Medicare Telehealth Parity Act of 2015

Health Care Reform Implementation & Taxation of Medical Technology Devices e.g. (Patient Protection and Affordable Care Act (H.R. 3590/P.L. 11-148); Health Care and Education Reconciliation Act (H.R. 4872/P.L. 11-152), the Protect Medical Innovation Act (H.R. 160/S. 149); The Medicare Access and CHIP Reauthorization Act (H.R. 2). Telemedicine and connected care; remote patient monitoring including: Medicare Telehealth Parity Act (H.R. 2948); CONNECT for Health Act (S. 2484/HR 4442); Diabetic Eye Disease Prevention Act (H.R. 4642). Safe Patient Handling, FDA Reform, Technology research.

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE, Vice President of the U.S., White House Office

Health Care Reform Implementation & Taxation of Medical Technology Devices e.g. (Patient Protection and Affordable Care Act (H.R. 3590/P.L. 11-148); Health Care and Education Reconciliation Act (H.R. 4872/P.L. 111-152), the Protect Medical Innovation Act (H.R. 1041/S.108); The Medicare Access and CHIP Reauthorization Act (H.R. 2). Telemedicine and connected care; remote patient monitoring including: Medicare Telehealth Parity Act (H.R. 2948); CONNECT for Health Act (S. 2484/HR 4442); Diabetic Eye Disease Prevention Act (H.R. 4642). Safe Patient Handling, FDA Reform, Technology research.

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE, Vice President of the U.S., White House Office

H.R. 2948, "Medicare Telehealth Parity Act" , regarding all provisions. S.934, "FDA Reauthorization Act of 2017", regarding all provision. Issues relating to Home Dialysis Expansion Legislation. H.R.1245, "Affordable and Safe Prescription Drug Importation Act", regarding all provisions. H.R.1628, "American Health Care Act of 2017", regarding all provisions. H.R. 1628, "Better Care Reconciliation Act of 2017", regarding all provisions. S.1016, "CONNECT for Health Act of 2017", regarding all provisions. Issues related to ESRD Reimbursement for Hemodialysis. H.R.28, "Biological Implant Tracking and Veteran Safety Act of 2017", regarding all provisions. Implementation of the 21st Century Cures regulations. Issues relating to 340B Drug Pricing.

Client expense: $430,000 · Firm income: Not reported

Government targets: Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

Health Care Reform Implementation & Taxation of Medical Technology Devices e.g. (Patient Protection and Affordable Care Act (H.R. 3590/P.L. 11-148); Health Care and Education Reconciliation Act (H.R. 4872/P.L. 11-152), the Protect Medical Innovation Act (H.R. 160/S. 149); The Medicare Access and CHIP Reauthorization Act (H.R. 2). Telemedicine and connected care; remote patient monitoring including: Medicare Telehealth Parity Act (H.R. 2948); CONNECT for Health Act (S. 2484/HR 4442); Diabetic Eye Disease Prevention Act (H.R. 4642). Safe Patient Handling, FDA Reform, Technology research.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE, Vice President of the U.S., White House Office

Health Care Reform Implementation & Taxation of Medical Technology Devices e.g. (Patient Protection and Affordable Care Act (H.R. 3590/P.L. 11-148); Health Care and Education Reconciliation Act (H.R. 4872/P.L. 11-152), the Protect Medical Innovation Act (H.R. 160/S. 149); The Medicare Access and CHIP Reauthorization Act (H.R. 2). Telemedicine and connected care; remote patient monitoring including: Medicare Telehealth Parity Act (H.R. 2948); CONNECT for Health Act (S. 2484/HR 4442); Diabetic Eye Disease Prevention Act (H.R. 4642). Safe Patient Handling, FDA Reform, Technology research.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE, Vice President of the U.S., White House Office

HR 2948, "Medicare Telehealth Parity Act" , regarding all provisions. S.934, "FDA Reauthorization Act of 2017", regarding all provision. Issues relating to Home Dialysis Expansion Legislation. H.R.1245, "Affordable and Safe Prescription Drug Importation Act", regarding all provisions. H.R.1628, "American Health Care Act of 2017", regarding all provisions. H.R. 1628, "Better Care Reconciliation Act of 2017", regarding all provisions. S.1016, "CONNECT for Health Act of 2017", regarding all provisions. Issues related to ESRD Reimbursement for Hemodialysis. H.R.28, "Biological Implant Tracking and Veteran Safety Act of 2017", regarding all provisions. Implementation of the 21st Century Cures regulations. Issues relating to 340B Drug Pricing.

Client expense: $670,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Care Reform Implementation & Taxation of Medical Technology Devices e.g. (Patient Protection and Affordable Care Act (H.R. 3590/P.L. 11-148); Health Care and Education Reconciliation Act (H.R. 4872/P.L. 11-152), the Protect Medical Innovation Act (H.R. 160/S. 149); The Medicare Access and CHIP Reauthorization Act (H.R. 2). Telemedicine and connected care; remote patient monitoring including: Medicare Telehealth Parity Act (H.R. 2948); CONNECT for Health Act (S. 2484/HR 4442); Diabetic Eye Disease Prevention Act (H.R. 4642). Safe Patient Handling, FDA Reform, Technology research.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE, Vice President of the U.S., White House Office

Health Care Reform Implementation & Taxation of Medical Technology Devices e.g. (Patient Protection and Affordable Care Act (H.R. 3590/P.L. 11-148); Health Care and Education Reconciliation Act (H.R. 4872/P.L. 11-152), the Protect Medical Innovation Act (H.R. 160/S. 149); The Medicare Access and CHIP Reauthorization Act (H.R. 2). Telemedicine and connected care; remote patient monitoring including: Medicare Telehealth Parity Act (H.R. 2948); CONNECT for Health Act (S. 2484/HR 4442); Diabetic Eye Disease Prevention Act (H.R. 4642). Safe Patient Handling, FDA Reform, Technology research.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of the Vice President of the United States, SENATE, Vice President of the U.S., White House Office

Raise awareness with legislators about the barriers to and the importance of protecting access for home dialysis. S. 598 / H.R. 1130, "Chronic Kidney Disease Improvement in Research and Treatment Act of 2015", regarding all provisions. H.R. 2948, "Medicare Tele-health Parity Act of 2015", regarding all provisions. S. 2484, "CONNECT for Health Act", regarding all provisions. S. 3504, "Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016", regarding all provisions. Medicare ESRD reimbursement for hemodialysis.

