting Affordable Coverage for Employees (PACE) Act H.R. 2017 - Common Sense Nutrition Disclosure Act H.R. 2646 - Helping Families in Mental Health Crisis Act H.R. 2690 - Including Families in Mental Health Recovery Act H.R. 2713 - Title VIII Nursing Workforce Reauthorization Act H.R. 2948 - Medicare Telehealth Parity Act H.R. 3081/S. 1778 - Telemedicine for Medicare (TELE-MED) Act H.R. 3379 - Airplane Kits Act H.R. 3495 - Women's Public Health and Safety Act H.R. 3660 - Preventive Health Savings Act H.R. 3659 - Exchange Inclusion for a Healthy America Act H.R. 3762 - Restoring Americans Healthcare Freedom Reconciliation Act H.R. 4276 - Behavioral Health Coverage Transparency Act S. 30 - Forty Hours Is Full Time Act S. 142/H.R. 1375/H.R. 3242 - Child Nicotine Poisoning Prevention Act S. 185 - Promise for Antibiotics and Therapeutics for Health (PATH) Act S. 203 - American Liberty Restoration Act S. 339 - ObamaCare Repeal Act S. 481 - Improving Regulatory Transparency for New Medical Therapies Act S. 522 - Protecting & Retaining Our Children's Health Insurance Program (PRO-CHIP) Act S. 621 - Prevention of Antibiotic Resistance Act S. 673 - Winding Down Obamacare Act S. 674 - 21st Century Womens Health Act S. 971 - Medicare Independence at Home Medical Practice Demonstration Improvement Act S. 993/H.R. 1854 - Comprehensive Justice and Mental Health Act S. 1014 - Personal Care Products Safety Act S. 1016 - Preserving Freedom and Choice in Health Care Act S. 1456 - Rural ACO Improvement Act S. 1549 - Care Planning Act S. 1893 - Mental Health Awareness and Improvement Act S. 1945 - Mental Health Reform Act S. 2002 - Mental Health and Safe Communities Act S. 2045/H.R. 2050 - Middle Class Health Benefits Tax Repeal Act S. 2075 - American Worker Health Care Tax Relief Act S. 2100 - Tobacco to 21 Act S. 2153 - Provider Payment Sunshine Act S. 2173/H.R. 3712 - Improving Access to Mental Health Act S. 2218/H.R. 1218 - Personal Health Investment (PHIT) Act S. 2259 - ACO Assignment Improvement Act S. 2261 - Rural ACO Provider Equity Act S. 2343/H.R. 4155 - Telehealth Innovation and Improvement Act S. 2408/H.R. 4266 - Nurse and Health Care Worker Protection Act

Client expense: Not reported · Firm income: $23,450

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

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, it is a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with members of congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients; Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome;Discussed S. 1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning; Supported expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund; Support the H.R. 2745, Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER Act), a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Support HR 1784, Making the Education of Nurses Dependable for Schools Act (MEND Act), a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs;Urged that HHS refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals in discussion about member concerns regarding remarks of CMS official that were confusing during a health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948 Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Comment on HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis;Spoke with Rep. Kinds office on legislation to address the opioid epidemic in America; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Testified at three Insurance Consolidation Hearings to discuss the impact of the proposed acquisitions involving Aetna/ Humana and Anthem/Cigna; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893, The Mental Health Awareness and Improvement Act of 2015, a bill to reauthorize and improve programs related to mental health and substance use disorders; Letter asking for modifications to H.R. 3298 Medicare Post-Acute Care Value-Based Purchasing (PAC VBP) Act of 2015, the legislation would establish a value-based purchasing program for LTCHs, IRFs, SNFs and HH agencies. Worked to streamline and improve quality measures; Discussed how to implement the framework in the National Academy of Medicines Vital Signs report to streamline and focus quality measures used in Medicare programs; Discussed Opioid prescribing guidelines with the CDC to provide feedback on the opioid prescribing guidelines they were developing; Discussion with CMS regarding CAH designation status, negative impact of Insurance Consolidations on Medicare Advantage and for modifications to Comprehensive Care for Joint Replacement (CJR) model regarding aspects of the proposed rule.

