Improving Access to Medicare Coverage Act of 2015

DEA nurse agent issues; EHR and meaningful use specific to a long term care setting; Improve Access to Medicare Coverage Act S. 843/H.R. 1571; S. 1549, the Care Planning Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act; H.R. 1571: Improving Access to Medicare Coverage Act of 2015; S.843: Improving Access to Medicare Coverage Act of 2015; Post-acute payment and reform issues; S. 2000: The Veteran Access to Long Term Care and Health Services Act and VA Provider Agreement and Proposal; Health information technology issues; H.R.4111 and S.1916: Rural Health Care Connectivity Act was incorporated into H.R. 2576 - Frank R. Lautenberg Chemical Safety for the 21st Century Act (Public Law No. 114-182); Hospitals Improvements for Payment (HIP) Act of 2014.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6 - 21st Century Cures Act; H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015; S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016; H.R.3696 - Medicare Premium Fairness Act of 2015; P.L. 111-148: The Patient Protection and Affordable Care Act; H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014; H.R. 1571: Improving Access to Medicare Coverage Act of 2015; S. 843: Improving Access to Medicare Coverage Act of 2015; S. 539 and H.R.775 The Medicare Access to Rehabilitation Services Act; H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT).; S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program; Protect and Preserve Medicaid Provider Assessment; Protect and Preserve Medicare Bad Debt Reimbursement; Improving the CMS State Plan Amdt. Process; Sustainable Growth Rate (SGR) and other reform proposals; Reducing hospital readmissions from skilled nursing facility; The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal; MedPAC site neutral payment system for post acute care; CME proposed Rule for SNF Prospective Payment System (PPS); PL. 113-185 Impact Act of 2014; H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes; H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015; H.R. 876: Notice Act (P.L. 114-42); S.1916: The Rural Health Care Connectivity Act of 2015 (Public Law No. 114-182); H.R.4111 Rural Health Care Connectivity Act of 2015 (Public Law No. 114-182); Skilled Nursing Episodic Payment Reform.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3040, H.R. 5926, H.R. 5325, H.R. 2028, Labor, Health and Human Services Appropriations bill, FY2017 - Lobbied in support of increased funding for CMS' state survey and certification program. Discussed Medicaid per capita caps and block grants. Discussed DOJ investigation regarding findings of Olmstead and ADA violations by South Dakota. Discussed Olmstead and older adults roundtable and next steps (Administration for Community Living). Discussed arbitration provision in long-term care facility requirements final rule and related issues (no bill, Senate) and discussed final rule in general (CMS webinar). Provided information regarding Medicaid managed long-term services and supports and discussed family caregiver assessment in Medicaid home and community-based services. Discussed impending nursing home closure and resident relocation in the Virgin Islands and related issues. Discussed extension of the Money Follows the Person Rebalancing Demonstration Program. Discussed long-term services and supports financing, Social Security Caregiver Credit Act of 2015 (H.R. 3377), and family caregiving. S. 3504, Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act - Discussed and provided feedback on draft bill. PL 113-185, Participated in CMS call on the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. Discussed caregiver-focused health risk assessment in Medicare physician fee schedule final rule. Discussed AARP statement on Medicare physician fee schedule. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015 - Discussed bill. Discussed health care quality and measurement. Discussed changes to the Medicare benefit design, such as copays, premiums, and deductibles. Discussed MACRA implementation. P.L. 111-148, P.L. 111-152 - Discussed potential repeal of Affordable Care Act. S. 9 - Sent endorsement letter for the Over the Counter Hearing Aid Act of 2016.

Client expense: $2,530,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 539 and H.R.775 The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Reducing hospital readmissions from skilled nursing facility. The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 (Public Law No. 114-182) H.R.4111 Rural Health Care Connectivity Act of 2015 (Public Law No. 114-182) Skilled Nursing Episodic Payment Reform

Client expense: $930,000 · Firm income: Not reported

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

P.L. 111-148: The Patient Protection and Affordable Care Act H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S.843: Improving Access to Medicare Coverage Act of 2015. Post-acute payment and reform issues. S. 2000: The Veteran Access to Long Term Care and Health Services Act and VA Provider Agreement and Proposal Health information technology issues H.R.4111 and S.1916: Rural Health Care Connectivity Act was incorporated into H.R. 2576 - Frank R. Lautenberg Chemical Safety for the 21st Century Act (Public Law No. 114-182) Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: $930,000 · Firm income: Not reported

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

H.R. 1571/S. 843 - to require all time a Medicare beneficiary spends in a hospital to count toward the 3-day stay requirement for coverage of subsequent post-acute care - support. H.R. 1383, Medicare Adult Day Services Act, allowing home health care to be provided in a certified adult day services center - support. Support expansion of Medicare coverage of telehealth services Support H.R. 1342/S. 578, Home Health Planning Improvement Act, authorizing nurse practitioners, clinical nurse specialists and physician assistants to write orders for home health services to be covered by Medicare. Support H.R. 2704/S. 704, Community Based Independence for Seniors Act, to authorize demonstration programs under which Medicare Advantage programs could offer supplemental services. Support H.R. 3243/S. 1362, PACE Innovation Act, allowing CMS to test different PACE models, including those serving high-need individuals aged 55 and under. Oppose H.R. 3298, Medicare Post-Acute Care Value-Based Purchasing Act, which would replace the present value-based purchasing initiative for skilled nursing facilities with a new system requiring larger payment withholds. Support reauthorization and expansion of Money Follows the Person

Client expense: $40,945 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocacy with House and Senate offices on behalf of and related to proposals to improve chronic care in Medicare and elsewhere in the health care system, including the efforts of the Senate Finance Committee's Chronic Care Working Group. Advocacy with House and Senate offices on behalf of the Community based Independence for Seniors Act (S. 4212/HR 2704). Advocacy with House and Senate offices on behalf of HR 4275, the Medicare Advantage Quality Payment Relief Act. Advocacy regarding possible improvements to HR 3298, the Medicare Post-Acute Care Value-Based Purchasing Act. Advocacy on behalf of S 843/HR 1571 the Improving Access to Medicare Act of 2015. Advocacy with House and Senate offices regarding the importance of moving forward with reauthorization of the Children's Health Insurance Program. Discussion with House and Senate Committee staff regarding potential opportunities for bipartisan legislation in Medicare and Medicaid for the remainder of this Congress and during the next Congress.