Client expense: $500,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1465 / HR 2799: Furthering Access to Stroke Telemedicine (FAST) Act S. 2484 / HR 4442: CONNECT for Health Act; Section 303 S.3504: CHRONIC Care Act of 2016 HR 2948: Medicare Telehealth Parity Act of 2015, Section 105(a)(1) HR 5122: To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models. Preservation of the in-office ancillary exception to the Stark law; urging changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1465 / HR 2799: Furthering Access to Stroke Telemedicine (FAST) Act S. 2484 / HR 4442: CONNECT for Health Act; Section 303 HR 2948: Medicare Telehealth Parity Act of 2015, Section 105(a)(1) HR 5122: To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models. Preservation of the in-office ancillary exception to the Stark law; urging changes to the Meaningful Use Program and Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2511: Improving Health Information Technology Act S. 1465 / HR 2799: Furthering Access to Stroke Telemedicine (FAST) Act S. 2484: HR 4442: CONNECT for Health Act; Section 303 S. 2978: Protect Continuing Physician Education and Patient Care Act HR 2948: Medicare Telehealth Parity Act of 2015, Section 105(a)(1) HR 5122: To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models. Preservation of the in-office ancillary exception to the Stark law; urging changes to the Meaningful Use Program and Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Client expense: $280,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE

S. 737/ H.R. 2253: Ensuring Access to Primary Care for Women & Children Act S. 849 / H.R. 292: The Advancing Research for Neurological Diseases Act S. 1465 / H.R. 2799: Furthering Access to Stroke Telemedicine (FAST) Act S. 2118: Ensuring Enhanced Access to Primary Care Act S. 2484/ H.R. 4442: CONNECT for Health Act; Section 303 H.R. 2948: Medicare Telehealth Parity Act of 2015, Section 105(a)(1) Preservation of the in-office ancillary exception to the Stark law; urging changes to the Meaningful Use Program.

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

Government targets: HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE

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

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

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

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

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

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

HR556/S313, Prevent Interruptions to Physical Therapy: adding physical therapists to the Medicare locum tenens program; channeling grassroots support for this bill's inclusion in the 21st Century Cures legislation. HR775/S539, Medicare Access to Rehabilitation Services: to repeal the monetary cap on physical therapy for Medicare beneficiaries. HR2948, Medicare Telehealth Parity to allow for Medicare to reimburse all eligible providers--including physical therapists--for care provided via telehealth. HR1650/S1849, Medicare Patient Empowerment Act: to allow Medicare providers to opt out of Medicare on a case-by-case basis to empower patients to chose their provider and how to pay for care. HR2712, Commonsense Reporting and Verification Act and S1996, Commonsense Reporting Act: simplify the process for employer reporting of employees using the ACA Marketplace to purchase health insurance while increasing transparency and disclosure for employees. HR2799/S1465; Furthering Access to Stroke Telemedicine (FAST) Act: to allow for stroke assessment via telehealth regardless of location of the originating site. HR4442/S2484, CONNECT for Health Act of 2016: telehealth reform bill in three parts: 1. allowing for Medicare Advantage to provide telehealth coverage as a basic benefit; 2. allowing stroke assessment via telehealth regardless of originating site; and 3. allow for MIPS providers to be covered for use of telehealth, and allows for HHS Secretary to add additional providers such as physical therapists; Medicare Telehealth Parity Act (H.R.2948) to allow for complete access to care via telehealth for Medicare beneficiaries. Supporting the Promoting Integrity in Medicare Act (H.R.5088)to remove physical therapists from the in-office ancillary services exception. Also lobbying for any reforms to veterans health coverage to ensure continued access to community based providers. Evaluate CMS final rules re: MIPS and MPFS

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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: $462,139 · 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.34-21st Century Cures 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 H.Res.877-Encouraging each State to enact legislation that increases the likelihood of survival after sudden cardiac arrest in our Nation's schools. 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 S. 3407, Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths (MISSION ZERO) Act P.L.114-10-Medicare Access and CHIP Reauthorization Act of 2015 P.L.114-324-Justice for All Reauthorization Act

Client expense: $462,139 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1725-National All Schedules Prescription Electronic Reporting Reauthorization 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 S.480-National All Schedules Prescription Electronic Reporting Reauthorization Act of 2015 S.1465-Furthering Access to Stroke Telemedicine (FAST) Act S.1778-TELEmedicine for MEDicare (TELE-MED) Act of 2015 S.2873-Expanding Capacity for Health Outcomes (ECHO) Act