Client expense: $4,800,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Medical liability reform (H.R. 836/S. 884) Mental health & opioid abuse policy (S. 599, H.R. 2646, S. 1893, S. 799/H.R. 1462, ) 340B discount drug program Chronic care policy Nurse education policy (H.R. 977 / H.R. 1784 / S. 629, H.R. 2713)

Client expense: $73,623 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 546 - Advancing Care for Exceptional Kids Act of 2015 S. 298 - Advancing Care for Exceptional Kids Act of 2015 H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 Issues regarding the Children's Health Insurance Program (CHIP) H.R. 6 - 21st Century Cures Act, and untitled Senate HELP Committee innovations bill, issues relating to pediatric research S. 1893 - Mental Health Awareness and Improve Act of 2015, issues relating to pediatric mental health H.R. 2646 - Helping Families in Mental Health Crisis Act of 2015 S. 1945 - Mental Health Reform Act of 2015 Issues related to 340B Drug Pricing Program Omnibus Guidance Issues related to pharmaceutical pricing FY 2016 Senate and House Labor-HHS appropriations provisions - Children's Hospital Graduate Medical Education (CHGME) program FY 2017 CHGME Funding S. 799/ H.R. 1462 - Protecting Our Infants Act of 2015 Families First Act H.R. 4994 - Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, issues related to childrens hospitals H.R. 3952/S. 2248 - Congenital Heart Futures Reauthorization Act of 2015 Issues related to extension of pediatric quality funding for the Pediatric Quality Measures Program (PQMP) and related demonstration grants Issues related to implementation of aspects of childrens health coverage under H.R. 3590 - Patient Protection and Affordable Care Act Issues related to Merit-based Incentive Payment Systems Issues related to Discharge Planning Proposed Rule Issues related to Medicaid Access Final Rule and Medicaid Access Standards Issues relating to pediatrics within Medicaid managed care

Client expense: $1,030,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Personnel Management (OPM), SENATE, Treasury, Dept of

Renewable Fuel Standard Issues: -Renewable Fuel Standard Repeal: H.R. 1461 -Renewable Fuel Standard Reform: H.R. 1462 Renewable Fuel Standard Issues (continued): -Renewable Fuel Standard Repeal: H.R. 1195 -Renewable Fuel Standard Reform: H.R.1469 -Renewable Fuel Standard Reform: S.1807 -Advanced Biofuel Mandard: Foreign Fuels Reducation Act (S.977) -RFS2 rule -E15 blend wall issues

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Children's Health Insurance Program (CHIP). 21st Century Cures discussion draft (and Senate's Innovations for Healthier Americans), concerning vaccine and maternal/child health provisions. Precision medicine initiative, concerning maternal and child health aspects. National Children's Study (ECHO). S.697, Frank R. Lautenberg Chemical Safety for the 21st Century Act, concerning child and maternal environmental health. S. 799 & H.R. 1462, Protecting Our Infants Act, on reducing neonatal abstinence syndrome. Legislation relating to maternal therapeutics, postpartum depression, and personal care products safety.