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

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

Medicare Part B Premium. (No bill.) Proposals to mitigate the expected increase in the 2017 Part B premium for beneficiaries not protected by the "hold harmless" provision. Medicare Part B Enrollment. Comments on the CMS/HHS Proposed Notice of Benefit and Payment Parameters for 2018. Medicare Supplemental Insurance. H.R. 6265, the Medigap Consumer Protection Act of 2016: proposal to improve access to and improve beneficiary information about Medigap for seniors and disabled individuals in the traditional Medicare program. Medicare Affordability. S. 3371, H.R. 6109, Medicare Affordability and Enrollment Act of 2016: proposals to improve Medicare for beneficiaries by capping out-of-pocket costs in traditional Medicare; increasing financial assistance for low-income beneficiaries; aligning the Medicare Savings Programs and Low-Income Subsidy; eliminating the 24- month waiting period for Medicare coverage for people receiving Social Security Disability Insurance benefits; making changes in the enrollment period for Medicare; eliminating gaps between enrollment and when actual coverage begins; limiting the Part B late enrollment penalty; and providing permanent funding for the State Health Insurance Assistance Programs (SHIPs), Area Agencies on Aging (AAAs), Aging and Disability Resource Centers ADRCs) and the National Center for Benefits Outreach and Enrollment. Medicare Part B Enrollment. S. 3236, H.R. 5772, the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act: legislation to modernize and simplify Part B enrollment. Medicare Hearing Coverage. H.R. 1653, the Medicare Hearing Aid Coverage Act of 2015: proposal to provide Medicare coverage for the cost of hearing aids and examinations. Medicare Dental Coverage. S. 570, H.R. 1055, the Comprehensive Dental Reform Act of 2015: proposal to expand Medicare coverage to include dental care. Medicare Dental, Vision, and Hearing Coverage. H.R. 5396, H.R. 3308: Proposals to expand Medicare coverage to include comprehensive coverage of dental, vision, and hearing care. Home-based Primary Medical Care. S. 3130, Independence at Home Act of 2016: legislation to expand the Independence at Home Medicare demonstration project providing home-based primary medical care to elders with severe chronic illness and disability. Continuous Glucose Monitoring Devices. S. 804, Medicare CGM Access Act: legislation to provide Medicare coverage of continuous glucose monitoring (CGM) devices for beneficiaries with diabetes who meet specified medical criteria. Biologics Market Exclusivity Period. S. 3094, H.R. 5573, Price Relief, Innovation and Competition for Essential Drugs (PRICED) Act: legislation to reduce the market exclusivity period for biologics from its current 12 years to seven years. Drug Manufacture Transparency. S. 3335, H.R. 6043, Fair Accountability and Innovative Research Drug Pricing Act of 2016: proposal to require drug manufacturers to be more transparent about justification for increases in drug prices over ten percent, namely to report their spending on a drug's research and development as well as their profits on a drug each year since its approval. Drug Importation. H.R. 2623, the Personal Drug Importation Fairness Act: proposal to establish policies for the safe reimportation of pharmaceutical drugs by individuals for their personal use. Containment of Prescription Drug Costs. S. 2023, the Prescription Drug Affordability Act: proposals to require Medicare to negotiate drug prices under the Medicare Part D prescription drug program; allow for importation of prescription drugs from licensed Canadian pharmacies; require manufacturers to provide a rebate to the federal government for drugs covered under Medicare Part D for low-income Medicare beneficiaries; require generic drug manufacturers to pay an additional rebate to Medicaid if their drug prices rise faster than inflation; close the Medicare Part D donut hole for brand and generic drugs by 2017; and prohibit anti-competitive pay-for-delay arrangements between brand and generic drug makers. Medicare Prescription Drug Negotiation Authority. H.R. 4207, Medicare Fair Drug Pricing Act: proposal to allow the Secretary of Health and Human Services (HHS) to negotiate prices with pharmaceutical companies when drugs lack sufficient competition. Medicare Observation Status. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015: proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Medicare Privatization. (No bill.) Proposals to transform traditional Medicare to a private insurance carrier program. Medicare Eligibility Age. (No bill.) Proposals to raise the eligibility age for Medicare from 65 to 67. Medicaid Restructuring. (No bill.) Proposals to change Medicaid from an entitlement program to block grants or per capita caps, forms of lump sum payments from the federal government. Affordable Care Act (ACA) repeal. (No bill.) Proposals to repeal the ACA affecting the closing of the Medicare Part D donut hole, Medicare coverage of ACA-mandated preventive services, and payment and delivery reforms that extend the life of the Medicare Part A Trust Fund. Childrens Health Insurance Program (CHIP) extension. (No bill.) Proposal to add an extension of the Medicare therapy cap exceptions process.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), President of the U.S., SENATE, Social Security Administration (SSA), Treasury, Dept of, Vice President of the U.S.

P.L. 111-148: The Patient Protection and Affordable Care Act H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S.843: Improving Access to Medicare Coverage Act of 2015. Post-acute payment and reform issues. S. 2000: The Veteran Access to Long Term Care and Health Services Act and VA Provider Agreement and Proposal Health information technology issues H.R.4111 and S.1916: Rural Health Care Connectivity Act was incorporated into H.R. 2576 - Frank R. Lautenberg Chemical Safety for the 21st Century Act (Public Law No. 114-182) Hospitals Improvements for Payment (HIP) Act of 2014

Client expense: $950,000 · Firm income: Not reported

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

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 539 and H.R.775 The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 (Public Law No. 114-182) H.R.4111 Rural Health Care Connectivity Act of 2015 (Public Law No. 114-182) Skilled Nursing Episodic Payment Reform

Client expense: $950,000 · Firm income: Not reported

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

Issues regarding reimbursement and Medicare program issues regarding long term care and post acute care vendors, suppliers, and providers including cuts to portable x-ray providers and including the following: HR 6 21st Century Cures Initiative, Medicare Tele Health Parity Act of 2015 H.R. 2948, improving information technology interoperability, electronic prescribing, S. 1349/H.R. 876, Improving Access to Medicare Coverage Act of 2015 S.843/H.R.1571, Medicare Post-Acute Care Value-Based Purchasing H.R. 3298,Protecting Seniors Access to Medicare Act of 2015 H.R. 1190, Medical Device Tax Repeal Bill H.R. 160, Audit and Appeals Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015, Consolidated Appropriations Act.

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

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

Improving Access to Medicare Act, H.R. 1571

Client expense: $27,206 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1571/S. 843 - to require all time a Medicare beneficiary spends in a hospital to count toward the 3-day stay requirement for coverage of subsequent post-acute care - support. H.R. 1383, Medicare Adult Day Services Act, allowing home health care to be provided in a certified adult day services center - support. Support expansion of Medicare coverage of telehealth services Support H.R. 1342/S. 578, Home Health Planning Improvement Act, authorizing nurse practitioners, clinical nurse specialists and physician assistants to write orders for home health services to be covered by Medicare. Support H.R. 2704/S. 704, Community Based Independence for Seniors Act, to authorize demonstration programs under which Medicare Advantage programs could offer supplemental services. Support H.R. 3243/S. 1362, PACE Innovation Act, allowing CMS to test different PACE models, including those serving high-need individuals aged 55 and under. Oppose H.R. 3298, Medicare Post-Acute Care Value-Based Purchasing Act, which would replace the present value-based purchasing initiative for skilled nursing facilities with a new system requiring larger payment withholds. Support reauthorization and expansion of Money Follows the Person

Client expense: $40,945 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

DEA nurse agent issues; EHR and meaningful use specific to a long term care setting; Improve Access to Medicare Coverage Act S. 843/H.R. 1571; S. 1549, the Care Planning Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6-21st Century Cures Act H.R.33-Protecting Volunteer Firefighters and Emergency Responders Act H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.293-To amend title XI of the Social Security Act to exempt from manufacturer transparency reporting certain transfers used for educational purposes, and for other purposes. H.R.398-Trafficking Awareness Training for Health Care Act H.R.639-Improving Regulatory Transparency for New Medical Therapies Act H.R.647-Access to Life-Saving Trauma Care for All Americans Act H.R.648-Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.836-Health Care Safety Net Enhancement Act H.R.953-Comprehensive Addiction and Recovery Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.1641-Jason Simcakoski Memorial Opioid Safety Act H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 H.R.1818-Veteran Emergency Medical Technician Support Act of 2015 H.R.1821-Opioid Overdose Reduction Act of 2015 H.R.1854-Comprehensive Justice and Mental Health Act of 2015 H.R.1877-Mental Health First Aid Act of 2015 H.R.2050-Middle Class Health Benefits Tax Repeal Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2366-Field EMS Modernization and Innovation Act H.R.2463-Dispose Responsibly of your Pills (DROP) Act of 2015 H.R.2536-Recovery Enhancement for Addiction Treatment (TREAT) Act H.R.2603-Saving Lives, Saving Costs Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2805-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 H.R.2850-Stop Overdose Stat Act of 2015 H.R.2872-Opioid Addiction Treatment Modernization Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3014-Medical Controlled Substances Transportation Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3250-DXM Abuse Prevention Act of 2015 H.R.3299-Strengthening Public Health Emergency Response Act H.R.3537-Synthetic Drug Control Act of 2015 H.R.3677-Opioid Abuse Prevention and Treatment Act of 2015 H.R.3680-Co-Prescribing to Reduce Overdose Act of 2015 H.R.3681-Improving Access to Emergency Psychiatric Care Act H.R.3682-Reducing Employer Burdens, Unleashing Innovation, and Labor Development Act of 2015 H.R.3691-Improving Treatment for Pregnant and Postpartum Women Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.3865-Cradle Act H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4063-Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act H.R.4150-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act H.R.4365-Protecting Patient Access to Emergency Medications Act of 2016 H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.4447-Opioid and Heroin Epidemic Emergency Supplemental Appropriations Act H.R.4499-Promoting Responsible Opioid Prescribing Act of 2016 H.R.4599-Reducing Unused Medications Act of 2016 H.R.4641-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, and for other purposes. H.R.4697-Prevevent Drug Addiction Act of 2016 H.R.4771-Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R.4732-Advancing Medical Resident Training in Community Hospitals Act of 2016 H.R.5243-Zika Response Appropriations Act H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.425-Homeless Veterans' Reintegration Programs Reauthorization Act of 2015 S.453-Veteran Emergency Medical Technician Support Act of 2015 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.524-Comprehensive Addiction and Recovery Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.636-Increasing the Safety of Prescription Drug Use Act of 2015 S.707-Opioid Overdose Reduction Act of 2015 S.711-Mental Health First Act of 2015 S.763-Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.884-Health Care Safety Net Enhancement Act S.843-Improving Access to Medicare Coverage Act of 2015 S.954-FDA Accountability for Public Safety Act S.993-Comprehensive Justice and Mental Health Act of 2015 S.1134-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 S.1392-Safer Prescribing of Controlled Substances Act S.1410-Treatment and Recovery Investment Act S.1431-Prescription Drug Abuse Prevention and Treatment Act of 2015 S.1446-SOAR to Health and Wellness Act of 2015 S.1450-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.1452-Veterans Emergency Health Safety Net Expansion Act of 2015 S.1455-Recovery Enhancement for Addiction Treatment Act S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1475-Saving Lives, Saving Costs Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1654-Overdose Prevention Act S.1693-To amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment, and for other purposes. S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1893-Mental Health Awareness and Improvement Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.1945-Mental Health Reform Act of 2015 S.2002-Mental Health and Safe Communities Act of 2015 S.2045-Middle Class Health Benefits Tax Repeal Act of 2015 S.2256-Co-Prescribing Saves Lives Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2562-Heroin and Prescription Drug Abuse Prevention and Reduction Act S.2567-Preventing Overprescribing for Pain Act of 2016 S.2578-Reducing Unused Medications Act of 2016 S.2597-Medicare Mental Health Access Act S.2671-Advancing Medical Resident Training in Community Hospitals Act of 2016 S.2680-Mental Health Reform Act of 2016 S.2687-Plan of Safe Care Improvement Act S.2932-Protecting Patient Access to Emergency Medications Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016 P.L.114-10-Medicare Access and CHIP Reauthorization Act of 2015