Client expense: $462,139 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose home health and hospice payment cuts and co-pays. Legislative and regulatory proposals affecting home care and hospice. Fostering Independence Through Technology Act (to be re-filed). S. 578/H.R. 1342, Home Health Care Planning Improvement Act. H.R. 5926/S. 3040, Labor/Health and Human Services/Education Appropriations, FY2017, provisions relating to Lifespan Respite Program, caregiver, and falls prevention matters. Recognition and payment for telehealth services under Medicare and Medicaid. Face to Face Physician Encounter Requirement. Medicare Home Health Rebasing Relief and Reassessment Act (to be re-filed). H.R. 2066, Telehealth Enhancement Act of 2015. H.R. 2948, Medicare Telehealth Parity Act. Home health rural add on payment. H.R. 1202, Medicare Patient Access to Hospice Act of 2015. S. 2389, Preserve Access to Medicare Rural Home Health Services Act of 2015. Value Based Purchasing and Bundling. S. 1650, Home Health Documentation and Program Improvement Act of 2015. Medicare reimbursement of advance care planning services. Appropriations for Family Caregiver Support Programs. H.R. 2208, Hospice Commitment to Accurate and Relevant Encounters Act. S. 1549, Care Planning Act of 2015. H.R. 1202/S. 1354, Medicare Patient Access to Hospice Act of 2015. H.R. 3298, Medicare Post-Acute Value-Based Purchasing Act of 2015. Chronic Care Management Proposals. Case Mix "Creep" Payment cuts Home Health Access Protection Act (draft legislation). S. 2368, Audit and Appeal Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015. Medicare Advantage hospice proposals. S. 2416, VERIFI Act. H.R. 2446, to amend the Social Security Act to require the use of electronic visit verification for Medicaid personal care services. H.R. 3119, Palliative Care and Hospice Education and Training Act. S. 2364, Medicare Home Health Flexibility Act of 2015. VA Home Care Services. Home Health Prior Authorization and Pre-Claim review. H.R. 4994 (Public Law 113-185), Improving Medicare Post-Acute Care Transformation (IMPACT) Act. H.R. 4111, Rural Healthcare Connectivity Act. H.R. 2646, Helping Families in Mental Health Crisis Act. H.R. 5799/S. 2786, Rural Access to Hospice Care Act. H.R. 6226, Pre-Claim Undermines Senior's Health (PUSH) Act. S. 2484, CONNECT for Health Care. H.R. 34, 21st Century Cures Act.

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

Government targets: Executive Office of the President (EOP), 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: $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

Support for Home Health Planning Improvement Act, H.R. 1342/S. 578. Support for the Nurse and Health Care Worker Protection Act, H.R. 4266 Support for the Registered Nurse Safe Staffing Act, HR 2083/S.1132 Opposition to the Restoring America's Access to Freedom Reconciliation Act, H.R. 3762 Support for the CONNECT for Health Act, S. 2484/H.R. 4442 Support for H.R. 2948, the Medicare Telehealth Parity Act Support for S. 2873, the Expanding Capacity for Health Outcomes (ECHO) Act Support for S. 3504, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act

Client expense: $430,200 · Firm income: Not reported

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

Raise awareness with legislators about the barriers to and the importance of protecting access for home dialysis. S. 598 / H.R. 1130, "Chronic Kidney Disease Improvement in Research and Treatment Act of 2015", regarding all provisions. H.R. 2948, "Medicare Tele-health Parity Act of 2015", regarding all provisions. H.R. 5659, "ESRD Choice Act of 2016", regarding all provisions. S. 2484, "CONNECT for Health Act", regarding all provisions. S. 3504, "Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016", regarding all provisions.

Client expense: $300,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 578, H.R. 1342 Home Health Care Planning Improvement Act of 2015 S. 628, H.R. 1209 The Improving Access to Maternity Care Act S. 737, H.R. 2253 Ensuring Access to Primary Care and Children Act H.R. 34 - 21st Century Cures Act H.R. 2713/S. 3245 Title VIII Nursing Workforce Reauthorization Act H.R. 2948 Medicare Telehealth Parity Act of 2015 S. 2153 Provider Payment Sunshine Act H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 H.R. 5164, Rural Hospital Regulatory Relief Act of 2016 Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Opioid Abuse Epidemic Chronic Care Proposed Rule on Medicare Access and CHIP Reauthorization Act (MACRA)

Client expense: $40,248 · Firm income: Not reported

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

S. 1465 / HR 2799: Furthering Access to Stroke Telemedicine (FAST) Act S. 2484 / HR 4442: CONNECT for Health Act; Section 303 S.3504: CHRONIC Care Act of 2016 HR 2948: Medicare Telehealth Parity Act of 2015, Section 105(a)(1) HR 5122: To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models. Preservation of the in-office ancillary exception to the Stark law; urging changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Client expense: Not reported · Firm income: $196,982