Client expense: $61,135 · Firm income: Not reported

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

H.R. 6, the 21st Century Cures Act, Title I. H.R. 546/S. 298, the ACE Kids Act of 2015, all provisions. H.R. 1462, the Protecting our Infants Act of 2015,all provisions. General issues related to infant mortality and public health.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 114 - 20 - the Medicare Access and Chip Reauthorization Act - SGR repeal, CHIP reauthorization, Community Health Center Reauthorization - comments on regulations re: quality measurements, technical support for small businesses, MIPS, APMS HR 293 - the Protect Continuing Physician Education Act and Patient Care Act - regulations implementing the Sunshine Act HR 6 - 21st Century Cures - provisions impacting Sunshine Act S 320 - Medical Innovation Act - NIH funding Opioid Addiction issues S. 1455 - TREAT ACT, Recovery Enhancement for Addiction Act S. 1641 - The Jason Simcakoski Memorial Opioid Safety Act s. 480 - Reauthorization of NASPER - The National All Schedules Prescription Electronic Reporting Act - No specific bill S. 1392 Safer Prescribing of Controlled Substances Act HR 2085/S. 1134 - Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 HR 1462/S 799 - Protecting our Infants Act of 2015 - PL 114-91 Partial Fill legislation - no specific bill Funding for demonstration projects for access to pain specialists - no specific bill DEA - change/classification of regulations regarding partial fill of prescriptions E Prescribing - no specific bill S. 524 - Comprehensive Addiction and Recovery Act of 2015 S. 1134 - Heroin and Prescription Opioid Abuse Education and Enforcement Act Draft CDC Guideline for Prescribing Opioids for Chronic Pain Prescriber Education on the VA System draft legislation Prescription Drug Pricing - no specific bill Direct to Consumer Advertising - no specific bill Negotiating Prescription Drug Prices for Medicare and Medicaid - no specific bill Access to medically tailored food for low income people - no specific bill S 139/HR 209 - the Ensuring Access to Clinical Trials Act of 2015 - PL 114-63 Meaningful Use and Electronic Medical Records - HR 3309 - Future Flexibility on HIT Reporting and Advancing Interoperability Act Opposition to Meaningful Use Stage III Rules HR 3940 - Meaningful Use Hardship Relief Act - PL 114-115 HR 2568 - Fair Medical Audits Act of 2015 DEA Reclassification of marijuana to allow scientific research and study

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Opioid Addiction issues S. 1455 - TREAT ACT, Recovery Enhancement for Addiction Act S. 1641 - The Jason Simcakoski Memorial Opioid Safety Act s. 480 - Reauthorization of NASPER - The National All Schedules Prescription Electronic Reporting Act - No specific bill S. 1392 Safer Prescribing of Controlled Substances Act HR 2085/S. 1134 - Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 HR 1462/S 799 - Protecting our Infants Act of 2015 - PL - 114-91 Partial Fill legislation - no specific bill Funding for demonstration projects for access to pain specialists - no specific bill DEA - change/classification of regulations regarding partial fill of prescriptions E Prescribing - no specific bill S. 524 - Comprehensive Addiction and Recovery Act of 2015 S. 1134 - Heroin and Prescription Opioid Abuse Education and Enforcement Act Draft CDC Guideline for Prescribing Opioids for Chronic Pain Prescriber Education on the VA System draft legislation

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 6 - 21st Century Cures H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 33/S. 420 - Protecting Volunteer Firefighters and Emergency Responders Act/Standard of Care protection act H.R. 1462/S. 799 - Protecting Our Infants Act of 2015 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. H.R. 3309 - Flex-IT 2 Act H.R. 3024 - Disproportionate Share Hospital bill H. Res 487 - Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care HR 2846 - Planning Actively for Cancer Treatment (PACT) Act of 2015 HR 3119 - Palliative Care and Hospice Education and Training Act S. 1170 - Breast Cancer Research Stamp Reauthorization Act of 2015 GME Surgical Workforce Shortages/Issues ICD-10 HEALTH Act Response to Senate FDA report HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system Health Insurance Mergers Stark Law APMS Alternative Payment Models Meaningful Use Stage 3 Delay Firearm safety Primary Care Incentive Payment Merit-Based Incentive Payment System (MIPS) implementation Medicare Physician Fee Schedule Quality and Payment Issues General Surgery, Rural Surgery Bonuses Chronic Care Issues Qualified clinical data registry (QCDR) and Physician Quality Reporting System (PQRS)