Client expense: $512,329 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3288-Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 H.R.3291-Medicare Crosswalk Hospital Code Development Act of 2015 H.R.3292-Medicare IME Pool Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.843-Improving Access to Medicare Coverage Act of 2015 S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2680-Mental Health Reform Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016 P.L.114-10-Medicare Access and CHIP Reauthorization Act of 2015

Client expense: $512,329 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues regarding reimbursement and Medicare program issues regarding long term care and post acute care vendors, suppliers, and providers including cuts to portable x-ray providers and including the following: HR 6 21st Century Cures Initiative, Medicare Tele Health Parity Act of 2015 H.R. 2948, improving information technology interoperability, electronic prescribing, S. 1349/H.R. 876, Improving Access to Medicare Coverage Act of 2015 S.843/H.R.1571, Medicare Post-Acute Care Value-Based Purchasing H.R. 3298,Protecting Seniors Access to Medicare Act of 2015 H.R. 1190, Medical Device Tax Repeal Bill H.R. 160, Audit and Appeals Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015, Consolidated Appropriations Act.

Client expense: $44,000 · Firm income: Not reported

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

P.L. 111-148: The Patient Protection and Affordable Care Act H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S.843: Improving Access to Medicare Coverage Act of 2015. Post-acute payment and reform issues. S. 2000: The Veteran Access to Long Term Care and Health Services Act and VA Provider Agreement and Proposal Health information technology issues H.R.4111 and S.1916: Rural Health Care Connectivity Act was incorporated into H.R. 2576 - Frank R. Lautenberg Chemical Safety for the 21st Century Act (Public Law No. 114-182) Hospitals Improvements for Payment (HIP) Act of 2014

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

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

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 539 and H.R.775 The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 H.R.4111 Rural Health Care Connectivity Act of 2015 Skilled Nursing Episodic Payment Reform

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

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

H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3288-Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 H.R.3291-Medicare Crosswalk Hospital Code Development Act of 2015 H.R.3292-Medicare IME Pool Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.843-Improving Access to Medicare Coverage Act of 2015 S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2680-Mental Health Reform Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016

Client expense: $217,135 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6-21st Century Cures Act H.R.33-Protecting Volunteer Firefighters and Emergency Responders Act H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.293-To amend title XI of the Social Security Act to exempt from manufacturer transparency reporting certain transfers used for educational purposes, and for other purposes. H.R.398-Trafficking Awareness Training for Health Care Act H.R.639-Improving Regulatory Transparency for New Medical Therapies Act H.R.647-Access to Life-Saving Trauma Care for All Americans Act H.R.648-Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.836-Health Care Safety Net Enhancement Act H.R.953-Comprehensive Addiction and Recovery Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.1641-Jason Simcakoski Memorial Opioid Safety Act H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 H.R.1818-Veteran Emergency Medical Technician Support Act of 2015 H.R.1821-Opioid Overdose Reduction Act of 2015 H.R.1854-Comprehensive Justice and Mental Health Act of 2015 H.R.1877-Mental Health First Aid Act of 2015 H.R.2050-Middle Class Health Benefits Tax Repeal Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2366-Field EMS Modernization and Innovation Act H.R.2463-Dispose Responsibly of your Pills (DROP) Act of 2015 H.R.2536-Recovery Enhancement for Addiction Treatment (TREAT) Act H.R.2603-Saving Lives, Saving Costs Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2799-Furthering Access to Stroke Telemedicine (FAST) Act H.R.2805-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 H.R.2850-Stop Overdose Stat Act of 2015 H.R.2872-Opioid Addiction Treatment Modernization Act H.R.2948-Medicare Telehealth Parity Act of 2015 H.R.3014-Medical Controlled Substances Transportation Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3250-DXM Abuse Prevention Act of 2015 H.R.3299-Strengthening Public Health Emergency Response Act H.R.3537-Synthetic Drug Control Act of 2015 H.R.3677-Opioid Abuse Prevention and Treatment Act of 2015 H.R.3680-Co-Prescribing to Reduce Overdose Act of 2015 H.R.3681-Improving Access to Emergency Psychiatric Care Act H.R.3682-Reducing Employer Burdens, Unleashing Innovation, and Labor Development Act of 2015 H.R.3691-Improving Treatment for Pregnant and Postpartum Women Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.3865-Cradle Act H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4063-Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act H.R.4150-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act H.R.4365-Protecting Patient Access to Emergency Medications Act of 2016 H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.4447-Opioid and Heroin Epidemic Emergency Supplemental Appropriations Act H.R.4499-Promoting Responsible Opioid Prescribing Act of 2016 H.R.4599-Reducing Unused Medications Act of 2016 H.R.4641-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, and for other purposes. H.R.4697-Prevevent Drug Addiction Act of 2016 H.R.4771-Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R.4732-Advancing Medical Resident Training in Community Hospitals Act of 2016 H.R.5243-Zika Response Appropriations Act H.R.5273-Helping Hospitals Improve Patient Care H.R.5284-World's Greatest Healthcare Plan Act of 2016 H.R.5547-Health Care Price Transparency Promotion Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.425-Homeless Veterans' Reintegration Programs Reauthorization Act of 2015 S.453-Veteran Emergency Medical Technician Support Act of 2015 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.524-Comprehensive Addiction and Recovery Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.636-Increasing the Safety of Prescription Drug Use Act of 2015 S.707-Opioid Overdose Reduction Act of 2015 S.711-Mental Health First Act of 2015 S.763-Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.884-Health Care Safety Net Enhancement Act S.843-Improving Access to Medicare Coverage Act of 2015 S.954-FDA Accountability for Public Safety Act S.993-Comprehensive Justice and Mental Health Act of 2015 S.1134-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 S.1392-Safer Prescribing of Controlled Substances Act S.1410-Treatment and Recovery Investment Act S.1431-Prescription Drug Abuse Prevention and Treatment Act of 2015 S.1446-SOAR to Health and Wellness Act of 2015 S.1450-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.1452-Veterans Emergency Health Safety Net Expansion Act of 2015 S.1455-Recovery Enhancement for Addiction Treatment Act S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1475-Saving Lives, Saving Costs Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1654-Overdose Prevention Act S.1693-To amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment, and for other purposes. S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1893-Mental Health Awareness and Improvement Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.1945-Mental Health Reform Act of 2015 S.2002-Mental Health and Safe Communities Act of 2015 S.2045-Middle Class Health Benefits Tax Repeal Act of 2015 S.2256-Co-Prescribing Saves Lives Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2562-Heroin and Prescription Drug Abuse Prevention and Reduction Act S.2567-Preventing Overprescribing for Pain Act of 2016 S.2578-Reducing Unused Medications Act of 2016 S.2597-Medicare Mental Health Access Act S.2671-Advancing Medical Resident Training in Community Hospitals Act of 2016 S.2680-Mental Health Reform Act of 2016 S.2687-Plan of Safe Care Improvement Act S.2932-Protecting Patient Access to Emergency Medications Act of 2016 S.2985-World's Greatest Healthcare Plan Act of 2016