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition of essential health benefits and provider network adequacy Health information technology and electronic health records Telehealth provisions of draft medical innovation legislation Mental health services and violence prevention Lead contamination of drinking water H.R. 6/H.R. 34 - 21st Century Cures Act H.R. 30 - Save American Workers Act H.R. 248/S. 305 - American Job Protection Act H.R. 512 - Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act H.R. 596 - To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 609/S. 287 - Safe Food Act H.R. 879 - Ax the Tax on Middle Class Americans' Health Plans Act H.R. 897 - Zika Vector Control Act H.R. 931 - Helping Effective Antibiotics Last (HEAL) Act H.R. 932/S. 497 - Healthy Families Act H.R. 933/S. 486 - Head Start on Vaccinations Act H.R. 1151 - USPSTF Transparency and Accountability Act of 2015 H.R 1189/S. 620 - Preserving Employee Wellness Programs Act H.R. 1209/S. 628 - Improving Access to Maternity Care Act H.R. 1372 - Home Visiting Extension Act H.R. 1462/S. 799 - Protecting Our Infants Act H.R 1517 - Stop Selling and Marketing to Our Kids E-Cigarettes (SMOKE) Act H.R. 1552 - Preservation of Antibiotics for Medical Treatment Act H.R. 1599 - Safe and Accurate Food Labeling Act H.R 1624 - Protecting Affordable Coverage for Employees (PACE) Act H.R. 2017/S. 2217 - Common Sense Nutrition Disclosure Act H.R. 2300/S. 2519 - Empowering Patients First Act of 2015 H.R. 2646 - Helping Families in Mental Health Crisis Act H.R. 2653 - American Health Care Reform Act H.R. 2690 - Including Families in Mental Health Recovery Act H.R. 2713 - Title VIII Nursing Workforce Reauthorization Act H.R. 2948 - Medicare Telehealth Parity Act H.R. 3081/S. 1778 - Telemedicine for Medicare (TELE-MED) Act H.R. 3299 - Strengthening Public Health Emergency Response Act of 2015 H.R. 3379 - Airplane Kits Act H.R. 3463 - Aligning Childrens Dental Coverage Act H.R. 3495 - Women's Public Health and Safety Act H.R. 3660 - Preventive Health Savings Act H.R. 3659 - Exchange Inclusion for a Healthy America Act H.R. 3762 - Restoring Americans Healthcare Freedom Reconciliation Act H.R. 3865/S. 2542 - Cradle Act H.R. 4276 - Behavioral Health Coverage Transparency Act H.R. 4400/S. 2512 - Adding Zika Virus to the FDA Priority Review Voucher Program Act H.R. 4479 - Families of Flint Act H.R. 4723 - Protecting Taxpayers by Recovering Improper Obamacare Subsidy Overpayments Act H.R. 4724 - Reducing Duplicative and Ineffective Federal Funding Act H.R. 4771 - Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2016 H.R. 5001/S. 2822 - Flexibility in Health IT Reporting (Flex-IT) Act H.R. 5003 - Improving Child Nutrition and Education Act of 2016 H.R. 5065/S. 3299 - Bottles and Breastfeeding Equipment Screening (BABES) Act H.R. 5284 - Worlds Greatest Healthcare Plan Act of 2016 H.R. 5456/S. 3065 - Family First Prevention Services Act S. 30 - Forty Hours Is Full Time Act S. 142/H.R. 1375/H.R. 3242 - Child Nicotine Poisoning Prevention Act S. 185 - Promise for Antibiotics and Therapeutics for Health (PATH) Act S. 203 - American Liberty Restoration Act S. 339 - ObamaCare Repeal Act S. 481 - Improving Regulatory Transparency for New Medical Therapies Act S. 522 - Protecting & Retaining Our Children's Health Insurance Program (PRO-CHIP) Act S. 612 - Water Infrastructure Improvements for the Nation Act S. 621 - Prevention of Antibiotic Resistance Act S. 673 - Winding Down Obamacare Act S. 674 - 21st Century Womens Health Act S. 764 - National Bioengineered Food Disclosure Standard S. 971 - Medicare Independence at Home Medical Practice Demonstration Improvement Act S. 993/H.R. 1854 - Comprehensive Justice and Mental Health Act S. 1014 - Personal Care Products Safety Act S. 1016 - Preserving Freedom and Choice in Health Care Act S. 1456 - Rural ACO Improvement Act S. 1549 - Care Planning Act S. 1793 - Promoting Physical Activity for Americans Act S. 1893 - Mental Health Awareness and Improvement Act S. 1945 - Mental Health Reform Act S. 2002/H.R. 3722 - Mental Health and Safe Communities Act S. 2045/H.R. 2050 - Middle Class Health Benefits Tax Repeal Act S. 2075 - American Worker Health Care Tax Relief Act S. 2100 - Tobacco to 21 Act S. 2153 - Provider Payment Sunshine Act S. 2173/H.R. 3712 - Improving Access to Mental Health Act S. 2218/H.R. 1218 - Personal Health Investment (PHIT) Act S. 2259 - ACO Assignment Improvement Act S. 2261 - Rural ACO Provider Equity Act S. 2343/H.R. 4155 - Telehealth Innovation and Improvement Act S. 2380 - Public Health Emergency Response and Accountability Act S. 2408/H.R. 4266 - Nurse and Health Care Worker Protection Act S. 2484 - Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act S. 2525/H.R. 4567 - Expand Excellence in Mental Health Act of 2016 S. 2609 - An original bill to amend the Agricultural Marketing Act of 1946 to require the Secretary of Agriculture to establish a national voluntary labeling standard for bioengineered foods S. 2680 - Mental Health Reform Act of 2016 S. 2687 - Plan of Safe Care Improvement Act S. 2821 - Testing, Removal, and Updated Evaluations of Lead Everywhere in America for Dramatic Enhancements that Restore Safety to Homes, Infrastructure, and Pipes (True LEADership) Act of 2016 S. 2848/H.R. 5303 - Water Resources Development Act of 2016 S. 2873/H.R. 5395 - Expanding Capacity for Health Outcomes (ECHO) Act S. 3136 - Improving Child Nutrition Integrity and Access Act of 2016 S. 3190 - Strengthening Our Rural Health Workforce Act of 2016 S. 3239 - Research to Accelerate Cures and Equity (RACE) for Children Act S. 3245 - Nursing Workforce Reauthorization Act of 2016 S. 3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act