Client expense: $20,300 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 6 - 21st Century Cures H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 33/S. 420 - Protecting Volunteer Firefighters and Emergency Responders Act/Standard of Care protection act H.R. 1462/S. 799 - Protecting Our Infants Act of 2015 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. H.R. 3309 - Flex-IT 2 Act H.R. 3024 - Disproportionate Share Hospital bill H. Res 487 - Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care HR 2846 - Planning Actively for Cancer Treatment (PACT) Act of 2015 HR 3119 - Palliative Care and Hospice Education and Training Act S. 1170 - Breast Cancer Research Stamp Reauthorization Act of 2015 GME Surgical Workforce Shortages/Issues ICD-10 HEALTH Act Response to Senate FDA report HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system Health Insurance Mergers Stark Law APMS Alternative Payment Models Meaningful Use Stage 3 Delay Firearm safety Primary Care Incentive Payment Merit-Based Incentive Payment System (MIPS) implementation Medicare Physician Fee Schedule Quality and Payment Issues General Surgery, Rural Surgery Bonuses Chronic Care Issues Qualified clinical data registry (QCDR) and Physician Quality Reporting System (PQRS)

Client expense: $20,300 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 6 - 21st Century Cures H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 33/S. 420 - Protecting Volunteer Firefighters and Emergency Responders Act/Standard of Care protection act H.R. 1462/S. 799 - Protecting Our Infants Act of 2015 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. H.R. 3309 - Flex-IT 2 Act H.R. 3024 - Disproportionate Share Hospital bill H. Res 487 - Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care HR 2846 - Planning Actively for Cancer Treatment (PACT) Act of 2015 HR 3119 - Palliative Care and Hospice Education and Training Act S. 1170 - Breast Cancer Research Stamp Reauthorization Act of 2015 GME Surgical Workforce Shortages/Issues ICD-10 HEALTH Act Response to Senate FDA report HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system Health Insurance Mergers Stark Law APMS Alternative Payment Models Meaningful Use Stage 3 Delay Firearm safety Primary Care Incentive Payment Merit-Based Incentive Payment System (MIPS) implementation Medicare Physician Fee Schedule Quality and Payment Issues General Surgery, Rural Surgery Bonuses Chronic Care Issues Qualified clinical data registry (QCDR) and Physician Quality Reporting System (PQRS)

Client expense: $96,000 · Firm income: Not reported

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

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 6 - 21st Century Cures H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 33/S. 420 - Protecting Volunteer Firefighters and Emergency Responders Act/Standard of Care protection act H.R. 1462/S. 799 - Protecting Our Infants Act of 2015 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. H.R. 3309 - Flex-IT 2 Act H.R. 3024 - Disproportionate Share Hospital bill H. Res 487 - Recognizing the importance of cancer program accreditation in ensuring comprehensive, high quality, patient-centered cancer care HR 2846 - Planning Actively for Cancer Treatment (PACT) Act of 2015 HR 3119 - Palliative Care and Hospice Education and Training Act S. 1170 - Breast Cancer Research Stamp Reauthorization Act of 2015 GME Surgical Workforce Shortages/Issues ICD-10 HEALTH Act Response to Senate FDA report HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system Health Insurance Mergers Stark Law APMS Alternative Payment Models Meaningful Use Stage 3 Delay Firearm safety Primary Care Incentive Payment Merit-Based Incentive Payment System (MIPS) implementation Medicare Physician Fee Schedule Quality and Payment Issues General Surgery, Rural Surgery Bonuses Chronic Care Issues Qualified clinical data registry (QCDR) and Physician Quality Reporting System (PQRS)

Client expense: $96,000 · Firm income: Not reported

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

Issues and policies relating to community behavioral health centers; issues and policies relating to behavioral healthcare; issues and policies relating to access to community-based addiction treatment services; implementation of Public Law 113-93 Section 223; issues relating to reform of the mental health system; and S. 524, H.R. 953, and H.R. 1462