Client expense: $217,135 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Responded to inquiry regarding in-home supportive services programs. S. 1549, Care Planning Act - Discussed the bill and urged cosponsorship. Discussed structural changes to Medicaid. Discussed health care quality and measurement. Discussed changes to the Medicare benefit design, such as copays, premiums and deductibles. H.R.1571, Improving Access to Medicare Coverage Act - Discussed bill. S.578, Home Health Planning Improvement Act - Discussed bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to lower prescription drug costs and related agency proposed rule changes. S. 1083, H.R.2005 - Discussed legislation to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. S. 1488, H.R. 2624, Part D Beneficiary Appeals Fairness Act - Discussed bill that would allow seniors to appeal the placement of their medications on a Medicare Part D specialty tier. Discussed Medicare Part D fraud and abuse legislation including lock-in provisions for high risk enrollees. Discussed legislation to require the addition of unique device identifier (UDI) of medical devices in health insurance claim forms. Discussed the Medicare Part B prescription drug demonstration proposal from the Centers for Medicare and Medicaid Services. S. 624, H.R.1220,Removing Barriers to Colorectal Cancer Screening Act - Discussed bill. S. 3040, Labor, Health and Human Services,FY2017 - Lobbied in support of increased funding for CMS' state survey and certification program. S. 1549 - Discussed support of Care Planning Act. Discussed the Medicare Part B prescription drug benefit program and changes needed to lower prescription drug costs and related agency proposed rule changes. H.R. 5122 - Discussed the Medicare Part B prescription drug demonstration proposal. Discussed potential benefit and coverage improvements under Medicare and Medicaid Savings Programs. H.R. 2759, Mental Health Access Improvement Act - Discussed support of bill. Discussed MACRA implementation. Discussed Medicare enrollment and coverage issues such as: provider access, direct billing and penalties. S. 1719, H.R. 3099, RAISE Act - Discussed CMS' efforts regarding family caregiving. Provided feedback on advanced directive registry bill. (no bill #) Discussed independence at home legislation. S. 2961, Compassionate Care Act - Discussed our position and provided feedback. Discussed DOJ investigation regarding Olmstead and ADA violations by South Dakota and provided feedback (DOJ). Responded to inquiry regarding roundtable (ACL). S. 3096, Removing Barriers to Person-Centered Care Act of 2016 - Discussed and provided feedback. Discussed possible hearing witnesses. Discussed Medicaid HCBS spousal impoverishment bill. (no bill #) Responded to inquiry regarding MACRA rules and value modifier. Discussed Medicare's 180-day coverage of skilled nursing facility care. S. 2836, H.R. 5036, Protecting Families with Disabilities Act - Signed letter in support of bill.

Client expense: $2,060,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Congressional Budget Office (CBO), Equal Employment Opportunity Commission (EEOC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

DEA nurse agent issues; EHR and meaningful use specific to a long term care setting; Improve Access to Medicare Coverage Act S. 843/H.R. 1571;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Transition to Independence Act, S. 1604 and H.R. 5903 RAISE Family Caregivers Act, H.R. 3099 Lifespan Respite Care Reauthorization Act, H.R 3913 Older Americans Act, S. 192 and House version Improving Access to Medicare Act, H.R. 1571 21st Century CURES Act, H.R. 6 Helping Families in Mental Health Crisis Act, H.R. 2646 Accelerating Individuals into the Workplace Act, H.R. 2990 ABLE to Work Act, H.R. 4795 and S. 2702 ABLE Age Adjustment Act, H.R. 4813 an S. 2704 ABLE Financing Planning Act, H.R. 4794 and S. 2703 Mental Health Reform Act, S. 2680 Medicaid CARE Act, S. 2605 Comprehensive Addiction and Recovery Act, S. 524

Client expense: $19,436 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 775 - to permanently repeal Medicare therapy caps. Support H.R. 1571/S. 843 - to require all time a Medicare beneficiary spends in a hospital to count toward the 3-day stay requirement for coverage of subsequent post-acute care - support. H.R. 1383, Medicare Adult Day Services Act, allowing home health care to be provided in a certified adult day services center - support. Support expansion of Medicare coverage of telehealth services Support H.R. 1342/S. 578, Home Health Planning Improvement Act, authorizing nurse practitioners, clinical nurse specialists and physician assistants to write orders for home health services to be covered by Medicare. Support H.R. 2704/S. 704, Community Based Independence for Seniors Act, to authorize demonstration programs under which Medicare Advantage programs could offer supplemental services. Support H.R. 3243/S. 1362, PACE Innovation Act, allowing CMS to test different PACE models, including those serving high-need individuals aged 55 and under. Oppose H.R. 3298, Medicare Post-Acute Care Value-Based Purchasing Act, which would replace the present value-based purchasing initiative for skilled nursing facilities with a new system requiring larger payment withholds.

Client expense: $57,010 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care issues related to Medicare/Medicaid Long Term Care and Post Acute Care services and benefits. Monitor and advocate funding of Medicare/Medicaid benefits. Quality care of standards, survey and certification standards and procedures for long term care providers of Medicare/Medicaid programs; Nursing Homes, Hospice, Long Term Care Hospitals, Inpatient Rehab Facilities, and related businesses. Medicare reimbursement for skilled nursing facilities, Medicare Conditions of Participation for Hospice. H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015; H.R. 1458 - Bundling and Coordinating Post-Acute Care Act of 2015 of 2015; H.R. 1470/S. 810 - SGR Repeal and Medicare Provider Payment Modernization Act of 2015; H.R. 1571/S. 843 - Improving Access to Medicare Coverage Act of 2015; H.R. 876 - NOTICE Act; H.R. 290 - Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015; H.R. 1184 - Medicare Skilled Nursing and Home Health Services Continuity of Care Act of 2015