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

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

Affordable Care Act, all provisions and related regulations, including repeal of ACA 40% excise tax; ACA Reporting (IRC 6055 and 6056); ACA Shared Responsibility for Employers Provisions; wellness issues; and out-of-pocket (OOP) limits related to cost sharing. ADA (in conjunction with employer-based wellness programs. Comprehensive health reform. GINA (in conjunction with employer-based wellness programs. HIPAA Stage 2 Audits. House GOP Health Reform Task Force Blueprint. Mental Health Parity Requirements. Tax Treatment of Employer-Sponsored Health Insurance. H.R. 30 - Save American Workers Act of 2015; all provisions. H.R. 879 - Ax the Tax on Middle Class Americans' Health Plans Act; all provisions. H.R. 1189 - Preserving Employee Wellness Programs Act; all provisions. H.R. 1624 - Protecting Affordable Coverage for Employees Act. H.R. 2029 - Consolidated Appropriations Act. H.R. 2050 - Middle Class Health Benefits Tax Repeal Act of 2015. H.R. 2066 - The Telehealth Enhancement Act. H.R. 2516 - VETS Act of 2015. H.R. 2712 - Commonsense Reporting and Verification Act of 2015. H.R. 2725 - 21st Century Care for Military and Veterans Act. H.R. 2911 - Small Business Healthcare Relief Act. H.R. 2948 - Medicare Telehealth Parity Act of 2015. H.R. 3081 - The Tele-Med Act. H.R. 3112 - Be Open Act. H.R. 3762 - Restoring Americans' Healthcare Freedom Reconciliation Act of 2015. H.R. 4442 - The CONNECT for Health Act. H.R. 4469 - Health Savings Act of 2016. H.R. 5445 - Health Care Security Act of 2016. S. 30 - Forty Hours Is Full Time Act of 2015; healthcare provisions. S. 305 - American Job Protection Act; all provisions. S. 620 - Preserving Employee Wellness Programs Act; all provisions. S. 1099 - Protecting Affordable Coverage for Employees Act or the PACE Act. S 1697 - Small Business Healthcare Relief Act. S. 1778 - The Tele-Med Act. S. 1996 - Commonsense Reporting Act of 2015. S. 2045 - Middle Class Health Benefits Tax Repeal Act of 2015. S. 2075 - American Worker Health Care Tax Relief Act of 2015. S. 2484 - The CONNECT for Health Act. S. 2698 - Preserving Consumer Health Accounts Act of 2016.

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

Government targets: Council of Economic Advisers (CEA), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

Medical and health care policy Graduate Medical Education (GME) issues Hospital payments Public Law 111-148, Patient Protection and Affordable Care Act, Implementation issues Physician payment issues; and Pay-fors H.R.5273, Helping Hospitals Improve Patient Care Act of 2016, Hospital quality measures Quality measures for Medicare Advantage Plans H.R.4442/S.2484, CONNECT for Health Act, Telehealth reimbursement issues H.R.2948, Medicare Telehealth Parity Act of 2015, Telehealth reimbursement issues Children's Health Insurance Program Disproportionate share hospital payments

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

HR 775/S 539 - Medicare Access to Rehabilitation Services Act: Advocate for removal of cap on occupational therapy services and support passage. HR 1516 - Ensuring Access and Quality Complex Rehabilitation Technology Act of 2015: Advocate for inclusion of occupational therapy professionals as providers of complex rehabilitation technology. HR 1608 - Lymphedema Treatment Act: Support passage and educate about role of occupational therapy services. HR 729 - Medicare Demonstration of Coverage for Low Vision Devices Act of 2015: Support passage and education about role of occupational therapy services. HR 6 - 21st Century Cures Act: Advocated to improve research under the National Institutes of Health (NIH)and inclusion of the Occupational Therapy Mental Health Act (HR 1761)language and inclusion of occupational therapy in the SAMHSA strategic plan. S. 313 - Prevent Interruptions in Physical Therapy Act: Advocated for inclusion of occupational therapy, specifically policies allowing occupational therapists to perform certain home health assessments. S. 2364/HR6404 - The Medicare Home Health Flexibility Act: support passage to allow occupational therapy as an initiating service in Medicare's home health setting. Seeking introduction of a companion bill in the House of Reps. H.R. 2948 - Medicare Telehealth Parity Act of 2015: Support passage especially as it relates to inclusion of occupational therapy services. S. 2484/HR 4442 - CONNECT for Health Act: Support occupational therapy provisions. No bill: Advocate for inclusion of occupational therapy services in legislation addressing the needs of those with chronic conditions. HR 5926/S 3040, Fiscal 2017 Labor-HHS-Education Appropriations - Advocated for funding for Agency for Health Research & Quality (AHRQ); Center for Medicare and Medicaid Innovation (CMMI); Center for Medicare and Medicaid Services (CMS); Substance Abuse and Mental Health Services Administration (SAMHSA); Administration for Children and Families (ACF); Administration for Community Living (ACL); education; Increase 302B levels, Title VII workforce programs and NIOSH. HR 3298, Medicare Post-Acute Care Value Based Purchasing Act: Advocated for more focus on function, quality, and long-term outcomes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

H.R. 775/S. 539 Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) Physician Quality Reporting System Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Manual Medical Review Essential Health Benefits Sustainable Growth Rate Reform Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process H.R. 556/5 & S. 313 Prevent interruptions in Physical Therapy Act Inclusion of physical therapists in quality programs in SGR reform FTC Anti-competition Self-referral Comments on CY2015 OPPS rule Coverage of telehealth APTA Registry H.R. 2 Medicare Access and CHIP reauthorization act Medicare, amendment to repeal the therapy cap H.R. 1650 Private contracting H.R. 1458 Bundling and coordinating post-acute care act Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management HR.2709 Professional Success to Health Workforce Integration Act of 2015 HR.1674 Protecting Affordable Coverage for Employees Act HR.4766/S.2408 Safe Patient Handling H.R. 2948 Medicare Telehealth Parity Act S. 2484/H.R. CONNECT for Health Act New evaluation and reevaluation CPT codes & misvalued codes EMG