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Insurance Coverage, Genetic Testing (general); Health Disparities (general); Emergency Contraception (general); Health Care Reform Implementation; Drug Dependence (general); HIV Screening (general); Gynecologic Cancer; Breast Cancer (general); Breastfeeding (general); Medical Liability Reform (general); Health IT (general); Prematurity (general); Disparities (general); Prevention and Public Health Fund (general); Maternal Mortality (general); Imaging (general); Graduate Medical Education (general); Quality Improvement Measurement (general); Contraception (general); Postpartum Depression (general); CMS Provider Penalties (general); Preeclampsia (general); National Health Service Corps (general); Abortion (general); Indian Health (general); Teaching Health Centers (general); Research in Pregnant and Breastfeeding Women (general); H.R. 2866, Healthy MOM Act; CMS Health IT Incentive Program, Meaningful Use Stage 3; H.R. 3940, Meaningful Use Hardship Relief Act; S. 466, Quality Care for Moms and Babies Act; S. 1427, Quality Measure Alignment Act of 2015; H.R. 836/S. 884, Health Care Safety Net Enhancement Act; H.R. 865, Good Samaritan Health Professionals Act; H.R. 2603/S. 1475, Saving Lives, Saving Costs Act; H.R. 3658/S. 84, GEDI Act; Pregnancy Discrimination (general); H.R. 2654/S. 1512, Pregnant Workers Fairness Act; H.R. 1209/S.628 Improving Access to Maternity Care Act; H.R. 1462/S.799, Protecting our Infants Act; H.R. 3691/S. 2226, Improving Treatment for Pregnant and Postpartum Women Act; H.R.36/S. 1553, Pain-Capable Unborn Child Protection Act; H.R. 448/S.217, Women's Health Protection Act of 2015; H.R. 3134/S. 764, Defund Planned Parenthood Act; H.R. 3504/S. 1603, Born-Alive Abortion Survivors Protection Act; H.R. 3495, Womens Public Health and Safety Act; H.Res. 461, Establishing a Select Investigative Panel of the Committee on Energy and Commerce; H.Res. 558/S.Res. 327, Condemning Violence That Targets Healthcare for Women; H.R. 6, 21st Century Cures Act; Innovation for Healthier Americans; H.R. 1375/S. 142, Child Nicotine Poisoning Prevention Act; H.R. 3656/S. 2100, Tobacco to 21 Act; H.R. 3652/S. 674, 21st Century Womens Health Act; S. 1532, Affordability is Access Act; H.R. 2191/S. 1170, Breast Cancer Research Stamp Reauthorization Act of 2015; H.R. 1925, To award a Congressional Gold Medal to Dr. Ernie Bodai; H.R. 2058, FDA Deeming Authority Clarification Act of 2015; H.R. 3441, Accurate Education for Prenatal Screenings Act; H.R. 3339/S. 1926, Protecting Access to Lifesaving Screenings Act; H.R. 3235, Bringing Postpartum Depression Out of the Shadows Act; Shackling During Pregnancy (general); and H.R. 3539, Reinvigorating Antibiotic and Diagnostic Innovation Act.

Client expense: $333,697 · Firm income: Not reported

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

H.R. 6, the 21st Century Cures Act, Title I. H.R. 546/S. 298, the ACE Kids Act of 2015, all provisions. H.R. 1462, the Protecting our Infants Act of 2015,all provisions. General issues related to Medicaid. General issues related to infant mortality.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

maternity care, FDA, research & pregnancy; health reform; Affordable Care Act, pre-term birth medication in pregnancy and breastfeeding, 21st Century Cures Innovations for Healthier Americans, Quality Care for Moms and Babies Act; HR 3441 Accurate for Prenatal Screenings Act; HR 1209/S 628 Improving Access to Maternity Care Act; S 799/HR 1462 Protecting Our Infants Act.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