Client expense: $77,872 · 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

Medicare Privatization. (No bill.) Proposals to transform traditional Medicare to a private insurance carrier program. Medicare Benefit Redesign. (No bill.) Proposals pertaining to Parts A and B deductibles; premiums, including means-testing; a catastrophic cap on out-of-pocket spending; the eligibility age; and proposals to privatize Medicare. Medicare Eligibility Age. (No bill.) Proposals to raise the eligibility age for Medicare from 65 to 67. Medicare Drug Savings. S. 1083, H.R. 2005, the Medicare Drug Savings Act: proposals to extend the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by Medicare-Medicaid eligible beneficiaries (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Prescription Drug Price Negotiation. H.R. 3061, S. 31, the Medicare Prescription Drug Price Negotiation Act of 2015: proposals to authorize the Secretary of the Department of Health and Human Services to negotiate discounts, rebates, and other price concessions to lower the cost paid by Medicare to pharmaceutical manufacturers. Medicare Prescription Drug Price Negotiation. H.R. 4207, Medicare Fair Drug Pricing Act of 2015: proposal to allow the Secretary of HHS to negotiate prices with manufacturers where little or no competition exists for drugs. Medicare Prescription Drug Plan Option. H.R. 3261, S. 1884, the Medicare Prescription Drug Savings and Choice Act of 2015: proposals to create one or more Medicare-administered drug plans with uniform premiums, providing seniors with the opportunity to purchase drugs directly through the Medicare program; requires the federal government to use its purchasing power to negotiate lower prices on prescription drugs for beneficiaries who enroll in the Medicare-administered plan. Medicare Home Health Benefits. (No bill.) Proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Observation Status. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015: proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Comprehensive Health Care Reform. P.L. 111-148, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010: implementation of provisions reducing Medicare Advantage plan payments; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); expanding coverage of prevention services; testing payment and delivery system reforms; and providing expanded Medicaid coverage. Patent Reform. S. 1137, Patent Act; H.R. 9, Innovation Act: proposal to carve brand-named pharmaceutical manufacturers out of an expedited United States Patent and Trademark Office (USPTO) review process that allows generic companies to bypass costly litigation when challenging drug patents. Expanding Drug Monopolies. H.R. 6, 21st Century Cures Act: proposal to extend orphan drug market exclusivity for existing drugs to new indications. Reducing Prescription Drug Costs. S. 2023, H.R. 3513, Prescription Drug Affordability Act: proposals to allow Medicare to negotiate drug prices, to allow Medicare and Medicaid to receive additional rebates from brand and generic drugs, and to allow for the re-importation of drugs from Canada. Reducing the cost of biologics. H.R. 5573, S. 3094, Price, Innovation and Competition for Essential Drugs (PRICED) Act: proposal to reduce the marketing exclusivity period for biologics from 12 to 7 years. Drug payment under Medicare Part B. H.R. 5122, to prohibit further action on the proposed rule regarding testing of Medicare Part B prescription drug models: proposal to prohibit implementation of a proposed demonstration testing new ways of paying physicians for drugs in order to eliminate incentives to unnecessarily prescribe high cost drugs. Medicare Fraud. H.R. 5340, Fighting Medicare Fraud Act: Legislation to close off a loophole allowing Medicare fraud offenders to evade enforcement authority when they move to a new company. Out-of-pocket drug costs. S.2864, RXCAP Act of 2016: proposal to cap out-of-pocket costs for Part D enrollees. Chronic Care Coordination. (No bill.) Proposals to facilitate the delivery of high-quality care for people with Medicare living with multiple chronic conditions. Medicare Vision, Dental and Hearing Coverage. H.R. 3308, Seniors Have Eyes, Ears and Teeth Act; H.R. 5396, the Medicare Dental, Vision, and Hearing Benefit Act of 2016: proposals to provide Medicare coverage for vision, hearing and dental services. Medicare Hearing Coverage. H.R. 1653, the Medicare Hearing Aid Coverage Act of 2015; H.R. 2748, the Help Extend Auditory Relief (HEAR) Act of 2015: proposals to provide Medicare coverage for the cost of hearing aids and examinations, to amend Medicare to cover aural rehabilitation services, hearing aids, audiology rehabilitation services, and related hearing services. Medicare Dental Coverage. S. 570, H.R. 1055, the Comprehensive Dental Reform Act: proposal to extend comprehensive dental coverage to all Medicare, Medicaid, and VA beneficiaries. Medicare Care Planning. S. 1549, the Care Planning Act of 2015: proposals to create a Medicare benefit for care planning, the coordination of services, to fill gaps in quality measurement in the advanced illness field. Medicare Private Plan Notification Improvements. (No bill.) Proposals to improve the annual notification Medicare private plans promulgate to Parts C and D enrollees pertaining to plan changes that will raise enrollee costs or limit access to products and services. Medicare Part B Payment Reforms. H.R. 5122: proposals to change the way Medicare pays doctors for administering drugs to eliminate incentives to prescribe drugs based on their expense instead of clinical need. Medicare Advantage Payment Reforms. (No bill.) Proposals to eliminate discrepancies in how much Medicare pays for services for similarly situated individuals in traditional Medicare and in Medicare Advantage plans. Medicare Access and CHIP Reauthorization Act. (Public Law 114-10). Comments to CMS/HHS proposing ways the proposed rule can be strengthened to ensure the new Quality Payment Program delivers on the promise of health system transformation. Medicaid Expansion. H.R. 4588 and S. 2787: proposal to provide a higher level of federal Medicaid funding for states that did not choose to expand Medicaid when the Affordable Care Act (ACA) first launched Medicaid expansion in 2014.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), President of the U.S., SENATE, Social Security Administration (SSA), Treasury, Dept of, Vice President of the U.S.

Issues regarding reimbursement and Medicare program issues regarding long term care and post acute care vendors, suppliers, and providers including cuts to portable x-ray providers and including the following: HR 6 21st Century Cures Initiative, Medicare Tele Health Parity Act of 2015 H.R. 2948, improving information technology interoperability, electronic prescribing, S. 1349/H.R. 876, Improving Access to Medicare Coverage Act of 2015 S.843/H.R.1571, Medicare Post-Acute Care Value-Based Purchasing H.R. 3298,Protecting Seniors Access to Medicare Act of 2015 H.R. 1190, Medical Device Tax Repeal Bill H.R. 160, Audit and Appeals Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015, Consolidated Appropriations Act.

Client expense: $44,000 · Firm income: Not reported

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

DEA nurse agent issues; EHR and meaningful use specific to a long term care setting; Improve Access to Medicare Coverage Act S. 843/H.R. 1571;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

CMS Requirements of Participation Rule (Behavioral Health Services, Transitions of Care, Pharmacy Services, Physician Services, Nursing Services, Compliance and Ethics Program, new staffing requirements, Quality Assurance and Performance Improvement, Arbitration agreements); Improving Access to Medicare Coverage Act (H.R. 1571/S. 843) entire legislation; CMS Rule: Medicare and Medicaid Programs (Revisions to requirements of discharge planning for hospitals, critical access hospitals, and home health agencies).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148: The Patient Protection and Affordable Care Act H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S.843: Improving Access to Medicare Coverage Act of 2015. Post-acute payment and reform issues. S. 2000: The Veteran Access to Long Term Care and Health Services Act and VA Provider Agreement and Proposal Health information technology issues S.1916: The Rural Health Care Connectivity Act of 2015 H.R.4111 Rural Health Care Connectivity Act of 2015 Hospitals Improvements for Payment (HIP) Act of 2014

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

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

H.R.6 - 21st Century Cures Act H.R.3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 S.2148 - A bill to amend title XVIII of the Social Security Act to prevent an increase in the Medicare part B premium and deductible in 2016 H.R.3696 - Medicare Premium Fairness Act of 2015 P.L. 111-148: The Patient Protection and Affordable Care Act. H.R. 4302: Protecting Access to Medicare Act of 2014 (PL 113-93) on 4.1.2014 H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S. 843: Improving Access to Medicare Coverage Act of 2015. S. 539 and H.R.775 The Medicare Access to Rehabilitation Services Act. H.R. 290: The Creating Access to Rehabilitation for Every Senior (CARES ACT). S. 1932: A bill to amend title XVIII of the Social Security Act to establish a Medicare Better Care Program. Protect and Preserve Medicaid Provider Assessment. Protect and Preserve Medicare Bad Debt Reimbursement Improving the CMS State Plan Amdt. Process. Sustainable Growth Rate (SGR) and other reform proposals. Reducing hospital readmissions from skilled nursing facility. The Veteran Access to Long Term Care and Health Services Act (S.2000) and VA Provider Agreement and Proposal MedPAC site neutral payment system for post acute care. CME proposed Rule for SNF Prospective Payment System (PPS). PL. 113-185 Impact Act of 2014 H.R. 952: To amend titles XVIII and XIX of the Social Security Act to establish a minimum direct care registered nurse staffing requirement at nursing facilities and skilled nursing facilities under Medicare and Medicaid and for other purposes. H.R. 2: Medicare Access & CHIP Reauthorization Act of 2015 H.R. 876: Notice Act (P.L. 114-42) S.1916: The Rural Health Care Connectivity Act of 2015 H.R.4111 Rural Health Care Connectivity Act of 2015 Skilled Nursing Episodic Payment Reform