Client expense: $258,406 · Firm income: Not reported

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

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT H.R. 582/S. 307 ConTACT Act H.R. 1383 Medicare Adult Day Services Act H.R. 263 Adult Day Care Enhancement Act H.R. 1707 Access to Frontline Healthcare Act H.R. 395/S. 536 Indian Health Service Health Professionals Tax Fairness Act H.R. 2 SGR Repeal Physician self-referra/Stark Law American Cures Act H.R. 1608/S. 2373 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees H.R. 1190/S. 141 IPAB repeal H.R. 1741 Truth In Healthcare Marketing Act Medicaid Expansion HR. 2342/S. 1426 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 921/S. 689 Sports Medicine Licensure Clarity Act S. 2364 Medicare Home Health Flexibility Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters 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. S. 524/H.R. 953 Comprehensive Addiction & Recovery Act of 2015 H.R. 5088 PIMA H.R. 5045 Preserving Access to Modern Prosthetic Limbs Act of 2016 H.R. 4266 Nurse & Health Care Worker Protection Act H.R. 1516 Ensuring Access to Quality CRT H.R. 1530 Medicare O&P Improvement Act H.R. 1420 National TBI Research & Treatment Improvement Act H.R. 2948 Medicare Telehealth Parity Act of 2015 S. 800/H.R. 1631 Enhancing the Stature and Visibility of Medicare Research at NIH Act

Client expense: $258,406 · Firm income: Not reported

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

Affordable Care Act, all provisions and related regulations, including repeal of ACA 40% excise tax; ACA Reporting (IRC 6055 and 6056), ACA Shared Responsibility for Employers Provisions, wellness issues, and out-of-pocket (OOP) limits related to cost sharing. GINA (in conjunction with employer-based wellness programs). ADA (in conjunction with employer-based wellness programs). HIPPA Stage 2 Audits. House GOP Health Reform Task Force Blueprint. Mental Health Parity Requirements. Tax Treatment of Employer-Sponsored Health Insurance. H.R. 30 - Save American Workers Act of 2015, all provisions. H.R. 879 - Ax the Tax on Middle Class Americans' Health Plans Act, all provisions. H.R. 1189 - Preserving Employee Wellness Programs Act, all provisions. H.R. 1624 - Protecting Affordable Coverage for Employees Act. H.R. 2029 - Consolidated Appropriations Act. H.R. 2050 - Middle Class Health Benefits Tax Repeal Act of 2015. H.R. 2066 - The Telehealth Enhancement Act. H.R. 2516 - VETS Act of 2015. H.R. 2712 - Commonsense Reporting and Verification Act of 2015. H.R. 2725 - 21st Century Care for Military and Veterans Act. H.R. 2911 - Small Business Healthcare Relief Act. H.R. 2948 - Medicare Telehealth Parity Act of 2015. H.R. 3081 - The Tele-Med Act. H.R. 3112 - Be Open Act. H.R. 3762 - Restoring Americans' Healthcare Freedom Reconciliation Act of 2015. H.R. 4442 - The CONNECT for Health Act. H.R. 4469 - Health Savings Act of 2016. H.R. 5445 - Health Care Security Act of 2016. S. 30 - Forty Hours Is Full Time Act of 2015, healthcare provisions. S. 305 - American Job Protection Act, all provisions. S 620 - Preserving Employee Wellness Programs Act, all provisions. S. 1099 - Protecting Affordable Coverage for Employees Act or the PACE Act. S. 1697 - Small Business Healthcare Relief Act. S. 1778 - The Tele-Med Act. S. 1996 - Commonsense Reporting Act of 2015. S. 2045 - Middle Class Health Benefits Tax Repeal Act of 2015. S. 2075 - American Worker Health Care Tax Relief Act of 2015. S. 2484 - The CONNECT for Health Act. S. 2698 - Preserving Consumer Health Accounts Act of 2016.

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

Government targets: Council of Economic Advisers (CEA), Equal Employment Opportunity Commission (EEOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Economic Council (NEC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Treasury, Dept of

Implementation of Patient Protection and Affordable Care Act (H.R. 3590/Pub. L. 111-148); telemedicine and connected care; remote patient monitoring; Health Care and Education Reconciliation Act (H.R. 4872/Pub. L. 111-152); Protect Medical Innovation Act of 2015 (H.R. 160/S. 149); The Medicare Access and CHIP Reauthorization Act (H.R. 2); Medicare Telehealth Parity Act (H.R. 2948); CONNECT for Health Act (S 2484/HR 4442); Diabetic Eye Disease Prevention Act (H.R. 4642); safe patient handling, FDA reform.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Technology research; telemedicine and connected care; remote patient monitoring; implementation of Patient Protection and Affordable Care Act (H.R. 3590/P.L. 111-148); Health Care and Education Reconciliation Act (H.R. 4872/P.L. 111-152); the Protect Medical Innovation Act (H.R. 160/S. 149); 21st Century Cures Act (H.R. 6/HR 34); The Medicare Access and CHIP Reauthorization Act (H.R. 2); Medicare Telehealth Parity Act (H.R. 2948); CONNECT for Health Act (S 2484/HR 4442); Diabetic Eye Disease Prevention Act (H.R. 4642); safe patient handling, FDA reform.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1470/S. 810 - SGR Repeal and Medicare Provider Payment Modernization Act of 2015 H.R. 1021 - Protecting the Integrity of Medicare Act of 2015 H.R. 2570 - Strengthening Medicare Advantage through Innovation and Transparency For Seniors H.R. 2948 - Medicare Telehealth Parity Act of 2015 H.R. 2505 - Medicare Advantage Coverage Transparency Act H.R. 2507 - Increasing Regulatory Fairness Act H.R. 2582 - Seniors Health Care Plan Protection Act S. 2425 - Patient Access and Medicare Protection Act H.R. 3831 - Securing Fairness in Regulatory Timing S. 2484 - Connect for Health Act H.R. 5659 - ESRD Choice Act of 2016 H.R. 34 - 21st Century Cures Act ***, no specific bill(s), Medicare, Medicare Fraud, Medicare Advantage, Medicaid, Electronic Prescribing, Health Care Reform Implementation, Medigap reform, Physician Payment Reform, Delivery System Reform, medical review, Benefit design, prescription drug safety, Regional PPOs, chronic care, CHIP Reform, Medicare Advantage Payment Shift Offset, call letter, Puerto Rico and Medicare Advantage