Support S 258 and HR 169, Critical Access Hospital Relief Act, a bill that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs); Support HR 293, a bill to exempt certain journals and text books used in continuing medical education (CME) from manufacturer transparency reporting requirements; Participated in the Hearing, Examining the 340B Drug Pricing Program and submitted testimony about the 340B program, a federal drug discount program to Subcommittee members who will review the functionality of the program to ensure it is meeting its intended goals; HR 6, 21st Century Cures, it is a bill that accelerates the discovery and development of cures, and also includes provisions addressing interoperability of health IT and would provide additional money to NIH and the FDA; Two midnight discussion with several members of Congress; Support, Advancing Telehealth Opportunities in Medicare Telehealth, submitted a letter outlining the benefits of telehealth and showcases successful hospital and health system efforts. It also outlines barriers to greater use of telehealth; Submitted letter pertaining to interoperabilty within the hospital communities; Support S. 599, Improving Access to Emergency Psychiatric Care Act of 2015, legislation easing the shortage of psychiatric beds and extend and expand the CMS emergency psychiatric demonstration project; Comments on H.R.1458, BACPAC Act of 2015, a bill to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, and submitted a statement for a hearing on HR 1458 (re bundled payments for post-acute and other post-hospital services); Discussed Equity of Care Issues with members of congress; Advocate for funding by working with the Office of the Assistant Secretary for Preparedness and Response (ASPR) and Hospital Preparedness Program staff on ensuring adequate Ebola hospital funding; Working with the Centers for Disease Control and Prevention (CDC) on ongoing Ebola-related issues and guidance; Working with the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to ensure that hospitals continue to be able to use blood glucose monitoring systems (BGMS) on hospitalized patients; Discussion of draft guidance on drug compounding and repackaging; Working with ASPR and CDC staff to define the impact of the Hospital Preparedness Program and Public Health Emergency Preparedness Program on improving health care system preparedness; Support efforts to advocate on Ebola within a discussion with FDA regarding impact on access to chest tubes regarding the Atrium Medical Corp and Maquet consent decree ; Advocate for regulatory approach in a discussion with White House staff regarding new initiative promoting bystander involvement in stopping hemorrhage in injured civilians; Attended a roundtable discussion on Opioid-related dependence, overdose, and death at HHS; Advocate for changes to The Care Planning Act, a bill that would provide for advanced illness care coordination services for Medicare beneficiaries; Support HR 2878 and S 1461,a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Support S.799/HR 1462, Protecting Our Infants Act of 2015, a bill to combat the rise of prenatal opioid abuse and neonatal abstinence syndrome;Discussed S. 1349, a bill that amends title XVIII (Medicare) of the Social Security Act to require a hospital or critical access hospital with an agreement with the Secretary of Health and Human Services to give each individual who receives observation services as an outpatient for more than 24 hours an adequate oral and written notification within 36 hours after beginning; Submitted a statement to the Senate Commerce Communications, Technology, Innovation and the Internet Subcommittee hearing on Advancing Telehealth through Connectivity. The statement supports expansions to Medicare reimbursement for telehealth along with changes to the Health Care Connect Fund at the Federal Communications Commission; Support the H.R. 2745, Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER Act), a bill to provide that the Federal Trade Commission shall exercise authority with respect to mergers only under the Clayton Act and only in the same procedural manner as the Attorney General exercises such authority; Comments on S.1648, Rural Emergency Acute Care Hospital Act of 2015, a bill to amend title XVIII of the Social Security Act to create a sustainable future for rural healthcare. Support HR 1784, Making the Education of Nurses Dependable for Schools Act (MEND Act), a bill to enable hospital-based nursing programs that are affiliated with a hospital to maintain payments under the Medicare program to hospitals for the costs of such programs; Submitted comments to HHS to refrain from finalizing a stage 3 meaningful use rule; Advocate for Appropriate Surveyor Guidance on Calculated Hospitals during a meeting with staff in Center for Clinical Standards and quality to discuss member concerns regarding remarks of CMS official confusing during health lawyers association webinar; Discussion with CMS staff regarding proposed rule on establishing market-based payments for clinical laboratory tests; Discussion to rescind the proposed 2 percent cut to CY 2016 outpatient PPS conversion factor; Support H.R.2948 Medicare Telehealth Parity Act of 2015, a bill to amend title XVIII (Medicare) of the Social Security Act to expand telehealth coverage in three phases; Comment on HR 2646, Helping Families in Mental Health Crisis Act of 2015,A bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis;Spoke with Rep. Kinds office on legislation to address the opioid epidemic in America; Support HR 1604, Veterans Mental Health Care Access Act, a bill that expands access to mental health services for veterans; Support H.R. 3183, The Veterans Health Care Freedom Act, a bill which makes significant improvements to the Veterans Choice Program; Testified at three Insurance Consolidation Hearings to discuss the impact of the proposed acquisitions involving Aetna/ Humana and Anthem/Cigna; Support S 1189 The Conrad State 30 and Physician Access Act, a bill that reauthorizes the Conrad 30 and makes other changes to the program to improve patient access to care; Discussed quality measurement, meaningful use and Conditions of Participation; Conversation with CMS about the IOM Vital Signs report and how its recommendations could make quality measurement more meaningful; Spoke with CMS urging the Agency to correct the misimpression that was created statements made during a National Association of Medical Staff Specialists webinar by a CMS employee; Discussion with CMS about proposals contained in the Inpatient Psychiatric Facility PPS proposed rule urging CMS not to finalize two quality measures; Meeting at CMMI to discuss CCJR; Discuss S. 2141the Transparent Ratings on Usability and Security to Transform Information Technology Act of 2015, the TRUST Act, a bill that includes a definition of information blocking and a framework to assess interoperability of certified health IT (a health IT ratings program); Support S.1461 and H.R. 2878 a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2015; Oppose S. 1648 Rural Emergency Acute Care Hospital ActTo establish an alternative payment model for CAHs and small, rural hospitals whereby they may transition to become a rural emergency hospital.; Oppose H.R. 3225 Save Rural Hospitals Act, a bill to amend titles XVIII and XIX of the Social Security Act to provide for enhanced payments to rural health care providers under the Medicare and Medicaid programs; Discuss S. 1945 Mental Health Reform Act of 2015, a bill to make available needed psychiatric, psychological, and supportive services for individuals with mental illness and families in mental health crisis. It would reauthorize certain federal mental health programs, revise the IMD exclusion, reform SAMHSA, and study parity in mental health laws. Support S. 1893The Mental Health Awareness and Improvement Act of 2015A bill to reauthorize and improve programs related to mental health and substance use disorders.