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

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

Responded to inquiry regarding in-home supportive services programs. (no bill #) S. 1549, Care Planning Act - Discussed the bill and urged cosponsorship. Discussed structural changes to Medicaid. (no bill #) Discussed health care quality and measurement. (no bill #) Discussed changes to the Medicare benefit design, such as copays, premiums and deductibles. (no bill #) Discussed Personalize Your Care Act and provided feedback. (no bill #) Discussed Money Follows the Person Rebalancing Demonstration. (no bill #) Made inquiry regarding DC Medicaid HCBS waiver. (no bill #) S. 1085, Military and Veteran Caregiver Services Improvement Act - Discussed bill. H.R. 4878, Better Care Lower Cost Act - Discussed bill. Discussed spousal impoverishment in Medicaid. (no bill #) H.R. 4059, S.2297, Medicare Choices Empowerment and Protection Act - Provided feedback on bill. H.R. 3298, Medicare Post-Acute Care Value-Based Purchasing Act - Discussed feedback and next steps. (no bill #) Inquired regarding final rule on discharge planning. (no bill #) H.R.1571, Improving Access to Medicare Coverage Act - Discussed bill. Discussed retroactive eligibility for Medicaid HCBS (no bill #) Discussed observations status issues. (no bill #) S.578, Home Health Planning Improvement Act - Discussed bill and urged cosponsorship. Discussed the Medicare Part D prescription drug benefit program and changes needed to lower prescription drug costs and related agency proposed rule changes. (no bill #) H.R.2005, S.1083 - Discussed legislation to require drug manufacturers to provide rebates for drugs provided to Medicare Part D low-income subsidy beneficiaries, including those who are dually eligible for Medicare and Medicaid. H.R. 2624, S.1488, Part D Beneficiary Appeals Fairness Act- Discussed bill that would allow seniors to appeal the placement of their medications on a Medicare Part D specialty tier. Discussed Medicare Part D fraud and abuse legislation including lock-in provisions for high risk enrollees. (no bill #) Discussed legislation to require the addition of unique device identifier (UDI) of medical devices in health insurance claim forms. Discussed the Medicare Part B prescription drug demonstration proposal from the Centers for Medicare and Medicaid Services. H.R.1220, S.624, Removing Barriers to Colorectal Cancer Screening Act - Discussed bill. Discussed Medicare site of service payment policy. (no bill #) H.R. 4442,S.2484,CONNECT Act - Sent letter of endorsement. Discussed Medicare coverage and reimbursement of cataract surgery. Labor, Health and Human Services,FY2017 - Lobbied in support of increased funding for CMS' state survey and certification program. (no bill #)

Client expense: $1,830,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Congressional Budget Office (CBO), Equal Employment Opportunity Commission (EEOC), Federal Transit Administration (FTA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), Veterans Affairs, Dept of (VA), White House Office

Health care issues related to Medicare/Medicaid Long Term Care and Post Acute Care services and benefits. Monitor and advocate funding of Medicare/Medicaid benefits. Quality care of standards, survey and certification standards and procedures for long term care providers of Medicare/Medicaid programs; Nursing Homes, Hospice, Long Term Care Hospitals, Inpatient Rehab Facilities, and related businesses. Medicare reimbursement for skilled nursing facilities, Medicare Conditions of Participation for Hospice. H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015; H.R. 1458 - Bundling and Coordinating Post-Acute Care Act of 2015 of 2015; H.R. 1470/S. 810 - SGR Repeal and Medicare Provider Payment Modernization Act of 2015; H.R. 1571/S. 843 - Improving Access to Medicare Coverage Act of 2015; H.R. 876 - NOTICE Act; H.R. 290 - Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015; H.R. 1184 - Medicare Skilled Nursing and Home Health Services Continuity of Care Act of 2015

Client expense: $77,872 · 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

Improving Access to Medicare Coverage Act, S.843/H.R. 1571

Client expense: $24,367 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3288-Strengthening DSH and Medicare Through Subsidy Recapture and Payment Reform Act of 2015 H.R.3291-Medicare Crosswalk Hospital Code Development Act of 2015 H.R.3292-Medicare IME Pool Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.843-Improving Access to Medicare Coverage Act of 2015 S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2680-Mental Health Reform Act of 2016

Client expense: $661,366 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6-21st Century Cures Act H.R.33-Protecting Volunteer Firefighters and Emergency Responders Act H.R.290-Creating Access to Rehabilitation for Every Senior (CARES) Act of 2015 H.R.293-To amend title XI of the Social Security Act to exempt from manufacturer transparency reporting certain transfers used for educational purposes, and for other purposes. H.R.398-Trafficking Awareness Training for Health Care Act H.R.639-Improving Regulatory Transparency for New Medical Therapies Act H.R.647-Access to Life-Saving Trauma Care for All Americans Act H.R.648-Trauma Systems and Regionalization of Emergency Care Reauthorization Act H.R.836-Health Care Safety Net Enhancement Act H.R.953-Comprehensive Addiction and Recovery Act of 2015 H.R.1190-Protecting Seniors Access to Medicare Act of 2015 H.R.1571-Improving Access to Medicare Coverage Act of 2015 H.R.1641-Jason Simcakoski Memorial Opioid Safety Act H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 H.R.1818-Veteran Emergency Medical Technician Support Act of 2015 H.R.1821-Opioid Overdose Reduction Act of 2015 H.R.1854-Comprehensive Justice and Mental Health Act of 2015 H.R.1877-Mental Health First Aid Act of 2015 H.R.2050-Middle Class Health Benefits Tax Repeal Act of 2015 H.R.2298-Medicare Patient Safety and Drug Abuse Prevention Act H.R.2366-Field EMS Modernization and Innovation Act H.R.2463-Dispose Responsibly of your Pills (DROP) Act of 2015 H.R.2536-Recovery Enhancement for Addiction Treatment (TREAT) Act H.R.2603-Saving Lives, Saving Costs Act H.R.2646-Helping Families in Mental Health Crisis Act of 2015 H.R.2805-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 H.R.2850-Stop Overdose Stat Act of 2015 H.R.2872-Opioid Addiction Treatment Modernization Act H.R.3014-Medical Controlled Substances Transportation Act of 2015 H.R.3081-TELEmedicine for MEDicare (TELE-MED) Act of 2015 H.R.3250-DXM Abuse Prevention Act of 2015 H.R.3379-Airplane Kids In Transit Safety (KITS) Act of 2015 H.R.3537-Synthetic Drug Control Act of 2015 H.R.3677-Opioid Abuse Prevention and Treatment Act of 2015 H.R.3680-Co-Prescribing to Reduce Overdose Act of 2015 H.R.3681-Improving Access to Emergency Psychiatric Care Act H.R.3682-Reducing Employer Burdens, Unleashing Innovation, and Labor Development Act of 2015 H.R.3691-Improving Treatment for Pregnant and Postpartum Women Act of 2015 H.R.3762-Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 H.R.3770-End Surprise Billing Act of 2015 H.R.3865-Cradle Act H.R.4059-Medicare Choices Empowerment and Protection Act H.R.4063-Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act H.R.4150-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act H.R.4365-Protecting Patient Access to Emergency Medications Act of 2016 H.R.4435-Comprehensive Behavioral Health Reform and Recovery Act of 2016 H.R.4447-Opioid and Heroin Epidemic Emergency Supplemental Appropriations Act H.R.4499-Promoting Responsible Opioid Prescribing Act of 2016 H.R.4599-Reducing Unused Medications Act of 2016 H.R.4641-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, and for other purposes. H.R.4697-Prevevent Drug Addiction Act of 2016 H.R.4771-Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 S.141-Protecting Seniors Access to Medicare Act of 2015 S.425-Homeless Veterans' Reintegration Programs Reauthorization Act of 2015 S.453-Veteran Emergency Medical Technician Support Act of 2015 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.524-Comprehensive Addiction and Recovery Act of 2015 S.599-Improving Access to Emergency Psychiatric Care Act S.636-Increasing the Safety of Prescription Drug Use Act of 2015 S.707-Opioid Overdose Reduction Act of 2015 S.711-Mental Health First Act of 2015 S.763-Trauma Systems and Regionalization of Emergency Care Reauthorization Act S.884-Health Care Safety Net Enhancement Act S.843-Improving Access to Medicare Coverage Act of 2015 S.954-FDA Accountability for Public Safety Act S.993-Comprehensive Justice and Mental Health Act of 2015 S.1134-Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 S.1392-Safer Prescribing of Controlled Substances Act S.1410-Treatment and Recovery Investment Act S.1431-Prescription Drug Abuse Prevention and Treatment Act of 2015 S.1446-SOAR to Health and Wellness Act of 2015 S.1450-Department of Veterans Affairs Emergency Medical Staffing Recruitment and Retention Act S.1452-Veterans Emergency Health Safety Net Expansion Act of 2015 S.1455-Recovery Enhancement for Addiction Treatment Act S.1475-Saving Lives, Saving Costs Act S.1549-Care Planning Act of 2015 S.1648-Rural Emergency Acute Care Hospital (REACH) Act S.1654-Overdose Prevention Act S.1693-To amend title 38, United States Code, to expand eligibility for reimbursement for emergency medical treatment to certain veterans that were unable to receive care from the Department of Veterans Affairs in the 24-month period preceding the furnishing of such emergency treatment, and for other purposes. S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.1893-Mental Health Awareness and Improvement Act of 2015 S.1913-Stopping Medication Abuse and Protecting Seniors Act of 2015 S.1945-Mental Health Reform Act of 2015 S.2002-Mental Health and Safe Communities Act of 2015 S.2045-Middle Class Health Benefits Tax Repeal Act of 2015 S.2256-Co-Prescribing Saves Lives Act of 2015 S.2297-Medicare Choices Empowerment and Protection Act S.2525-Expand Excellence in Mental Health Act S.2562-Heroin and Prescription Drug Abuse Prevention and Reduction Act S.2567-Preventing Overprescribing for Pain Act of 2016 S.2578-Reducing Unused Medications Act of 2016 S.2597-Medicare Mental Health Access Act S.2680-Mental Health Reform Act of 2016 S.2687-Plan of Safe Care Improvement Act