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

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

PL 111-148 - The Patient Protection and Affordable Care Act, implementation H.R. 2 - Medicare Access and CHIP Reauthorization Act of 2015 H.R. 1470/S. 810 - SGR Repeal and Medicare Provider Payment Modernization Act of 2015 H.R. 1021 - Protecting the Integrity of Medicare Act of 2015 H.R. 2570 - Strengthening Medicare Advantage through Innovation and Transparency For Seniors H.R. 2948 - Medicare Telehealth Parity Act of 2015 H.R. 2505 - Medicare Advantage Coverage Transparency Act H.R. 2507 - Increasing Regulatory Fairness Act H.R. 2582 - Seniors Health Care Plan Protection Act H.R. 3831 - Securing Fairness in Regulatory Timing S. 2425 - Patient Access and Medicare Protection Act S. 2484 - Connect For Health Act H.R. 5659 - ESRD Choice Act of 2016 H.R. 34 - 21st Century Cures Act ***, no specific bill(s), Medicare, Medicare and Medicaid Fraud, Medicare Advantage, Medicare Part D, Medicaid, Electronic Prescribing, Dual EligH.R. 34 - 21st Century Cures Actibles, Medigap reform, claims resolution, risk adjustment, Delivery System Reform, Special Needs Plans, Star Ratings, call letter, program integrity, Alzheimer's care, telehealth, chronic care, coding intensity

Client expense: Not reported · Firm income: $90,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 2713 Title VIII Nursing Workforce Reauthorization Act of 2015 S. 3245 Title VIII Nursing Workforce Reauthorization Act of 2016 S. 578, H.R. 1342 The Home Health Care Planning Improvement Act of 2015 S. 257, H.R. 1611 Protecting Access to Rural Therapy Services (PARTS) Act S. 628, H.R. 1209 The Improving Access to Maternity Care Act H.R. 1021 Protecting the Integrity of Medicare Act of 2015 (PIMA) H.R. 2253, S. 737 Ensuring Access to Primary Care for Women & Children Act S.1456 Rural ACO Improvement Act of 2015 S. 2259 ACO Assignment Improvement Act of 2015 H.R.6261 - To amend title XVIII of the Social Security Act to improve the way beneficiaries are assigned under the Medicare shared savings program by also basing such assignment on primary care services furnished by nurse practitioners, physician assistants, and clinical nurse specialists. H.R.2948 - Medicare Telehealth Parity Act of 2015 H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 S.1945 Mental Health Reform Act of 2015 S.2680 Mental Health Reform Act of 2016 H.R. 4756 Promoting Access to Diabetic Shoes Act S.1641 Jason Simcakoski Memorial Opioid Safety Act H.R.4981 - Opioid Use Disorder Treatment Expansion and Modernization Act S. 2562, H.R. 4396 Heroin and Prescription Drug Abuse Prevention and Reduction Act S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S.488/H.R.3355 - 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. Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Medication Assisted Therapies (MATs) Accountable Care Organizations (ACOs) Opioid Abuse Epidemic

Client expense: Not reported · Firm income: Not reported

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

PL 111-148: Patient Protection and Affordable Care Act (ACA) - various provisions including: Medical Device Excise Tax, various reimbursement cuts and policy proposals for medical imaging; remote monitoring technology in the context of accountable care organizations, medical homes and post acute bundling; transparency PL 111-152: Healthcare Education and Reconciliation Act: Imaging cuts, device tax transparency and remote monitoring S.2343 - The Telehealth Innovation and Improvement Act PL 110-275: "Medicare Improvements for Patient and Providers Act" (sec. 135) - Medical imaging accreditations program; medical imaging clinical appropriateness demonstration program Decline in growth rate of Medicare non-hospital imaging services CMS CPAP bundling proposal HR.2396 - The Software Act HR.2437 - To develop and implement a prior authorization process for certain DMEPOS. Fostering Independence Through Technology Act (potential reintroduction) - specifically the telehealth provisions H.R.284/S.128 - The Medicare DMEPOS Competitive Bidding Improvement Act of 2015 Site-neutrality in payments HR 2 - Long-term Sustainable Growth Rate (SGR) replacement legislation Appropriate Use Criteria HR.2066 - Telehealth Enhancement Act of 2015 The Health Care Innovation and Marketplace Technologies Act (potential reintroduction of HR.2363 from 113th Congress) - Telemedicine provisions HR.2948 - The Medicare Telehealth Parity Act (potential reintroduction) HR.2156 - The Medicare Audit Improvement and Reform Act HR.4185 - The Protecting Access Through Competitive Pricing Transition Act of 2015 S.2312 - The DME Access and Stabilization Act S.2736 - Patient Access to Durable Medical Equipment Act of 2016 H.R.5710 - Patient Access to Durable Medical Equipment Act of 2016 S.3195 - The BREATH Act of 2016 HR.6012 - The BREATH Act of 2016 Chronic care Non-invasive ventilators