Client expense: $4,020,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 6 - 21st Century Cures H.R. 1190 - Protecting Seniors' Access to Medicare Act of 2015 S. 258/H.R. 169 - Critical Access Hospital Relief Act of 2015 H.R. 3796 (113th) - Comprehensive Care Payment Innovation Act H.R. 648/S. 763 - Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R. 1070 (113th) - Removing Barriers to Colorectal Cancer Screening Act of 2013 H.R. 33/S. 420 - Protecting Volunteer Firefighters and Emergency Responders Act/Standard of Care protection act H.R. 1462/S. 799 - Protecting Our Infants Act of 2015 H.R. 531 - Accelerating Biomedical Research Act H.R. 887 - Electronic Health Fairness Act of 2015 H.R. 865 - Good Samaritan health professionals act H.R. 1220 - Removing Barriers to Colorectal Cancer Screening Act of 2015 S. 289 - American Cures Act H.R. 2603 /S. 1475 - Savings Lives, Saving Costs Act S. 884/H.R. 836 - the Health Care Safety Net Enhancement Act H.R. 647 - the Access to Life-Saving Trauma Care for All Americans Act S. 1148 - the Resident Physician Shortage Reduction Act of 2015 H.R. 1707 - the Access to Frontline Health Care Act H.R. 1859 - Ensuring Childrens Access to Specialty Care Act H.R. 1934 - Cancer Care Payment Reform Act of 2015 H.R. 1936 - Improving the Integrity of Disability Evidence Act H.R. 1688 - To amend the Veterans Access, Choice, and Accountability Act of 2014 to designate 20 graduate medical education residency positions specifically for the study of optometry. H.R. 3309 - Flex-IT 2 Act H.R. 3024 - Disproportionate Share Hospital bill GME Surgical Workforce Shortages/Issues ICD-10 HEALTH Act Response to Senate FDA report HPSA Surgical Incentive Program Cancer Program Accreditation IPAB Electronic Health Records Breast Cancer Research In-Office Ancillary Services Exception BETOS coding system Health Insurance Mergers Stark Law APMS Alternative Payment Models Meaningful Use Stage 3 Delay Gun safety Primary Care Incentive Payment Merit-Based Incentive Payment System (MIPS) implementation Medicare Physician Fee Schedule Quality and Payment Issues

Client expense: $22,111 · Firm income: Not reported

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