Client expense: $661,366 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 775 - to permanently repeal Medicare therapy caps. Support H.R. 1571/S. 843 - to require all time a Medicare beneficiary spends in a hospital to count toward the 3-day stay requirement for coverage of subsequent post-acute care - support. H.R. 1383, Medicare Adult Day Services Act, allowing home health care to be provided in a certified adult day services center - support. Support expansion of Medicare coverage of telehealth services Support H.R. 1342/S. 578, Home Health Planning Improvement Act, authorizing nurse practitioners, clinical nurse specialists and physician assistants to write orders for home health services to be covered by Medicare. Support H.R. 2704/S. 704, Community Based Independence for Seniors Act, to authorize demonstration programs under which Medicare Advantage programs could offer supplemental services. Support H.R. 3243/S. 1362, PACE Innovation Act, allowing CMS to test different PACE models, including those serving high-need individuals aged 55 and under. Oppose H.R. 3298, Medicare Post-Acute Care Value-Based Purchasing Act, which would replace the present value-based purchasing initiative for skilled nursing facilities with a new system requiring larger payment withholds.

Client expense: $25,866 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Privatization. (No bill.) Proposals to transform traditional Medicare to a private insurance carrier program. Medicare Benefit Redesign. (No bill.) Proposals pertaining to Parts A and B deductibles; premiums, including means-testing; a catastrophic cap on out-of-pocket spending; the eligibility age; and proposals to privatize Medicare. Medicare Eligibility Age. (No bill.) Proposals to raise the eligibility age for Medicare from 65 to 67. Medicare Drug Savings. S. 1083, H.R. 2005, the Medicare Drug Savings Act: proposals to extend the application of Medicaid drug rebates to prescription drugs paid for by Medicare and used by Medicare-Medicaid eligible beneficiaries (dual-eligibles), and by people receiving the Medicare Part D Low-Income Subsidy. Medicare Prescription Drug Price Negotiation. H.R. 3061, S. 31, the Medicare Prescription Drug Price Negotiation Act of 2015: proposals to authorize the Secretary of the Department of Health and Human Services to negotiate discounts, rebates, and other price concessions to lower the cost paid by Medicare to pharmaceutical manufacturers. Medicare Prescription Drug Price Negotiation. H.R. 4207, Medicare Fair Drug Pricing Act of 2015: proposal to allow the Secretary of HHS to negotiate prices with manufacturers where little or no competition exists for drugs. Medicare Prescription Drug Plan Option. H.R. 3261, S. 1884, the Medicare Prescription Drug Savings and Choice Act of 2015: proposals to create one or more Medicare-administered drug plans with uniform premiums, providing seniors with the opportunity to purchase drugs directly through the Medicare program; requires the federal government to use its purchasing power to negotiate lower prices on prescription drugs for beneficiaries who enroll in the Medicare-administered plan. Medicare Home Health Benefits. (No bill.) Proposals pertaining to copayments for beneficiaries receiving the Medicare home health benefit. Medicare Observation Status. S. 843, H.R. 1571, Improving Access to Medicare Coverage Act of 2015: proposal to count days in the hospital in observation status toward meeting the three-day prior hospitalization requirement for skilled nursing facility (SNF) care eligibility. Comprehensive Health Care Reform. P.L. 111-148, Patient Protection and Affordable Care Act; P.L. 111-152, Health Care and Education Reconciliation Act of 2010: implementation of provisions reducing Medicare Advantage plan payments; requiring higher income Medicare beneficiaries to pay an increased share of Medicare Parts B and D premium costs; expanding benefits for low-income beneficiaries under the Medicare Savings Programs and the Part D Low-Income Subsidy (LIS); expanding coverage of prevention services; testing payment and delivery system reforms; and providing expanded Medicaid coverage. Patent Reform. S. 1137, Patent Act; H.R. 9, Innovation Act: proposal to carve brand-named pharmaceutical manufacturers out of an expedited United States Patent and Trademark Office (USPTO) review process that allows generic companies to bypass costly litigation when challenging drug patents. Expanding Drug Monopolies. H.R. 6, 21st Century Cures Act: proposal to extend orphan drug market exclusivity for existing drugs to new indications. Reducing Prescription Drug Costs. S. 2023, H.R. 3513, Prescription Drug Affordability Act: proposals to allow Medicare to negotiate drug prices, to allow Medicare and Medicaid to receive additional rebates from brand and generic drugs, and to allow for the re-importation of drugs from Canada. Chronic Care Coordination. (No bill.) Proposals to facilitate the delivery of high-quality care for people with Medicare living with multiple chronic conditions. Medicare Vision, Dental and Hearing Coverage. H.R. 3308, Seniors Have Eyes, Ears and Teeth Act: proposal to provide Medicare coverage for vision, hearing and dental services. Medicare Hearing Coverage. H.R. 1653, the Medicare Hearing Aid Coverage Act of 2015: proposal to provide Medicare coverage for the cost of hearing aids and examinations. Medicare Dental Coverage. S. 570, H.R. 1055, the Comprehensive Dental Reform Act: proposal to extend comprehensive dental coverage to all Medicare, Medicaid, and VA beneficiaries. Medicare Part B Premium and Deductible Increase. S. 2148, Protecting Medicare Beneficiaries Act of 2015; H.R. 3696, Medicare Premium Fairness Act of 2015 and P.L. 114-74: proposals to prevent steep increases in Medicare Part B premiums and deductibles in 2016. Medicare Care Planning. S. 1549, the Care Planning Act of 2015: proposals to create a Medicare benefit for care planning, the coordination of services, to fill gaps in quality measurement in the advanced illness field, and to include advanced care planning information in the Medicare & You handbook. Medicare Private Plan Notification Improvements. (No bill.) Proposals to improve the annual notification Medicare private plans promulgate to Parts C and D enrollees pertaining to plan changes that will raise enrollee costs or limit access to products and services. Medicare Part B Payment Reforms. (No bill.) Proposals to change the way Medicare pays doctors for administering drugs to eliminate incentives to prescribe drugs based on their expense instead of clinical need. Medicare Advantage Payment Reforms. (No bill.) Proposals to eliminate discrepancies in how much Medicare pays for services for similarly situated individuals in traditional Medicare and in Medicare Advantage plans.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Office of Management & Budget (OMB), President of the U.S., SENATE, Social Security Administration (SSA), Treasury, Dept of, Vice President of the U.S.