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE

S. 578, H.R. 1342 The Home Health Care Planning Improvement Act of 2015 S. 257, H.R. 1611 Protecting Access to Rural Therapy Services (PARTS) Act S. 628, H.R. 1209 The Improving Access to Maternity Care Act Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 1021 Protecting the Integrity of Medicare Act of 2015 (PIMA) H.R. 2253, S. 737 Ensuring Access to Primary Care for Women & Children Act S.1456 Rural ACO Improvement Act of 2015 S.1641 Jason Simcakoski Memorial Opioid Safety Act S. 2259, H.R. 6261 ACO Assignment Improvement Act of 2015 H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 S.1945 Mental Health Reform Act of 2015 S.2680 Mental Health Reform Act of 2016 H.R. 4756 Promoting Access to Diabetic Shoes Act Medication Assisted Therapies (MATs) S. 1455, H.R. 2536 Recovery Enhancement for Addiction Treatment Act (TREAT) Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S. 2562, H.R. 4396 Heroin and Prescription Drug Abuse Prevention and Reduction Act H.R.2948 Medicare Telehealth Parity Act of 2015 S.488, H.R. 3355 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. S. 3245 Title VIII Nursing Workforce Reauthorization Act of 2016 H.R. 2713 Title VIII Nursing Workforce Reauthorization Act of 2015 H.R. 4981 Opioid Use Disorder Treatment Expansion and Modernization Act Opioid Abuse Epidemic Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Accountable Care Organization (ACO)

Client expense: $153,601 · Firm income: Not reported

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

Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 2713 Title VIII Nursing Workforce Reauthorization Act of 2015 S. 3245 Title VIII Nursing Workforce Reauthorization Act of 2016 S. 578, H.R. 1342 The Home Health Care Planning Improvement Act of 2015 S. 257, H.R. 1611 Protecting Access to Rural Therapy Services (PARTS) Act S. 628, H.R. 1209 The Improving Access to Maternity Care Act H.R. 1021 Protecting the Integrity of Medicare Act of 2015 (PIMA) H.R. 2253, S. 737 Ensuring Access to Primary Care for Women & Children Act S.1456 Rural ACO Improvement Act of 2015 S. 2259 ACO Assignment Improvement Act of 2015 H.R.6261 - To amend title XVIII of the Social Security Act to improve the way beneficiaries are assigned under the Medicare shared savings program by also basing such assignment on primary care services furnished by nurse practitioners, physician assistants, and clinical nurse specialists. H.R.2948 - Medicare Telehealth Parity Act of 2015 H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 S.1945 Mental Health Reform Act of 2015 S.2680 Mental Health Reform Act of 2016 H.R. 4756 Promoting Access to Diabetic Shoes Act S.1641 Jason Simcakoski Memorial Opioid Safety Act H.R.4981 - Opioid Use Disorder Treatment Expansion and Modernization Act S. 2562, H.R. 4396 Heroin and Prescription Drug Abuse Prevention and Reduction Act S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S.488/H.R.3355 - 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. Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Medication Assisted Therapies (MATs) Accountable Care Organizations (ACOs) Opioid Abuse Epidemic

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

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

Public Law No: 114-225/ H.R. 34: 21st Century Cures Act H.R. 2713 Title VIII Nursing Workforce Reauthorization Act of 2015 S. 3245 Title VIII Nursing Workforce Reauthorization Act of 2016 S. 578, H.R. 1342 Home Health Care Planning Improvement Act of 2015 S. 628, H.R. 1209 The Improving Access to Maternity Care Act S. 737, H.R. 2253 Ensuring Access to Primary Care and Children Act H.R. 2948 Medicare Telehealth Parity Act of 2015 S. 2153 Provider Payment Sunshine Act H.R. 2646 Helping Families in Mental Health Crisis Act of 2015 H.R. 5164, Rural Hospital Regulatory Relief Act of 2016 Public Law No: 114-198, S.524/ H.R. 953 Comprehensive Addiction and Recovery (CARA) Act of 2016 S.1455, H.R. 2536 Recovery Enhancement for Addiction Treatment (TREAT) Act Chronic Care: S.3504 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016 Opioid Abuse Epidemic

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

Legislation to fix or affecting the Medicare Physician Fee problem and Graduate Medical Education. Support to repeal IPAB. Regulations implementing Affordable Care Act, HIT, ACO's, Physician Fee Schedule, Medicare fraud and abuse, electronic records and ICD-10. Possible reforms to Medicare Graduate Medical Education funding. Regulations implementing the Medicare Access and CHIP Reauthorization Act of 2015 Regulations proposing changes to the Part B Drug Payment Model(CMS-1670-P) Support for H.R. 2948 - Medicare Telehealth Parity Act of 2015

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

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Telehealth Chronic Care Initiative, HR 2948 Telehealth Parity Act S 2484, HR 4442, Connect for Health Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for Home Health Planning Improvement Act, H.R. 1342/S. 578. Support for the Nurse and Health Care Worker Protection Act, H.R. 4266 Support for the Registered Nurse Safe Staffing Act, HR 2083/S.1132 Opposition to the Restoring America's Access to Freedom Reconciliation Act, H.R. 3762 Support for the CONNECT for Health Act, S. 2484/H.R. 4442 Support for H.R. 2948, the Medicare Telehealth Parity Act

Client expense: $478,462 · Firm income: Not reported

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