Medicaid Reform; Medicare Reform, Affordable Care Act Implementation related to Medicaid & Medicare; Transition to Independence Act; Improving Medicare Post Acute Transformation (IMPACT) Act; Improving Access to Medicare Coverage Act (S.843/H.R. 1571); Medicaid Coverage for Addiction Recovery Expansion (CARE) Act (S.2605)

Client expense: $263,975 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, State, Dept of (DOS), Treasury, Dept of, White House Office

Medicaid; Medicare; Older Americans Act Reauthorization Act; Health Reform Implementation; economic stimulus initiatives related to healthcare; Health Information Technology; Disability issues; Holocaust Survivor Aging Issues; Long-Term Care Financing and Delivering Reform; Behavioral Health Information Technology; HR 3913 Lifespan Respite Care Reauthorization Act of 2015; Recognize, Assist, Include, Support, Engage (RAISE) Family Caregivers Act; Improving Access to Medicare Coverage Act (S.843/H.R. 1571);Comprehensive Mental Health Reform Legislation (H.R. 2646/S.1945/S.2680); BHIT (H.R. 2646/S.1945; IMPACT Act; Medicaid Coverage for Addiction Recovery Expansion (CARE) Act (S.2605); CONNECT for Health Act (S. 2484/H.R. 4442); Excellence in Mental Health Act (S.2525/H.R. 4567); Mental Health Awareness Semipostal Stamp Act (H.R. 3640)

Client expense: $263,975 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), SENATE, State, Dept of (DOS), Treasury, Dept of, White House Office

P.L. 111-148 Patient Protection and Affordable Care Act: Employer responsibility requirements, treatment of excepted benefits P.L. 111-152 Health Care and Education Reconciliation Act of 2010: Employer responsibility requirements, treatment of excepted benefits Repeal of the Affordable Care Act excise tax on high cost plans; provisions repealing the excise tax on employer-based high cost health plans, H.R. 3999 FMLA 2014 Prescription drug prices H.R. 2712 Common Sense Reporting Act OSHA's Infections Disease Rulemaking Regulatory: safety and health H.R. 1786/S.928 James Zadroga 9/11 Health and Compensation Reauthorization Act: coverage, funding H.R.2050 Middle Class Health Benefits Tax Repeal Act of 2015: Provisions repealing the tax on high cost health care plans H.R.30/ S. 30 Save American Workers Act of 2015: Change of hours threshold from 30 to 40 for required offer of health coverage by employer S.Con.Res.11 An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2016 and setting forth the appropriate budgetary levels for fiscal years 2017 through 2025: Amendments that would allow for a change in the definition of full time employee for the purposes of the ACA and exempting educational employers from the employer mandate S.568 Trade Adjustment Assistance Act of 2015: Provisions related to extension of the Health Coverage Tax Credit S.1005 A bill to amend the Internal Revenue Code of 1986 to extend and modify the credit for health insurance costs of certain eligible individuals, and for other purposes: Provisions related to extension of the Health Coverage Tax Credit S.1083/ H.R. 2005 Medicare Drug Savings Act of 2015: Provisions that would apply the Medicaid drug rebate to drugs for Medicare LIS beneficiaries H.R.2712 Commonsense Reporting and Verification Act of 2015: Provisions reducing employers' requirements to report compliance with the ACA employer responsibility requirement H.R.1974 HEAL for Immigrant Women and Families Act of 2015: Provisions expanding Medicaid and ACA premium subsidy eligibility for immigrants H.R.1571 Improving Access to Medicare Coverage Act of 2015: Provisions defining inpatient stay for Medicare reimbursement H.R.1650 Medicare Patient Empowerment Act of 2015: Provisions allowing physicians to charge Medicare beneficiaries fees that exceed Medicare's reimbursement for services

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

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Vice President of the United States, Pension Benefit Guaranty Corporation (PBGC), SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R. 1650, Medicare Patient Empowerment Act of 2015, all provisions H.R. 2, Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, all provisions H.R. 1470, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, all provisions S. 810, SGR Repeal and Medicare Provider Payment Modernization Act of 2015, all provisions H.R. 1892, Trade Adjustment Assistance (TAA) Reauthorization Act of 2015, provisions relating to Medicare Sequestration Offset S. 1268, Trade Adjustment Assistance (TAA) Reauthorization Act of 2015, provisions relating to Medicare Sequestration Offset H.R. 1295, Trade Preferences Extension Act of 2015, provisions relating to Medicare cuts H.R. 1314, Trade Act of 2015, provisions relating to Medicare sequester H.R. 1190, Protecting Seniors' Access to Medicare Act of 2015, provisions relating to IPAB repeal H.R. 1220, Removing Barriers to Colorectal Cancer Screening Act of 2015, all provisions S. 624, Removing Barriers to Colorectal Cancer Screening Act of 2015, all provisions S. 1549, Care Planning Act of 2015, all provisions H.R. 2102, Medicare Diabetes Prevention Act of 2015, all provisions S. 1131, Medicare Diabetes Prevention Act of 2015, all provisions H.R. 2126, Cutting Costly Codes Act of 2015, all provisions H.R. 1571, Improving Access to Medicare Coverage Act of 2015, all provisions S. 843, Improving Access to Medicare Coverage Act of 2015, all provisions H.R. 2404, Treat and Reduce Obesity Act of 2015, all provisions S. 1509, Treat and Reduce Obesity Act of 2015, all provisions H.R. 270, Flexibility in Health IT Reporting (Flex-IT) Act of 2015, all provisions S. 1549, Care Planning Act of 2015, all provisions H.R. 2247, ICD-TEN Act, all provisions S. 488, A bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs, all provisions H.R. 1021, Protecting the Integrity of Medicare Act of 2015, provisions relating to Medicare pharmacy and physician lock-in Stopping Medication Abuse and protecting Seniors Act of 2015 draft legislation, provisions related to Medicare lock-in Audit and Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 draft legislation Medicare program: Alternate payment models, merit-based incentive payment systems Medicare program: Two Midnights rule Medicare program: Private Contracting Medicare program: ICD-10 Repeal Medicare program: SGR Repeal Medicare program: ICD-10 transition Medicare program: Payment Reform - Means Testing; Medigap Reform Medicare program: EHR - Meaningful Use/Interoperability Medicare program: Meaningful Use, Stage 3 Medicare program: Meaningful Use - Certification, Physician Quality Reporting System, Physician Compare, penalties Medicare program: Advance care planning Medicare program: Medicare Appeals Backlog Medicare program: Recovery Audit Contractors Medicare program: Part D Coverage Medicare program: Part D Beneficiary Lock-in Medicare program: Part B drug payment policies Medicare program: Value-based Modifier Medicare program: Relative Value Update Committee (RUC) Medicare program: ICD-10 Implementation Medicare program: Chronic Care Medicare program: In-office Ancillary Services Exception Medicare program: Program Integrity Medicare program: Laboratory Developed Tests (LDTs) Medicare program: Shared Savings Program - ACO regulations Medicare program: Annual Wellness Visit Medicare program: Telehealth Medicare program: Quality measure development funding Medicare program: Medicare Advantage/transparency and beneficiary and provider protections Medicare program: Data Release Medicare program: HIPAA Administrative simplification (ICD-10, EFT, virtual credit cards) Medicare program: CLIA modernization Medicare program: Graduate Medical Education Medicare program: Global surgical services unbundling Medicare program: Physician-owned hospitals Medicare program: Sequester Medicare program: Alternative payment models Medicare program: Prescription drug diversion Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act implementation Medicare and Medicaid programs: Primary care payment

Client expense: $5,680,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), SENATE, White House Office

P.L. 111-148: The Patient Protection and Affordable Care Act H.R. 1571: Improving Access to Medicare Coverage Act of 2015. S.843: Improving Access to Medicare Coverage Act of 2015. Post-acute payment and reform issues. S. 2000: The Veteran Access to Long Term Care and Health Services Act and VA Provider Agreement and Proposal Health information technology issues S.1916: The Rural Health Care Connectivity Act of 2015 H.R.4111 Rural Health Care Connectivity Act of 2015 Hospitals Improvements for Payment (HIP) Act of 2014

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

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